Sunday, April 28, 2013

Should health care be means tested? What about aftercare?

One could argue that if I pay into a private health care scheme, they should pay me out when I need help, regardless of my bank account. The NHS is an insurance scheme. It's not money waved goodbye given to a charity for only the those who can prove they can't pay.
It should not be like a charity for the homeless. If it is, the recipients get treated as second class citizens. Look what happened when the free meals for everybody in schools were withdrawn. Kids receiving free meals were only the poorest. They were afraid to claim because they were looked down on by other pupils and teachers. They were too embarrassed to claim.
The same happens in hospitals. Has happened and will happen. Hospital staff start getting hostile to patients when the patients contain a higher than average proportion of the underclass.
If the NHS takes money off everybody, it should give out to everybody. If I pay when I am healthy, I should be entitled to help if I'm unhealthy.
It was found out long ago when recruiting for the army in WWI that if you don't give free health care to everybody, only a small number of people look after their health. Large numbers (was it three out of four?) were not fit for the front line. They had foot problems and eye problems. And hearing problems. Plus chronic health problems, preventable diseases, injuries which had not healed properly, hearing problems. Recruits could not hear orders, read instructions or even stand, let alone run. They coughed and spit and spread illness.
People don't save for illness when they are fit, they won't visit doctors if you must pay. You then get nobody getting innoculated, childhood deaths and everything from lice to TB and VD spreading throughout the population, sick people spreading disease, and if you fall over and fall unconscious when alone because you don't have identity documents, the ability to sign forms and enough cash to pay thousands for medical care you just lie rotting on the street corner.
The other problem is that many rich self-made men won't pay for private health care for themselves nor for their employees until forced to join or create a medical scheme.
The reason is that they started poor and still think like a poor person who can't afford medical care and are parsimonious and won't spend. Hence the people dressed as paupers who die in rags and are found with millions under the pillow.
The whole point of the NHS is that it is not like the private medical schemes which take only the rich and healthy. Once you start means testing, you siphon off huge amounts of time and money and staff and managers have to be paid to decide who won't get treated, and those needing help with health care can't get help until they've filled in forms. The elderly and frail don't have the eyesight and energy to fill in forms or go to offices which won't answer the phone. They'd rather die at home in bed than start fighting for their right to claim money. So they die alone and they get discovered months or even years later as rotting skeletons in filthy flats, over run by rats which infect the neighbours and the rest of the neighbourhood, health conditions ignored by the health services and social services because if you can't or won't pay or are too dumb to claim no help for you or anybody else affected by your ill health.

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