IOM DHSC & MANX CARE

[mad_manx]

4 minutes ago, Two-lane said:

Presumably it is possible to pay for insurance to cover this?

So if everyone pays for insurance for everything health-wise, it is inefficient to have competing insurance companies (some of which occasionally go bust) - the most efficient organisation is a well-run monopoly. Therefore the  best solution is to have one insurance company - let's call it National Insurance.

The simplest way to get people to pay for the insurance is to take from taxes.

The problem  is that it's not ring fenced..

[wrighty]

11 minutes ago, Two-lane said:

Presumably it is possible to pay for insurance to cover this?

So if everyone pays for insurance for everything health-wise, it is inefficient to have competing insurance companies (some of which occasionally go bust) - the most efficient organisation is a well-run monopoly. Therefore the  best solution is to have one insurance company - let's call it National Insurance.

The simplest way to get people to pay for the insurance is to take from taxes.

Most insurance schemes vary their premiums according to individual risk, with no claims discounts.  Private health insurance is no different - a fit and healthy 25 year old pays a lot less than an overweight smoking alcoholic 70 year old who had 5 hospital admissions in the previous year. 

Once again, I'm not suggesting we go all American on health - theirs is the worst system in the world in many respects - just pointing out that 'national insurance' is not necessarily the way (and in any case NI doesn't pay for the NHS - it's state pensions and statutory sick pay)

[Gladys]

1 hour ago, Two-lane said:

Presumably it is possible to pay for insurance to cover this?

So if everyone pays for insurance for everything health-wise, it is inefficient to have competing insurance companies (some of which occasionally go bust) - the most efficient organisation is a well-run monopoly. Therefore the  best solution is to have one insurance company - let's call it National Insurance.

The simplest way to get people to pay for the insurance is to take from taxes.

I was going to suggest the very same!

[cissolt]

2 hours ago, Andy Onchan said:

So how much will that reduce the funding gap by? Genuine question as I have no idea.

Lawrie posted this on twitter earlier from the Jonathan Michaels report but this was based on a 50-150 million funding gap by 2035!

[Pontius]

The no-nonsense NHS 'guru' Roy Lilley made these two comments a few years ago - they are still a good summary:

"The smart lads' casual conclusion; if our taxes don't pay for our healthcare we will, directly. Left pocket taxes, right pocket insurance. They didn't seem to realise that it's the same pair of trousers"

and

"They could insure but premiums must include an excess for risk, a margin for profit and dividends for the insurer's shareholders. It has to be more efficient for the state to collect taxes and distribute them against a socio-demographic, population based formula? After all, wasn't that the point back in 1948: a disaggregated, mixed economy on the supply-side was costly, unwieldy and impossible to integrate"

[WTF]

26 minutes ago, Pontius said:

The no-nonsense NHS 'guru' Roy Lilley made these two comments a few years ago - they are still a good summary:

"The smart lads' casual conclusion; if our taxes don't pay for our healthcare we will, directly. Left pocket taxes, right pocket insurance. They didn't seem to realise that it's the same pair of trousers"

and

"They could insure but premiums must include an excess for risk, a margin for profit and dividends for the insurer's shareholders. It has to be more efficient for the state to collect taxes and distribute them against a socio-demographic, population based formula? After all, wasn't that the point back in 1948: a disaggregated, mixed economy on the supply-side was costly, unwieldy and impossible to integrate"

but in 1948 it was just after a culling,  there weren't millions of pensioners living 25 years plus after they retired and medical practices didn't keep you living well beyond your expiry date with expensive treatments and medications, the game has changed.

[Two-lane]

Is it possible for an independent  private health service, funded by private insurance, to operate on the IoM without using assets paid for by the NHS?

Edited April 14, 2023 by Two-lane

[Banker]

1 hour ago, Two-lane said:

Is it possible for an independent  private health service, funded by private insurance, to operate on the IoM without using assets paid for by the NHS?

Anything is possible but very doubtful that a purpose built private hospital would be financially viable because we haven’t got the population to use it. 
we need the private wing reopening to get income eg GUernsey  healthcare received £10m from private patients last year 

[Dirty Buggane]

5 hours ago, BriT said:

I agree they’re sunk costs but honestly I can’t believe we’re now trying to find £40M for healthcare when some moron signed off £25M for the substandard shite project that is Douglas prom. We should have had priority budgeting for years which would have stopped a lot of this waste. If it’s a priority between finding more money for Nobles or running the horse trams for the next 10 years it’s a no brainer. Get the trams cleared and auction the scrap off. 

You wish it was 25 million, I recon closer to 61 million at a Conservative guestemate .

[Two-lane]

1 hour ago, Banker said:

we need the private wing reopening to get income eg GUernsey  healthcare received £10m from private patients last year 

Are the private health insurance companies being charged a commercial rate for use of the private wing - taking into account the cost of the land, construction, fitting out etc?

If they are not, and the income is just viewed as a bit-of-extra-income, then the average NHS patient is subsidising the private patient's health insurance premiums.

[cissolt]

21 minutes ago, Two-lane said:

Are the private health insurance companies being charged a commercial rate for use of the private wing - taking into account the cost of the land, construction, fitting out etc?

If they are not, and the income is just viewed as a bit-of-extra-income, then the average NHS patient is subsidising the private patient's health insurance premiums.

https://www.itv.com/news/granada/2018-10-16/iom-private-patients-unit-to-close-jan-2019-for-upgrades

Hard to tell if it was making money or not.  The fact they are closing to save 200k suggests it wasn't making enough.  Do the gambling company employees all have private healthcare?

[forestboy]

18 minutes ago, cissolt said:

https://www.itv.com/news/granada/2018-10-16/iom-private-patients-unit-to-close-jan-2019-for-upgrades

Hard to tell if it was making money or not.  The fact they are closing to save 200k suggests it wasn't making enough.  Do the gambling company employees all have private healthcare?

Pokerstars do. 

[code99]

2 hours ago, cissolt said:

https://www.itv.com/news/granada/2018-10-16/iom-private-patients-unit-to-close-jan-2019-for-upgrades

Hard to tell if it was making money or not.  The fact they are closing to save 200k suggests it wasn't making enough.  

Thanks for posting the link.

The announced ‘temporary’ closure of the private patient unit due to "renovation" was authorised by the same letter-shredder, who promised the GMP a point-by-point rebuttal regarding Dr Glover’s allegations. This same Minister was forced to resign over Dr Ranson’s constructive dismissal/ her legal case.  As I recall his statement on Manx Radio, at the time, he had been somewhat 'mislead' by some senior DHSC staff…it is therefore quite plausable that the £200k savings is another unsubstantiated claim, and possibly even an error. From my (limited) personal experience dealing with our local healthcare service, I would describe their admin processes/procedures/systems as a bit of a mess (which lacks professionalism and competency). For that reason alone, I would not be surprised if a mistake had been made which allocated expenses incorrectly to income and/ or that something presented as a financial loss was a financial gain.

I am also hearing that some consultants are reluctant to take up full-time employment here if that would prevent them from doing a bit of private work. I may be wrong, but it seems to me that the closure of the private wing at Nobels has been a lose-lose situation for everyone affected and that there have been no material benefits for NHS patients.

Edited April 14, 2023 by code99

[Ghost Ship]

6 hours ago, Pontius said:

The no-nonsense NHS 'guru' Roy Lilley made these two comments a few years ago - they are still a good summary:

"The smart lads' casual conclusion; if our taxes don't pay for our healthcare we will, directly. Left pocket taxes, right pocket insurance. They didn't seem to realise that it's the same pair of trousers"

and

"They could insure but premiums must include an excess for risk, a margin for profit and dividends for the insurer's shareholders. It has to be more efficient for the state to collect taxes and distribute them against a socio-demographic, population based formula? After all, wasn't that the point back in 1948: a disaggregated, mixed economy on the supply-side was costly, unwieldy and impossible to integrate"

I met him when I was on a course at the King's Fund.  Interesting man.

The IoM govt might have done better to commission him rather than Sir John Michael to carry out the review of healthcare provision on the island.

 

[Moddey Dhoo]

16 minutes ago, Ghost Ship said:

I met him when I was on a course at the King's Fund.  Interesting man.

The IoM govt might have done better to commission him rather than Sir John Michael to carry out the review of healthcare provision on the island.

 

But does he have real world experience of large scale change projects like JM? https://www.henricodolfing.com/2019/01/case-study-10-billion-it-disaster.html