Capitalism
Posted by: cunningplan on 12 March 2005
TRADITIONAL CAPITALISM:
You have two cows.
You sell one and buy a bull.
Your herd multiplies, and the economy grows.
You sell the herd and retire on the income.
ENRON CAPITALISM:
You have two cows.
You sell three of them to your publicly listed company, using letters of credit opened by your brother-in-law at the bank, then execute a debt/equity swap with an associated general offer so that you get all four cows back, with a tax exemption for five cows. The milk rights of the six cows are transferred via an intermediary to a Cayman Island company secretly
owned by the majority shareholder who sells the rights to all seven cows back to your listed company. The annual report says the company owns eight cows,with an option on one more. Sell one cow to buy a new President of the United States, leaving you with nine cows. No balance sheet provided with the release.
The public buys your bull.
AN AMERICAN CORPORATION
You have two cows.
You sell one, and force the other to produce the milk of four cows.
You are surprised when the cow drops dead.
A FRENCH CORPORATION
You have two cows.
You go on strike because you want three cows
A JAPANESE CORPORATION
You have two cows.
You redesign them so they are one-tenth the size of an ordinary cow and produce twenty times the milk.
You then create irritating cow cartoon images called Cowkimon and market them world-wide at a fantastic profit.
A GERMAN CORPORATION
You have two cows.
You reengineer them so they live for 100 years, eat once a month, and milk themselves.
AN ENGLISH CORPORATION
You have two cows.
Both are mad.
AN ITALIAN CORPORATION
You have two cows, but you don't know where they are.
You break for lunch.
A SWISS CORPORATION
You have 5000 cows, none of which belong to you.
You charge others for storing them.
A CHINESE CORPORATION
You have two cows.
You have 300 people milking them.
You claim full employment, high bovine productivity, and arrest the newsman who reported the numbers.
A WELSH CORPORATION
You have two cows.
The younger one is rather attractive
A MICK PARRY CORPORATION
You have two cows.
You count them and learn you have five cows.
You count them again and learn you have 42 cows.
You count them again and learn you have 12 cows.
You stop counting cows and open another bottle of whisky.
Regards
Clive
Posted on: 14 March 2005 by --duncan--
quote:
Originally posted by 7V:
I have also had the opportunity to compare the system with the French system (we lived in France during my wife's pregnancy), the German system (my wife is German and we go there often) and the US system (my parents lived there for a number of years). Of these, the UK NHS comes a very poor third, in my experience.
Health expenditure (US$) per capita per annum in 2000 in the countries you mention:
USA: 4499
Germany: 2768
France: 2380
UK: 1804
Figures from UN source, normalised for purchasing power in each country and include money spent on private healthcare in the UK, so NHS funding is rather worse than this suggests.
If we want a better health-care system then we are going to have to pay for it.
Posted on: 14 March 2005 by Berlin Fritz
Sorry old chap, but I find those figures quoted above UN or not totally wild of the mark (Maybe they're the military spending qoutas?). Year 2000, U.S. with some 30 million totally un-insured, no ! sounds more like Daily Mail Juggling Bullshit.
If we assume that UK, France, Germany, have insured 99% of their populations, the US figures I feel are drawn (from wherever) and denote only those actually insured, classic Brown tactics.
Fritz Von The Gord Giveth Gord Taketh Awaaa
Posted on: 14 March 2005 by 7V
quote:
Originally posted by Berlin Fritz:
Sorry old chap, but I find those figures quoted above UN or not totally wild of the mark (Maybe they're the military spending qoutas?). Year 2000, U.S. with some 30 million totally un-insured, no ! sounds more like Daily Mail Juggling Bullshit.
Typing
health spending per capita into Google reveals that it may not be so wide of the mark - and there's not a Daily Mail site in evidence.
Of course expenditure per capita does not tell anything like the whole story - witness the marginal improvements in the NHS that have occured whilst funding has greatly increased.
There are many criteria that need to be accounted for. For example, I believe that UK doctors earn more than doctors in France, different countries have differing proportions of the budget for administration, etc., etc.
Perhaps, more meaningful statistics would include:
What proportion of people survive specific illnesses in different countries?
What's the infant mortality rate?
What's the life expectancy?
Against an index of questions like these, one could argue that the lower the relative spending on health, the more efficient the system.
Even with such statistics, the whole story wouldn't be clear. Obesity, for example, is a drag on a nation's health but affects richer nations. Malnutrition is precisely the opposite. Pressures on school children in Japan might lead to lifetimes of depression, while the climate in parts of Scandinavia probably leads to thousands throwing themselves off cliffs.
It's clearly a highly complex question. I suspect that we're all just shooting in the dark, really - although if anyone gets hit, it might be a 4 hour wait in casualty.
Regards
Steve M
Posted on: 14 March 2005 by Berlin Fritz
Last week I recieved a letter from my pension people of who'm some 30 million folk in this country are insured with (BFA). Having now 24 full years here paid in, plus four in UK (though credited for only 2, in other words they ripped me off in Newcastle so to speak) I have a total of 26 paid in. They sent me voting paperwork for their next social elections to choose the leaders of this fund, which I find most Democratic, and wonder what similarities it has with say UK setups and individuals seriously being responsible for such Capital plans ?
Fritz Von I recieve every two years or so a summary of my personal plan guarateeing pay out at present rates, (Ie, if I were to become a coffee grinder tommorow for some reason I'd know exactly what to expect, which is good, innit.
Posted on: 14 March 2005 by 7V
quote:
Originally posted by 7V:
Those thinking of making overly 'cowist' remarks should be careful. They bare grudges - according to the latest research:
Don't say you haven't been warned.
This is a
must click.
Cows with GunsPosted on: 14 March 2005 by JonR
Brilliant!
Posted on: 15 March 2005 by Jez Quigley
quote:
My views are based largely on my own experience over the last five years whilst ferrying my parents to and from a number of doctors, hospitals, etc.
I have also had the opportunity to compare the system with the French system (we lived in France during my wife's pregnancy), the German system (my wife is German and we go there often) and the US system (my parents lived there for a number of years). Of these, the UK NHS comes a very poor third, in my experience.
I don't read the Daily Mail.
Ok 7v, fair comment. It's just that there seems to be a campaign to rubbish the NHS regardless when many people are surprised to see for themselves how good things are now in many areas. I'm particularly pleased you dont read the Daily Hate :-)
There is a long way to go but the improvements are there to see now despite the Govs insistence on targets which actually hamper real performance improvement work and increase costs.
Posted on: 15 March 2005 by Mick P
Jez
The NHS is a joke.
My mother in law is going into Oxford hospital for the third time today because her operation was cancelled the previous two times.
Swindon has a brand new hospital which has longer waiting lists and fewer beds than the old one which was sold off and flattened two years ago.
Naturally all of the problems disappear the moment you mention private health care. Then you immediately get to see a consultant who had a six month waiting list for patients on the NHS.
Possibly it needs more cash injecting into it but atpresent things are totally inadequate.
I believe we have the worst treatment for cancer in Europe and a friend of mine who broke a leg whilst in Spain said the treatment and facilities far outstripped those in Swindon.
I have another friend who had lazer treatment on her eyes in Prague becaue it was quicker, cheaper and worst of all better. More choice etc than in the UK.
Something needs doing about it and fast.
Regards
Mick
Posted on: 15 March 2005 by 7V
quote:
Originally posted by Jez Quigley:
There is a long way to go but the improvements are there to see now despite the Govs insistence on targets which actually hamper real performance improvement work and increase costs.
Jez,
To be honest I don't think that the NHS has been moving in the right direction, either under the Tories or Labour. Although it's certainly not any sort of magic bullet, I think that we should look carefully at the so-called 'Stockholm Transition' to see how this part of Sweden's health service has improved dramatically over the last 10 years and how the principles might be applied to the UK.
You can look into the Stockholm Transition
here if you're interested.
Regards
Steve M
Posted on: 15 March 2005 by 7V
quote:
Originally posted by Mick Parry:
The NHS is a joke.
My mother in law is going into Oxford hospital for the third time today because her operation was cancelled the previous two times.
Unfortunately, Mick is right.
I heard that the relevance of the cancellations - the issue that was highlighted by the Conservatives last week but without adequate explanation - is that the waiting time goes back to zero after a cancellation. Therefore the NHS uses cancellations to massage their statistics.
Posted on: 15 March 2005 by Bruce Woodhouse
Mick, and others.
Just remember the NHS is more than just the service of your local hospital. 90% of activity takes place in primary care. Not that this is beyond criticism of course-as I'm sure I'm about to find out.
Bruce
Posted on: 15 March 2005 by cunningplan
quote:
The NHS is a joke.
My mother in law is going into Oxford hospital for the third time today because her operation was cancelled the previous two times.
Swindon has a brand new hospital which has longer waiting lists and fewer beds than the old one which was sold off and flattened two years ago.
Naturally all of the problems disappear the moment you mention private health care. Then you immediately get to see a consultant who had a six month waiting list for patients on the NHS.
Possibly it needs more cash injecting into it but atpresent things are totally inadequate.
I believe we have the worst treatment for cancer in Europe and a friend of mine who broke a leg whilst in Spain said the treatment and facilities far outstripped those in Swindon.
I have another friend who had lazer treatment on her eyes in Prague becaue it was quicker, cheaper and worst of all better. More choice etc than in the UK.
Something needs doing about it and fast.
Regards
Here we go again
And please Steve don't come out with blanket statements. I'm afraid unlesss you work in it you don't fully understand. Please don't get my wife's backup again with these remarks. And I'm sure Bruce as well feels pissed off when he sees you guys pretending you know better than the professionals.
Regards
Clive
PS And how does a thread which was meant to be a light hearted joke end up bashing people that work in the NHS.Some of you should be ashamed of yourselves
Posted on: 15 March 2005 by Mick P
Cunningplan
It is not a case of here we go again, the NHS is a total mess.
Take the purchase of Electricity.
The NHS is one of the biggest consumers of electricity and as such should be able to command really low prices but it does not.
To get a good price, you have to get a quote, analyse it and place a contract within a few hours. This is why online reverse auctions are popular.
The NHS has 192 trusts, each one had to be asked, are you happy with the price of electricity. Some trusts took weeks to reply and hence there is no coordinated national contract and prices are high.
Just one quick example of why money is not being put in the front line but wasted.
Also Swindon Hospital shut its doors last week, the reason being overcrowded wards and this is a new hospital.
What a bloody mess.
Regards
Mick
Posted on: 15 March 2005 by Mick P
Clive
We are not saying we know better than the professionals, what we are saying is that as "customers" we are getting bad treatment.
I cannot see how you can defend a system where a 75 yr old woman (my mother in law) has had two operations cancelled. There is a 50/50 chance that todays will go the same way.
It is bloody poor from our perspective.
I recognise that perhaps it needs more money pumping into it but how the hell could Swindon trust build a new hospital with less beds than the old one (which is now demolished) and we have the absurd spectacle of it shutting its doors to ambulances.
Sorry it is a bloody mess and unworthy of a developed country in the year 2005.
Regards
Mick
Posted on: 15 March 2005 by Nime
You're wrong about Britain having the worst cancer tratment. But if you were talking about MRSA you'd be (dead) right.
Another case of too many chiefs and not enough indians? Collecting statistics for the sake of it. Too many economists and not enough doctors. Too much paperwork and not enough nurses, constables or teachers doing something useful. The high price of medicines. Costly equipment without trained operatives to make proper use of it.
Constantly raised expectations without the least responsibility for ones own health. Cronic obesity, high stress levels, zero exercise, smoking, shit diet and rising use of recreational drugs. Driving kids to school instead of a breathless dash or bike ride to be on time.
"Farmers" stuffing their animals full of ever more antibiotics.
It can only get worse. There is no paliative, miracle cure, or placebo for a largely damaged population bent on slow suicide.
Nime
Posted on: 15 March 2005 by cunningplan
Mick
It's unfortunate that your mum in law has had two operations cancelled, and hopefully the third on will go ahead for her, but there were probably clinical reasons as to why. Just like this Dixon woman in Chesire, the Tories upset a lot of hard working people in that hospital with incorrect info.
Me and the wife both except the NHS isn't perfect, but believe us when we say that it has improved a hell of a lot since Labour came to power, and lots of other health professionals will agree.
Regards
Clive
Posted on: 15 March 2005 by Mick P
Clive
Both cancellations were due to a shortage of beds in Oxford. Nothing clinical.
Swindon hospital shut its doors last week.
This is bloody appalling, not just poor but appalling.
Yes I accept that Gordon Brown is rightfully pumping more money into it but there is a massive way to go in order to make it acceptable.
I suspect that it will still be a mess within my lifetime.
Regards
Mick
Posted on: 15 March 2005 by 7V
quote:
Originally posted by cunningplan:
Here we go again
And please Steve don't come out with blanket statements.
Clive,
???
Did you mean me? If so, please tell me which 'blanket statements' I've made so I can expand or detail them.
Regards
Steve M
Posted on: 15 March 2005 by JonR
Clive,
I don't think anybody here has any intention of using this thread as a stick to beat the people like Mrs CP, Bruce or yourself who work long hours trying to provide the best service they can. Nor, however, do I agree with you that not working in the NHS should preclude discussion here of one's experiences. I'm an outsider too but I get the distinct impression, and you're more than welcome to correct me if I am wrong, that there's not one person in the whole of the NHS who knows exactly how it works, where the resources go, and who can provide any sort of joined up thinking as to the direction it's supposed to be going in! Mick and Steve have both shared from personal experience - they were not knocking you, just IMO trying to inform.
Another example of the 'bloody mess' Mick refers to...a few years ago the A&E department of the local hospital near where my parents live was shut. Edgware General, the hospital in question, is about two miles away from where they live. A few months later my dad suffered a nose bleed which he couldn't staunch so we called an ambulance. He had to be taken all the way to Barnet Hospital - 6 miles away. Might not seem much but in traffic it's quite a distance. Not as serious a case as Mick's or Steve's but another example of something going seriously amiss, in my view.
Regards,
Jon
Posted on: 15 March 2005 by cunningplan
Steve the top remark was for Mick,and with regard yourself
quote:
To be honest I don't think that the NHS has been moving in the right direction,
and
quote:
witness the marginal improvements in the NHS that have occured whilst funding has greatly increased.
On what info do you base this on... Tory propaganda?
My wife would happy to explain to you in detail far better than I could on how the NHS has improved considerably in lots of areas, and when she gets home late this evening I'll ask her to address any point you may have.
Yes there still is room for improvement no doubt, but it'll take time. Margaret Thatcher did more damage to the NHS than any subsequent leader or party. Just remember the people that work in the NHS feel personally insulted when people complain about the service.
Hundreds of thousands of patients are treated every year in the system, and the vast majority of them are completely satisfied with the care they receive. It's just that you don't hear from them, which is a shame.
Regards
Clive
Posted on: 15 March 2005 by Mick P
Clive
Taking flack is all part of the job. I worked for the Post Office which has consistently provided the best postal service in Europe at the lowest price and yet it still gets knocked. Thats life, so get used to it and learn to use it as a motivator rather than something which gets you down.
I was not getting at you but the system in general.
My mother in laws cancelled operations are a fact.
Swindon hospital closing its doors is a fact.
The fragmented purchasing system I quoted is a fact.
I did not quote the Dixon woman because I know nothing about it.
However, my limited experience of the NHS is not good.
My shoulder dislocated 4 years ago and I was quoted 9 months for an operation on the NHS or 10 days in a BUPA hospital with the very same surgeon.
My son had to wait 5 hours about a year ago in Swindon A&E when my Grandson had some sort of accident. There is no way that anyone can justify a 5 hour wait.
My own view (not an expert one) is that the population is aging and treatments are getting better but more expensive, thus we need more money putting into the NHS.
I pay £160 per month for private medical care insurance and I would honestly prefer that the money went into the NHS if it meant I could get a comparable service.
Regards
Mick
Posted on: 15 March 2005 by Bruce Woodhouse
Once again I'll remind you that 90% of care takes place in primary care. This includes a huge slug of the management of chronic diseases such as diabetes/heart disease/asthma/arthritis that previously would have been cared for in hospital. The obsession with hospital treatment is unbalanced as a barometer of the state of the NHS, even if it is one that politicians love to use.
FWIW I could write chapter and verse about the NHS, briefly I think that the improvement in the last 8 years have been patchy across the service and across the country. We have also have a major crisis in medical manpower looming that will make the issue of bed availability appear trivial.
My main sadness is that successive governments (and to an extent the profession) continue to give people the impression that we can have a perfect-for-all service if we only had enough money/organise better. Only when we have an honest debate about rationing will we really revolutionise the NHS. We need to accept that free for all care cannot continue to encompass every technological 'advance' (and I use the inverted commas intentionally) ad-infinitum. We need to specify what are the core treatments and responsibilities of the NHS and fund them properly without regional variability.
...and if you want some politics, I think the emphasis on 'choice' of the two main parties is bonkers. People do not want to choose between 5 hospital providers, they want the most local one to be good enough for the job without having to travel I reckon.
Posted on: 15 March 2005 by 7V
quote:
Originally posted by cunningplan:
quote:
To be honest I don't think that the NHS has been moving in the right direction,
and
quote:
witness the marginal improvements in the NHS that have occured whilst funding has greatly increased.
On what info do you base this on... Tory propaganda?
Clive,
No, I don't believe that the Tories were or would be any better than Labour. I believe that they're all misguided and I'd rather that they based their policies on other systems that have shown the sort of improvements that the NHS needs - hence my interest in Sweden's 'Stockholm Transition'.
The information that I base my comments on are statistics of spending on the one hand and changes to waiting times, etc. on the other. These statistics are readily available to anyone who can be bothered to search.
I don't deny that there have been slight improvements in the main measures over the last 5 years. I don't believe that they justify the enormous increased cost which is about 50% in real terms.
Regards
Steve M
Posted on: 15 March 2005 by Mick P
Bruce
If I read your posting correctly, you are suggesting that advanced treatments should be outside of the NHS.
If that is correct, then the service operated by the NHS would be "yesterdays treatment" and as such, second best.
That is even more scarier.
Regards
Mick
Posted on: 15 March 2005 by Bruce Woodhouse
Mick, I posted in a hurry so not terribly clear.
What I mean is we need a decision as a country, lead by politicians and public debate, about what we consider essential NHS care. This may well incorporate high tech, high cost treatments. If we decide this 'menu' then we should provide it to all, not just those fortunate enough to live near a centre of excellence, or in an area fortuitously better funded. Equally we should decide which treatments are either ineffective or 'cost inefficient' or simply low priority and stop providing them. I say this because I think we need to be honest and say what we can and will afford to do well, and what we must accept is beyond the remit of the NHS.
This debate is happening almost every health care system but in the NHS it is a piecemeal process and we have implemented 'rationing by stealth' without being explicit.
I'll lob in the following scenarios, without suggesting specificslly these should be 'cut' but as examples of the sort of difficult decisions that might be taken. Some are cheap, some very expensive. All will doubtless raise passionate views.
Intensive treatment of extreme prematurity.
Treatment of teenage acne.
Varicose vein surgery for cosmetic reasons.
Growth hormone for small stature.
Third line chemotherapy when previous Rx has failed.
Surgery for obesity.
Long term care of the dependent elderly. Oh, sorry, that has already been given to the private sector.
I'm not advocating that the NHS only offers a totally basic service.
Bruce
