Perhaps not anything, but certainly healthcare. They do certain things well. The ideal is to pick the best of each country and implement it in your own.
Absolutely, we copy their failed policies years later just as we see them failing. We should be looking at our more enlightened EU brethren or Singapore or Switzerland!
Healthcare is an inelastic market, which doesn't produce real prices like other markets do. The comparison to cosmetic surgery does not work. People do not NEED cosmetic surgery and so the market allows for competition
We mention that elective procedures is specifically where this ‘shopping around’ happens. Elasticity is not 0 - healthcare will produce real prices if it is allowed to do so
@@TheWolfXCIX The food comparison isn't really equivalent though. You can easily survive on no-name brands and don't need the fancy stuff - but if you need a heart bypass, you need a heard bypass.
@@xBrisYeah, but a heart bypass from your nearest public hospital might be the equivalent of a no-name brand compared to flying abroad to a world-leading cutting edge hospital
I'm disappointed by the low number of sources for this video. Moreover you uncritically interview John C. Goodman without mentoning some of the criticisms he receives amongst academics for his ideas. See "Are Medical Savings Accounts a Viable Option for Funding Health Care?" Anna Dixon 2002 or "Medical savings accounts: assessing their impact on efficiency, equity and financial protection in health care" 2016 for example. Citing the abstract of the latter: "The available evidence suggests that MSA schemes have generally been inefficient and inequitable and have not provided adequate financial protection. The impact of these schemes on long-term health-care costs is unclear." This video feels more like a biased presentation of one man's ideas than a serious discussion of healthcare policy.
Hey, the focus of the episode is a) to discuss UHI, and its superior performance to tax funded systems b) to question why Ireland is blindly moving to less the less performant Beverdige model c) to discuss HSAs as an optional extra layer, precisely to overcome the equity issues i.e. government injecting money into the HSAs of the less well off. Singapore's success with this is notable, would you not agree? As for Goodman, given that he is regarded as "Father of HSAs", it seemed relevant to interview him - but this episode would've been made regardless of whether he spoke to us
@@polysee you might want to look at the amount of waste there is in the UHI system in Germany. You’re forced by law to pay a minimum of €150 per month and it goes directly to insurance companies whose CEOs pull down massive salaries. These salaries are not “incentives” to create a better healthcare system, contrary to neoliberal ideology-it’s a massive waste. The German government could have created a not-for-profit system paid for by tax in general but the lobbyists won. Neoliberalism is an extremist, wasteful ideology which has poisoned the West.
All Polysee's videos are biased opinions on shrinking government, privatisation, and deregulation. Never mind that Ireland's services ended up in such a poor state due to the excesses caused by such thinking.
@@polysee You ignored his point. You gave a one-sided view to it without providing much of any data to support it. You also ignored the reasons the NHS has struggled which is largely due to the conservative policies that benefit the rich. Moreover, I can't see a way that the HSA method works out for anyone who has a disability. Are they expected to pay more simply because you would rather them not get healthcare? The issue you have with healthcare seems all based on cost which is worth the spending economically.
While looking into Singapore, it's interesting to note their almost Georgist approach to land ownership. Including, but not limited to, leased government land being used to build cheap public housing, as well as Annual Value taxes that disincentivises speculative holding. They have ten times less people sleeping rough, while having a greater population than Ireland. So it's certainly worth looking into.
காசிவிஸ்வநாதன் “கா [/கே]” சண்முகம் - then the world’s highest paid foreign affairs minister - mentioned in New York City (NY) that Singapore is “a city, not a country”. That probably explains why the daddy-cum-paternal-uncle-SELLOUT DOCTOR ஜனில் ஆருஷா புதுச்சேரி does not have to know what the abbreviations “NSF” & “NSman/NSmen” stand (no pun intended) for.
“These foreigners [- including dodgy permanent residents (PRs)] - are here [in Singapore] to contribute economically & who will want to come to Singapore if we subject them to the conscription & lifelong reservist liability which we compel onto all our local lads, regardless of how many male children the parents conceive? [...] THEY WILL LEAVE”! - 楊康海 (good riddance)
I qualified as a doctor in 2022 from UCD. Did a year as an intern and moved to New Zealand. In Vincents emergency department i saw 84 year old women in ED wait for days on a trolley in ED. When i moved to NZ one of the hospitals I worked in it made the news when we had patients on trolleys in the corridor
One that I *can* think of is people generally still going to A&E with bone breaks rather than to minor injury clinics as they should do. Drug users also end up in A&E because we don't have other health services (or addiction services more generally either) for them.
@@cianmcguire5647 That's fair enough but a lot of injury units in my area simply aren't open beyond regular business hours. So your options are A&E or sit with a broken arm at home
Long answer alert - pretending to have things like chest pain to get a free lift to a hospital in an ambulance, drug dispensing, drug seeking, psychological issues resulting in unnecessary diagnostics, fear of litigation resulting in ordering unnecessary diagnostics - some of the headlines, below are some specifics if anyone can be bothered, I havent even so probably typo and spelling errors throughout. I tried not to rant!! But its good to offload, even if its just one person that just scans what looks like a wall of text! Pharmacy dispensing!!! Ok all prescribed drugs are not free but they are heavily subsidised even if it deosnt seem like it if you have to pay €80pm (was much higher in the past iirc) if unlucky enough to have some relatively mild chronic condition that to keep mild, or completely symptomless, needs a monthly dispensing of a prescrption. If people can avoid paying this fee they may ask their GP to review their meds at least semi regularly, many dont. If meds are being dispensed for free on medical cards there is no financial motivation for the patient to keep their meds checked with their GP regularly, pharmacies get paid for dispensed items on medical card scripts so there isnt incentive to question if a full review of meds prescribed is needed. Pharma companies certinly dont have issue with getting paid for drugs that may eventualy go out of date and get binned. Medical Card prescriptions for 'regular' despensing are usually ordered from a GP every 3 months. It is not uncommon for people to stop taking a drug, maybe a consultant says stop taking a drug but that is not communicated to a GP or a prescription is not updated on on the chart (paper or digital systems) and x drug removed. For whatever reason it is not uncommon for people to have what amounts to a stash of unused dispensed prescription meds sitting in cupboards all over the country. Prescriptions that havent been updated for potentially years are quite common. Im not talking about controlled drugs here which are dispensed carefully. Im talking about say cholecalciferol or Vit D, supplements, nasal sprays, antihistimines, drugs for conditions that have resolved like a NSAID for an old back injury. Maybe the dosage has been reduced on some tablet but a person is still getting the equivalent of a larger dose so get say 2 packets instead of one, not uncommon with antidepressants. If someone is years being prescribed pain meds, paracetemol, then surely it should raise questions on what better can be done to stop overuse of the system and reduce use of the service initially by being referred to an appropriate part of the service, pain management clinics, OT, physio and surgical services ultimately, until there is nothing left that can be done but by then is not overuse if im even making sense. Im not saying its nefarious, just inefficient where it is easy for year on year for a patient to ring a GP practice for a new 3 monthly script, gets sent to pharmacy, is dispensed in full, patient doesnt use some of the items and this happens for maybe years. The growing number of integrated GP patient record systems tied in to a national system that pharmacies also use can be a big help to sort this issue but it still need people to take greater responsibility for their own meds, doctors to do more regular reviews and pharmacies to ask at the point of dispensing how cunstomers/patients' (hate the term client) conditions are, if they're being managed etc. Blister packs while Im sure a nuisance to sort, they were a significant step forward when introduced years ago for all sorts or reasons but one would be to help with identifying unnecessary dispensing im sure but Im not a pharmacist thankfully. Drugs should be disposed of carefully not flushed or binned but its exactly what happens when they over accumulate, brings its own problems if getting in to water supplies, contributing to antibiotic resistance probably best known, pharmacies take back unused drugs but unfortunately, for obvious reasons, they cant be redispensed once they leave the pharmacy even if unopened and sealed. For many years I worked in Pre Hospital Emergency Care, this very often involved responding to calls to peoples homes, asking about their medication as part of their history and being directed to a press to open and nearly swamped in a cartoonish like manner by all sorts of packets and bottles of meds, unopened, out of date, patient barely knowing what they are for why they didnt take them, just kept getting them etc, of a relative hands you a Lidl bag for life full to the brim and I'd be going wtf, ye get the picture. This could happen once every shift. Ive moved to in hospital care, still in Emergency Department/Resus and in an Operating Department for emergency surgery (anaesthetic side) but scheduled/elective lists too so do pre-assessment clinics and I find the same issues. Patients handing you a list of their prescribed meds, you question them on how issues are and they will often say I stopped taking that stomach tablet as the auld heartburn went away, as an example, I'd bet whats left of my back thats not i bits that that patiet would have months of tabs at home. Specifics would be H2 blockers to reduce acid, antacids but have more recently been put on Proon Pump Inhibitors (PPI) that are more effective for this person but the older meds especially the antacid are still on the prescription. I seriously could give lots more examples. One of the reasons I left an ambulance service, the proverbial straw, was getting a callout to a cardiac event at a house about 1km from the countries best known cardiac department. We loaded the person to transfer, when we got to the hospital the person whipped off all the monitoring, on with a t-shirt and walked in to the hospital. It transpired that they had a clinic appointment, didnt have a lift, wouldnt walk, wouldnt pay for a taxi, so dialled 999 pretending to have chest pain. This person wasnt incapable of walking 1km, it wasnt even a cardiac clinic they were attending. Again I have plenty of other examples this was the cheekiest and the one that got unde the skin mainly because it turned out it wasnt the 1st time for this person but not a thing can be done as you have to treat all people as bona fides at all times. In rural areas NAS sadly get calls that really turn out to be lonliness related which is overuse. Drug seeking is common for pre-hospital and in the ED. I try not to be even a tiny bit amused by someone screaming the place down with back pain but rolling around or an arm injury that you hand a pen in to to sign paperwork and not even a wince. ts not something to make light of as its a serious issue in itself for the service and ther person. People suffer from anxiety and genuinely debilitating panic disorders in ever increasing numbers. They refuse to accept they have psychological/psychiatric disabilities so are often 'treated' by doing diagnostics, a reassurance for them so maybe in some way a part of treatment but overusing the service as there is an inevitable moving the goalpost and bounce back. There are some people who dont have any mental health issues who claim to have signs and symptoms to engineer being given diagnostic - there is an argument for say everybody at a certain age getting a full health screening, even head to toe scan as preventative measures and cheaper in the long run but yeah people lie to get scans and won accept that they are unnecessary eg little will have changed in 12 months. Ive worked for 3 different services in 3 different countries, NZ, Ireland, and UK (2 different Trusts of populations not far off this entire country) and I have found significant variance in doctors ordering diagnostics, from reasonable to all the time every time in fear, both of litigation and some self belief issues occasionally. Not so bad here but cant speak for every region. One Trust in the UK, rep was awful, under direct management of Ministry of Health, patients had zero confidence so everything that was not a good outcome litigation was threatened or happened. To cover their own backs doctors over tested, it caused serious waiting lists which itself caused poor outcomes which led to litigation, cycle got worse. It was a sh1t show where I watched staff ignore pagers until eventually someone with a conscience responded, night nursing staff in the Operating Department grabbing pillows and blankets from recovery and going in to offices, pulling chairs together to make a bed and locking the door and sleeping until about 5am when some rounds would start so they'd be up looking busy - these were Band 6 so like the old ward sister, boss person. Switched to a neighbouring Trust 20km away and it ran like alsmost like clockwork, not perfect but by comparison felt like perfection, civil patients and helpful colleagues who, if got quiet time on nights, would set up for staff coming on duty in the morning as a helping hand rather than sit about - really basic stuff like putting through pharmacy orders for scheduled drugs Finally EDs would be a lot less of a logjam if people didnt used an ED for GP issues, believe it or not even with waiting times. I'll give benefit of the doubt that some people really dont know what is an emergency. Id advocate for a 24hr GP in each ED and if you are triaged there you pay a private GP consult fee or referred to your on GP if on a medical card. Minor bugbear, I dislike the use of the term free healthcare!! It costs people, the taxpayer, the vast majority of people will all pay toward the healthcare system at some stage. So if we quit calling it free and it might change some attitude, the sense of entitlement that is used to justify abuses of the service. Havent figured out what term should be used but its not free it just may not cost directly out of pocket before being treated as some countries do and ship of to the charitable service if you havent it covered....
@@rocksock7999 Excellent post rocksock. I knew people years ago working for pharmacies that would go around collecting all these unused meds from peoples houses, repackage them and sell them again. It's definitely a long running issue. Putting even a token charge on everything would give all the abusers of systems and the mentally ill reason to second guess their waste of critical resources.
“Picking our pilots based on who is best at serving tea and coffee” is a great way to describe our election process that I haven’t heard before. Good example of the knock-ons of local / regional government disempowerment!
I first visited Singapore in 2000 and I've been back a dozen times since. I learned about their tax and pension structures and their public housing initiatives on that first visit and I've spent the past 24 years boring all around me about how we in Ireland should adopt their system of housing and enriching the populace over their working life. People look at me as if I'm daft. It's not a perfect society they assure me (where is?) but it's amazing to see a country that's almost crime-free and where everything, including their hospitals and public transport, works like clockwork. We could do with some of it but our parish pump politicians with all the vision of a dung beetle on the make will ensure that it never happens.
Well... most countries only look to the next election and not the long far term. SG's development is essentially based on the Master Plan published every 5 years in outlook to the next 10-15 years (there was a plan to develop Pulau Ubin, place to one of the last kampong in SG and the untamed nature at Chek Jawa, a wetland, but was changed after some “protest”.)
காசிவிஸ்வநாதன் “கா [/கே]” சண்முகம் - then the world’s highest paid foreign affairs minister - mentioned in New York City (NY) that Singapore is “a city, not a country”. That probably explains why the daddy-cum-paternal-uncle-SELLOUT DOCTOR ஜனில் ஆருஷா புதுச்சேரி does not have to know what the abbreviations “NSF” & “NSman/NSmen” stand (no pun intended) for.
Más cuid den Limistéar an Béarla í Poblacht na hÉireann, is iad iompróir í pasanna na hÉireann-cum-Eorpacha-Aontas na duine bréagchráifeacha is mó san Limistéar an Béarla.
You actually equate the positions of Beveridge and Goodman. That's like equating Pèle and Jason McAteer. They are not equal. Beveridge thought about the morality of care from the "cradle to the grave". Goodman thinks about Cash. He's a neolib, pro Thatcherism, Trump supporter who was fired for paying off an employee he sexually assaulted. You really should elaborate on guests background before giving their positions to dismiss the work of a historic figure.
I didn't know this, but having an American "expert" on the video when the US has the most expensive and ineffective healthcare systems in the developed world and don't even critique them I just found bizarre. The other thing I'd question is whether Ireland does have too much money than it knows what to do with? I know having big global companies like Apple and Microsoft have their headquarters here but do so because the tax rate for them is so low, but does this really provide so much money the government doesn't know what to do with it? I just don't believe this to be the case at all.
Forget Beveridge and forget Goodman. Have you compared the outcomes of the UHI vs Beveridge systems, and if so, do you still prefer the latter? If you can’t bring yourself to charge for healthcare, are you comfortable with making people wait instead? Singapore’s layer of healthcare savings is just an extra layer on top of UHI. It would be better if arguments were based on outcomes, not ideology or ad hominem attacks
@polysee Ireland is not Singapore, the only metric you seen to have is population size, but every time I see Singapore suggested as the model to follow it just makes me cringe. Singapore has unique circumstances that are just impossible to follow. For every Singapore health system that you think may want there's the American model that following what the American neocon in the video purposes either lead to. By all means suggest going down the European path, I don't know enough about it to know if people who aren't able to pay for visiting the doctor are supported to be able to do so, they might be a better system, but you're not suggesting this (I don't see any expert in the video giving evidence from this point of view). What I do know is the system your American friend is proposing will mean big profits for big healthcare providers, probably still funded by tax payer money, which you seem to be wanting (more Ryanair type companies, right?), and a lot of people not able to get the healthcare they need. I'm not saying certain reforms aren't needed, again I think, even though it isn't pushed in this video, that centralisation and political meddling is the main problem and not there not being a market for healthcare. If you go down the free market, Ryanair healthcare that you seem to want, then you end up with what they have in America, which is the most expensive healthcare in the world with there not being competition lowering prices, just big companies making a lot of money through insurance scams. If you don't want this and want a more European model why have this American "expert" taking up so much of the video?
I appreciate this channel, but I think a lot of the solutions proposed address the wrong problem. In this case the government pensions and savings must be paid for, just like healthcare. You say Singapore spends very little on healthcare, but really they give money to citizens which they spend on healthcare. Also, with this method I don’t see how hospitals can’t charge as much as they do in the US. I understand competition in price, but US hospitals are free to compete and costs are still ridiculously high.
Yeah, I agree - we currently live in a time of excessively growing corporate greed and unfortunately this video did not address any concerns regarding that. The US System isn't as expensive as it is because of Medicaid or Medicare, it's mainly shareholder profits driving up prices across the board.
Bizarre that a channel with some many videos criticising the high price of housing has an ad for investing in property that boasts about high returns. Seems like a conflict of interest. Also, I would be very careful around anything offering 9% return on investment, that's double the standard rate, so if something sounds too good to be true, be careful.
The NHS has been severely damaged by the Tories. I don't think it is very accurate to say it hasn't functioned since its founding. It worked incredibly well at the start until the Tories took over. State healthcare does have significant benefits. The number of people who don't go to the GP in Ireland due to funds is incredibly high. I know so many people who after college couldn't afford basic healthcare as the college provided a GP.
This is flawed due to the difference in geography between Singapore and Ireland. Its much easier to shop around if you live a metro ride away from all the hospitals. Can't have that in Ireland, every hospital is too far apart, which stifles competition.
Well worth a look ... I really like the idea of getting out from under the shadow of the UK. Switzerland and Singapore are well worth looking at. Thanks for the video.
Yes indeed. The Swiss decentralised model is much more democratic also. It would suit Unionists better. Also, in the sixties Gaeltacht native Irish speakers campaigned for greater autonomy, they wanted their own regional governments. The government pretended they were going to give them this and founded Údarás na Gaeltachta, which turned out to be just another regional economic development agency with no powers of local government in areas of housing, schooling etc. The folk who were involved with that (locally) popular campaign still express disappointment at how it all turned out. More recently sociolinguists have recommended the same for language maintenance purposes, so again a Swiss model of decentralisation an increased bottom up instead of top down version of democracy could benefit native Irish speakers as well as Unionists. (Switzerland is also one of the greatest model countries for maintaining varying language communities in a single nation, with regions strictly delineated by linguistic boundaries... something that could have been done here a long time ago, perhaps it is too late).
This is a really interesting concept and thanks for sharing it! Good luck convincing Ireland to stop copying England's homework though... I wish I could have gone on to do a masters in economics so I could have actually tested the feasibility of this myself, but even being able to mention it is amazing! Love your channel man, if you don't already you should look at working for somewhere like the ESRI or NESC ❤
Great insights into this comparison, it's pertinent to allude to the Oregon randomised trial, a landmark in health economics which very well demonstrated that having free access to healthcare doesn't strictly improve health outcomes (sadly). However, Goodman with his neoliberal views unfortunately would be a terrible candidate for the broken HSE we face if we aspire to become like the Netherlands or the Nordics. As mentioned, free healthcare at the point of access poses many problems like the NHS, to the limited healthcare budget. Very starkly we have different treatment paradigms (that is HSE vs NHS) in terms of medications offered to mention only one example. I would conclude with the importance of social cohesion extensively discussed in literature which Goodman would simply demolish. For-profit KPI driven facilities (Goodman's option) like the nursing home market for example we have in Ireland poses significant challenges in terms of output and standard of care. It is well documented that publicly-funded (government owned) nursing home models deliver better healthcare. Furthermore, Goodman's ideology would be detrimental to Slaintecare Healthy Communities initiative. It's reasonable to point to Arrow and Grossman where we learn that healthcare is inelastic in many ways and not a typical economic model and hence shouldn't be treated as one due to it's multifaceted nature.
The example of cosmetic surgery is a terrible one. Cosmetic surgery, particularly the kind that is referenced around 11:00, is almost *always* elective. People have *time* to pick and choose and shop around. It’s not at all in the same category as standard or emergency healthcare. I think this expertise was entirely misguided and very poor.
Another great video lads fair play. Would love to see a video about deemed disposal tax and how it affects residents compared to foreign investors. Also could mention capital gains tax and how retail investment incentives are some of the worst in the world. Really blows my mind how hard and complex the government has made it for us to become financially literate and build genuine wealth.
Opening healthcare as market might work for the more densely populated areas. I'd worry however, about it having a negative effect in more remote areas were less population will mean less potential for profits. So there will either be less competition in those areas or just no real services at all (which is what is the current case now)
@@polysee According to the economists Economic index not a proper democracy "Singapore Is considered Flawed democracy With an overall score of 6.18" Just below Moldova and just above Sri Lanka. en.wikipedia.org/wiki/The_Economist_Democracy_Index
I'm always curious what think tanks he's inspired by there's definitely a open up the hounds of free market capitalism and let that guiding hand all up in there. An interesting thing he's deliberately neglected is Singapore tryed a completely open Market health care system and it was an absolute disaster so the government was forced to intervene. A great video own Singapore's health care system ruclips.net/video/WtuXrrEZsAg/видео.html
@@polysee”free and fair” is subjective. The USA describes their election as “free and fair” but it’s never working class people winning, is it? Only one I can think of is Truman.
They have free and fair elections but the who can run in those elections and how they allocate seats in the parliament are weighted towards the ruling party. Also, they scored very poorly on media freedom. All the main media organisations are owned or funded direct by the Government.
I'm American attending University in Northern Ireland, when I talk to people my age here, they're way more likely to mention healthcare and housing as reasons for or against integration with the Republic compared to allegiance to religion or ethnicity.
The age of Freebee is over, in the Rep of Ireland our Health System Works for us....What do they have in N.I. a very broken system that is collapsing because they want everything free, good luck getting that gig in the future, as for the Doctor who went to N.Z. because of overcrowding in a Hospital in 1922....I hope you do not miss family or culture when you are older and so far from Home......P.S as I write this...... there are mass Demonstrations in Sydney by Health staff because of low pay....
Singapore has lots of good ideas. Its not Shangri-la, but pragmatic. IRL must get away from.following the UK lead kn major social issues like health care. Laudable as the British idea of tbe NHS is, it isn't working, and will bankrupt the state in time. The idea of personal health, retirement accounts, higher ed as well makes 100% sense. It works, for most in employment. It won't work for the chronic unemployment though, as you need to feed the garden, fkr decades. There will need to be a two tier system, with basic provision for those disabled in particular. Scroungers are inevitable here, but they can be weeded out.
Re. 'identity matters', Irish people are more concerned with the economy and less concerned with identity, in my experience. Plus the Irish-born children of economic migrants who will be voting on a future Irish unity referendum may be less interested in the historic struggle for national identity as they have no personal connection to it. Many of my son's college friends with foreign parents have told him they plan to leave Ireland after college as they think their future prospects are better elsewhere. A Polish friend on his engineering course told him he feels sorry for him as he has relatives in Poland and knows the language and the country which makes it easy for him to move there after his degree
Really good video. As a British person, i despair at the cult around the NHS and wish we could follow the likes of Singapore to a system that provides better care through economic incentives.
Just because 1 party has won every single General Election since independence in the end of the 1960s, that does not mean that they are a "dictatorship". The US has effectively been ruled by 2 major parties (Republicans, and Democrats) since independence in 1776, but no one (except Libertarians, and Anarcho-Capitalists, but they make up only ~3% of US legal Electorate) call the US a "dictatorship". But they do have free elections, albeit probably not very fair when the rules change so often; It's unlikely that they have Electoral Fraud in SG due to photo ID requirements to vote (I do not live in Singapore, so take as a pinch of salt, based on quick search result).
@@wclifton968gameplaystutorials the US has open primaries so no, it hasnt been ruled by "just" two parties. Literally Republican elites hated Trump in '16 and wanted Jeb Bush or Rubio to be nominees, but Trump won, for example: candidates are also chosen by the people, not the party, down the ballot, with the Squad (AOC, Ihlan Omar) winning against established democrats in the '18 midterms
Tá iomaíocht réalaíoch in áit atá chomh mór le Contae an Lú, ach má tá tú amuigh i gConnacht ní bheidh trí nó ceithre ospidéal thimpeall ort chun go mbeifeá ábalta an ceann is saoire a roghnú. Níl a fhios agam cad é an saghas margaidh a bheadh ann. Agus an bhfuil fianaise ann gur fadhb suntasach é overconsumption in Éirinn? Nuair a smaoiním ar an Roinn Timpiste is Éigeandála i Luimneach ná ar na liostaí feithimh d'obráidí droime ní fheicim an bhaint atá ag overconsumption leis. Tuigim an ról a bheadh ag overconsumption ag leibhéal an Dochtúra Teaghlaigh, is é sin go rachadh daoine isteach chun comhairle a lorg ar eagla na heagla - ach níl a fhios agam cé atá suite istigh in ospidéal nach gá dó a bheith ann
Thanks. We acknowledge that point on lower population densities and say that public hospitals would likely stay publicly owned, but they could be given more autonomy
@@polyseea hospital can function as a campus with numerous locations. It can have branches across the West. If there is a private system & publicly funded versions
@@LeMerchI don't see how that would help. I agree with more autonomy for healthcare providers but if you're not careful you would end up with a system like in the US where big corporations make a lot of money and only treat those who can afford to pay. In the end healthcare services are either paid for through taxation or by the individual. The problem is, as many who have private healthcare already claim, if there is only private healthcare people would want to pay less tax because they now aren't being provided a service they were previously getting through their taxes, which in the end means that if you have a low salary you probably wouldn't be able to afford to go to see your GP, something serious doesn't get picked up early on, you get sicker, and by the time it gets diagnosed you need expensive scans and operations costing you even more money you can't afford, or it has to be picked up by the remaining public service, which raises the question why you changed the system in the first place. This video seems to be wanting to create a system to create millionaires, but that money has to come from somewhere, you don't just magic it out of thin air, so it would be coming out of money that would otherwise be spent on healthcare and probably still heavily subsidized by the public purse, nice money if you can get it
By the time there's a referendum on reunification, health care won't be an issue. The new UK labour government will bring in so much means testing that the NHS will look just like the HSE without the high Irish pay. The only strategic bribe that would work is to offer Belfast civil servants the same high pay as Irish civil servants in Dublin.
What started off as interesting and valid takes on empowering local government these guys have since been sliding more and more bizarre takes on expanding neo lib policy which landed us where we are in the first place.
What do you mean by neoliberalism? Nobody ever defines that word, it seems to be a catchall pejorative used to shut down discussion. Do you have other data disputing the findings that UHI performs better than tax funded systems?
There are very few countries in the world that the health care works for the working class. All countries should look to copy working health policies. As for the United Ireland, why does there need to be one? If ROI are doing well then why do they want/ need the North and vice versa? If there was a united ireland under their own steam, it would be the first time it was a united island. As it's never been under one banner but a collective clans. As for the issues that concern NI people voting for a united ireland, there is a lot that would need to discussed: Defence security Language Education Health Infrastructure Energy Social services Pensions Flag National anthem This is by no means a full list, but as you can see, some will be around cost, changes to national identity (both sides), and quality of life. People don't like change and uncertainty. People from all nations have politicians that promise x but deliver y and surely that would be the same for this matter. So again, my question, aside from blind pride, is why should an all Ireland be discussed? Why risk a 2nd round of the Troubles? I'm a middle aged family man and open for a good open mind discussion. As I know there will be pros and cons to each side of the argument.
1922 was the time N.I. should have joined with the rest of Ireland, now Ireland is not interested in the spoilt brat, it needs to learn many lessons now the Empire is over and bankrupted....real will take another 15 years.......
No way should we be taking advice from Americans on health care. $70 for an inhaler I’d personally would have struggled as a child if this were the case. No thanks keep us style insurance of of medical care please. The Canadian model looks good to me.
The first thing a free state government would do in a united Ireland is close daisy hill hospital, Downpatrick hospital, Dungannon hospital, antrim hospital and erne hospital. What would happen to these empty buildings? Filled with unvetted migrants
You're right about British attitudes though. I always found it when talking to friends and family who live there. Its sacrosanct and can do no wrong. Any problem? Just not enough money of course. I always found it funny when talking to an aunt of mine over there when she'd complain that "we should do X like in Germany or Switzerland" and then rant on about private companies in healthcare. You cant have a rational discussion on this sadly and so in the event of a united Ireland the people up there will just have to put up and shut up. If they dont want it then they can always vote no. Let us focus on making the best system for Ireland
Anytime you give away for free something that costs money you will get waste. It doesn’t matter if it is plastic bags, water, drugs or free travel. There should be nothing for nothing.
But healthcare isn't free, it's paid for through taxes. If you charge for people to go to see their GP many of those who could be treated fairly cheaply just don't go, like in the US, and then health outcomes get worse, treatments get more expensive, and you either have more people dying or it's more expensive to stop them from doing so. One thing that might be useful is people get a yearly report on what their healthcare costs to provide it to them on a personal basis. Maybe it could just be available on an online system that gets added each time you use a service. I'm not really sure if this would deter anyone though, but are we really saying you want to deter people? I mean you go to see the doctor because you're sick and because you're not a doctor you want to be assessed by one in case it is something serious. We already get triaged by the GP surgery as to whether our symptoms are serious enough to be seen by a doctor anyway so I think those turning up every other day are a thing of the past in most cases. I have a problem with the whole premise of this video though, which basically says let the market decide and then wheels on an American "expert" from the one country that had failed at affordable healthcare, whilst big healthcare corporations make billions from overpriced services that bankrupt a lot of people.
@@mattpotter8725 if you are not charged at the point of use it is seen as free. The video is advocating for a Singaporean style system which has better outcomes and costs less to run. It is not advocating for the US system which is expensive with poor outcomes. Just like water & free travel, Healthcare should be heavily subsidized but not free as those leads to excessive waste and is ultimately unsustainable.
@paddieland I do get where you're coming from and my Irish grandpa, who passed earlier this year at the age of 104 who came to the UK during the war, had the attitude that he'd paid into the system all his working life so was entitled to everything, but I don't think he ever overused the system, he accessed it when he needed it, when he had problems he thought were serious or potentially serious. I'm the same so even though you're right you don't have to pay in the same way you would if you were buying a new car or a new TV, I think you're aware, especially now with healthcare the way it is, that you should only use the system when you really need it, that's been drilled into us for years now. I also get what you're saying about having a system where you pay into an individual health insurance pot (that's topped up by the government depending on your income) sounds great, but you know what this does, it means that instead of progressive taxes where when you earn over a certain income the money over that tax band gets increasingly higher, so now money is collected from those with the most money, money is now equally paid into your individual healthcare pot whether you are a road sweeper or a billionaire (I get this is slightly exaggerating things because billionaires will go private anyway, but the point stands for those below this threshold of being asked to go private). Surely if this system was introduced you would expect tax cuts to be able to afford to pay for the individual healthcare you would now have to self fund. So the government now would get less money in taxes, especially from the wealthy who aren't using the system anyway (and I get some make the argument that if you're not using something then why should you be paying for it, but without this principle the rich, who are generally more healthy, get richer, and the poor get poorer, just like in Victorian times). Putting all this aside to me this is just semantics, it just shifts who is paying and when. I'm not sure how this at all affects the healthcare provider, whether public or private, that's a completely separate issue in my opinion. If you want true competition then there would have to be a way of having new innovative entrants to the market to make sure competition is high and prices as low as possible and I just don't see how this is possible. GP surgeries here in the UK are privately run businesses that are contracted by the government to provide a service. It's very difficult to shop around and change from one to another unless you move where you're living because it's just not viable for a new surgery to open up just down the road because it could never gain enough of a patient base to make it viable, plus it creates slack in the system, it would most likely make both businesses not viable concerns. I'd love to be able to switch but there is no option. The same would be true at the hospital level where startup costs would be even higher. I'm not totally across the demographics of Singapore but economically they have huge wealth mainly from where they are geographically situated as it is on the Strait of Malacca where a huge portion of goal trade passes through. I suspect it has a younger population than either the UK or Ireland and so demand on healthcare isn't as high and it is probably healthier as well with its population eating healthier diets whilst exercising more, but some of this is a bit of a guess. The main problem we have in a lot of Western countries is that we have aging populations due to the baby boomer generation born just after WWII. This is what is causing the problem and putting increased demands on healthcare without any extra money coming in through taxes.
@@mattpotter8725 your grand dad is the exception rather than the rule. People with long term illness get free medication when some of these people pass away there is refuse sacks of medication that need to get destroyed this doesn’t happen when the medication isn’t free. Over half the tests carried out are also needless. The children’s hospital is being designed on the fly with zero foresight. This is all just pure waste of money. I’m happy enough with the taxes we pay but for the cost our health system should be so much better. This video shows us a better way. Willful waste makes woeful want and there is willful waste everywhere you turn in the HSE.
Like eye laser surgery, it is similar to elective procedures in that it is a non urgent procedure on the body. It is marked by price and quality competition.
1. Terrible clickbaity title that is essentially a privatisation lesson from a right wing yank. A nursing colleague of my sister in law (in Florida) got fired from the hospital she worked for because she was taking too many days off to get chemotherapy, and without the income she couldn't afford the drugs, so she died. I suggest Goodman look at the inequities of American healthcare before preaching to everyone else. 2. The entire premise of the title and the end of your video is that we're somehow desperate to get NI to unite with us. We removed articles 2 and 3 of the constitution to move on from the old republican propaganda of the previous 80 years. We can certainly be open to a shared island without dealing with the fall out of a shared Ireland. Indeed, NI is as, if not more sectarian than ever, with well in excess of 100 "peacewalls" compared to about 20 at the time of the GFA. Plus it's an economic basket case. 3. I love visiting Singapore but I doubt you would EVER get as ordered a society here, to match them, to allow us to make big policy shifts. You wouldn't last long in government, the healthcare unions would tear you down. 4. The size of Singapore is not much bigger than Cork to Bandon to Kinsale to Cork, with 20 Acute Hospitals in that footprint. This just isn't a realistic comparison. Also the dutch always complain about the cost of their model of healthcare.
The title is admittedly a bit clickbaity; it’s primarily a video about healthcare. Any thoughts on the substantive issue of UHI vs state funded systems? Specifically how many fewer Irish people would die each year if we had Dutch outcomes? Never mind Swiss outcomes. Just because Goodman is American it seems harsh to hold him accountable for the shortcomings of the US system, without giving him any credit for healthcare savings accounts - and therefore Singapore’s success. You have a strong negative reaction to markets, but you have little to say about waiting lists or poor outcomes in IE/UK vs European UHI systems - forget America. As for comparisons to Singapore, we mention public hospitals would likely remain due to lower population densities. To say you can’t compare X to us because of Y seems limiting - one always can and should compare one’s country to the best in the world, not necessarily copy them. This video just seeks to offer an alternative to Sláintecare groupthink
This channel has really deteriorated into cheap neoliberalism Why do you never mention British governments relentless defunding of NHS with a view to privatisation?
Free Market healthcare is an idea that needs to expand globally. It's been well known for decades among non-Communist and non-Keynsian economists, that free-er economies are richer ones, and that the most economically free country in each region, is also the richest country in that region (e.g. Botswana is the Free-est & richest country in Southern Africa). As for healthcare, before the socialisation of healthcare, Welfare, and other social services in Western countries, such as in the UK, rich people would fund/subsidise healthcare through hospitals, or living costs in terms of housing for poor and/or elderly people through almshouses (many still exist in England), but due to government, rich men no longer feel insecure about not helping poor people anymore, and too many people are reliant on the state, with costs soaring, and no competition in services where technology is consistently improving over time (e.g. Healthcare, Transport). Did not realise that Polysee was being run by Irish Free-Market "Libertarians" LOL.
Ha I don’t think we’d sign on the dotted line of libertarian, some sectors like energy we probably need more state involvement. But in healthcare, the death march to the Beveridge model needs to be seriously questioned, based on the evidence from around Europe
Are you seriously trying to suggest that the 19th century healthcare model (even allowing for technology) had better outcomes than socialised healthcare because of almshouses and charity from the super-rich? LOL! The rich help the poor a lot more today than they did in the 19th century... because it's not a choice for them anymore. If this utopia existed as you say then the NHS would never have been created.
@@polysee based on the cherry picked evidence*. I guess the Singaporean example is not valid anymore when it tells you that public housing is the solution for the housing problem, though.
@@asier_getxo Too right. We're a country with a housing problem first and foremost, and the Singaporean example shows a solution and proves that 'common good' should be placed above 'right to perpetually hold or alienate property' in Article 43 of our constitution.
This was a wonderful watch, thanks @Polysee . It's so great to see content that is specific to Ireland, particularly with unification in mind. Very interesting. Having been to Singapore I was amazed at how well things ran. The benefits of having the same government for decades, but also planning and good ol' common sense, something the Irish government seem remarkably short of on occasion. PS : I'd love to see a video about the government institutions that have been setup to plan for unification, their progress, considerations and what other groups (eg: civic forums) would be beneficial in planning.
As a protestant if the southern government could provide a better health service than the NHS I would vote for a new ireland- the NHS is broken
It already is much better bruh
It is better. Over 40% get free healthcare. People in the 26 counties live for a full year longer than in the 6 counties.
@fishyq5077 What you on about a full year bruh, you mean 3 full years?
It is far better and you'd pay less than you currently do. A family health plan is €100 per month. Compare that to what you pay in National insurance.
I'd imagine Ireland would just add the hospitals and other healthcare facilities to the current assets. We would both get better access to services.
Ireland needs to stop looking at the uk as an example for anything.
Perhaps not anything, but certainly healthcare. They do certain things well. The ideal is to pick the best of each country and implement it in your own.
As a Brit, agreed lol
Absolutely, we copy their failed policies years later just as we see them failing. We should be looking at our more enlightened EU brethren or Singapore or Switzerland!
@@OldManRogers Lol to the EU being enlightened
@@OldManRogers: Conscription-cum-lifelong-reservist-liability in Singapore, like the Irish language in the Republic of Ireland, is an industry.
'The Michael O'Learys of healthcare' - no thanks.
Bad timing 😅
@@polysee 😂
Healthcare is an inelastic market, which doesn't produce real prices like other markets do. The comparison to cosmetic surgery does not work. People do not NEED cosmetic surgery and so the market allows for competition
We mention that elective procedures is specifically where this ‘shopping around’ happens. Elasticity is not 0 - healthcare will produce real prices if it is allowed to do so
He goes into it in the video. Food is also inelastic, but we wouldn't ever want a National Food Service.
@@TheWolfXCIX The food comparison isn't really equivalent though. You can easily survive on no-name brands and don't need the fancy stuff - but if you need a heart bypass, you need a heard bypass.
@@xBrisYeah, but a heart bypass from your nearest public hospital might be the equivalent of a no-name brand compared to flying abroad to a world-leading cutting edge hospital
@@polyseeElasticity for the procedures we care about - life saving ones - are not elastic, unless you want to leave the poor people to die.
I'm disappointed by the low number of sources for this video. Moreover you uncritically interview John C. Goodman without mentoning some of the criticisms he receives amongst academics for his ideas.
See "Are Medical Savings Accounts a Viable Option for Funding Health Care?" Anna Dixon 2002 or "Medical savings accounts: assessing their impact on efficiency, equity and financial protection in health care" 2016 for example.
Citing the abstract of the latter: "The available evidence suggests that MSA schemes have generally been inefficient and inequitable and have not provided adequate financial protection. The impact of these schemes on long-term health-care costs is unclear."
This video feels more like a biased presentation of one man's ideas than a serious discussion of healthcare policy.
Hey, the focus of the episode is a) to discuss UHI, and its superior performance to tax funded systems b) to question why Ireland is blindly moving to less the less performant Beverdige model c) to discuss HSAs as an optional extra layer, precisely to overcome the equity issues i.e. government injecting money into the HSAs of the less well off. Singapore's success with this is notable, would you not agree? As for Goodman, given that he is regarded as "Father of HSAs", it seemed relevant to interview him - but this episode would've been made regardless of whether he spoke to us
@@polysee you might want to look at the amount of waste there is in the UHI system in Germany. You’re forced by law to pay a minimum of €150 per month and it goes directly to insurance companies whose CEOs pull down massive salaries. These salaries are not “incentives” to create a better healthcare system, contrary to neoliberal ideology-it’s a massive waste. The German government could have created a not-for-profit system paid for by tax in general but the lobbyists won. Neoliberalism is an extremist, wasteful ideology which has poisoned the West.
All Polysee's videos are biased opinions on shrinking government, privatisation, and deregulation. Never mind that Ireland's services ended up in such a poor state due to the excesses caused by such thinking.
@@polysee You ignored his point. You gave a one-sided view to it without providing much of any data to support it. You also ignored the reasons the NHS has struggled which is largely due to the conservative policies that benefit the rich. Moreover, I can't see a way that the HSA method works out for anyone who has a disability. Are they expected to pay more simply because you would rather them not get healthcare? The issue you have with healthcare seems all based on cost which is worth the spending economically.
@@stephencunniffe823exactly almost every one of those studies were done when tories were in power they look for any excuse to sell pieces off.
While looking into Singapore, it's interesting to note their almost Georgist approach to land ownership. Including, but not limited to, leased government land being used to build cheap public housing, as well as Annual Value taxes that disincentivises speculative holding.
They have ten times less people sleeping rough, while having a greater population than Ireland. So it's certainly worth looking into.
காசிவிஸ்வநாதன் “கா [/கே]” சண்முகம் - then the world’s highest paid foreign affairs minister - mentioned in New York City (NY) that Singapore is “a city, not a country”.
That probably explains why the daddy-cum-paternal-uncle-SELLOUT DOCTOR ஜனில் ஆருஷா புதுச்சேரி does not have to know what the abbreviations “NSF” & “NSman/NSmen” stand (no pun intended) for.
“These foreigners [- including dodgy permanent residents (PRs)] - are here [in Singapore] to contribute economically & who will want to come to Singapore if we subject them to the conscription & lifelong reservist liability which we compel onto all our local lads, regardless of how many male children the parents conceive? [...]
THEY WILL LEAVE”!
- 楊康海 (good riddance)
I qualified as a doctor in 2022 from UCD. Did a year as an intern and moved to New Zealand. In Vincents emergency department i saw 84 year old women in ED wait for days on a trolley in ED. When i moved to NZ one of the hospitals I worked in it made the news when we had patients on trolleys in the corridor
Can anyone here think of an example of people in Ireland over using Healthcare services?
One that I *can* think of is people generally still going to A&E with bone breaks rather than to minor injury clinics as they should do. Drug users also end up in A&E because we don't have other health services (or addiction services more generally either) for them.
@@cianmcguire5647 That's fair enough but a lot of injury units in my area simply aren't open beyond regular business hours. So your options are A&E or sit with a broken arm at home
Long answer alert - pretending to have things like chest pain to get a free lift to a hospital in an ambulance, drug dispensing, drug seeking, psychological issues resulting in unnecessary diagnostics, fear of litigation resulting in ordering unnecessary diagnostics - some of the headlines, below are some specifics if anyone can be bothered, I havent even so probably typo and spelling errors throughout. I tried not to rant!! But its good to offload, even if its just one person that just scans what looks like a wall of text!
Pharmacy dispensing!!! Ok all prescribed drugs are not free but they are heavily subsidised even if it deosnt seem like it if you have to pay €80pm (was much higher in the past iirc) if unlucky enough to have some relatively mild chronic condition that to keep mild, or completely symptomless, needs a monthly dispensing of a prescrption. If people can avoid paying this fee they may ask their GP to review their meds at least semi regularly, many dont. If meds are being dispensed for free on medical cards there is no financial motivation for the patient to keep their meds checked with their GP regularly, pharmacies get paid for dispensed items on medical card scripts so there isnt incentive to question if a full review of meds prescribed is needed. Pharma companies certinly dont have issue with getting paid for drugs that may eventualy go out of date and get binned.
Medical Card prescriptions for 'regular' despensing are usually ordered from a GP every 3 months. It is not uncommon for people to stop taking a drug, maybe a consultant says stop taking a drug but that is not communicated to a GP or a prescription is not updated on on the chart (paper or digital systems) and x drug removed. For whatever reason it is not uncommon for people to have what amounts to a stash of unused dispensed prescription meds sitting in cupboards all over the country. Prescriptions that havent been updated for potentially years are quite common. Im not talking about controlled drugs here which are dispensed carefully. Im talking about say cholecalciferol or Vit D, supplements, nasal sprays, antihistimines, drugs for conditions that have resolved like a NSAID for an old back injury. Maybe the dosage has been reduced on some tablet but a person is still getting the equivalent of a larger dose so get say 2 packets instead of one, not uncommon with antidepressants. If someone is years being prescribed pain meds, paracetemol, then surely it should raise questions on what better can be done to stop overuse of the system and reduce use of the service initially by being referred to an appropriate part of the service, pain management clinics, OT, physio and surgical services ultimately, until there is nothing left that can be done but by then is not overuse if im even making sense.
Im not saying its nefarious, just inefficient where it is easy for year on year for a patient to ring a GP practice for a new 3 monthly script, gets sent to pharmacy, is dispensed in full, patient doesnt use some of the items and this happens for maybe years. The growing number of integrated GP patient record systems tied in to a national system that pharmacies also use can be a big help to sort this issue but it still need people to take greater responsibility for their own meds, doctors to do more regular reviews and pharmacies to ask at the point of dispensing how cunstomers/patients' (hate the term client) conditions are, if they're being managed etc. Blister packs while Im sure a nuisance to sort, they were a significant step forward when introduced years ago for all sorts or reasons but one would be to help with identifying unnecessary dispensing im sure but Im not a pharmacist thankfully. Drugs should be disposed of carefully not flushed or binned but its exactly what happens when they over accumulate, brings its own problems if getting in to water supplies, contributing to antibiotic resistance probably best known, pharmacies take back unused drugs but unfortunately, for obvious reasons, they cant be redispensed once they leave the pharmacy even if unopened and sealed.
For many years I worked in Pre Hospital Emergency Care, this very often involved responding to calls to peoples homes, asking about their medication as part of their history and being directed to a press to open and nearly swamped in a cartoonish like manner by all sorts of packets and bottles of meds, unopened, out of date, patient barely knowing what they are for why they didnt take them, just kept getting them etc, of a relative hands you a Lidl bag for life full to the brim and I'd be going wtf, ye get the picture. This could happen once every shift.
Ive moved to in hospital care, still in Emergency Department/Resus and in an Operating Department for emergency surgery (anaesthetic side) but scheduled/elective lists too so do pre-assessment clinics and I find the same issues. Patients handing you a list of their prescribed meds, you question them on how issues are and they will often say I stopped taking that stomach tablet as the auld heartburn went away, as an example, I'd bet whats left of my back thats not i bits that that patiet would have months of tabs at home. Specifics would be H2 blockers to reduce acid, antacids but have more recently been put on Proon Pump Inhibitors (PPI) that are more effective for this person but the older meds especially the antacid are still on the prescription. I seriously could give lots more examples.
One of the reasons I left an ambulance service, the proverbial straw, was getting a callout to a cardiac event at a house about 1km from the countries best known cardiac department. We loaded the person to transfer, when we got to the hospital the person whipped off all the monitoring, on with a t-shirt and walked in to the hospital. It transpired that they had a clinic appointment, didnt have a lift, wouldnt walk, wouldnt pay for a taxi, so dialled 999 pretending to have chest pain. This person wasnt incapable of walking 1km, it wasnt even a cardiac clinic they were attending. Again I have plenty of other examples this was the cheekiest and the one that got unde the skin mainly because it turned out it wasnt the 1st time for this person but not a thing can be done as you have to treat all people as bona fides at all times. In rural areas NAS sadly get calls that really turn out to be lonliness related which is overuse.
Drug seeking is common for pre-hospital and in the ED. I try not to be even a tiny bit amused by someone screaming the place down with back pain but rolling around or an arm injury that you hand a pen in to to sign paperwork and not even a wince. ts not something to make light of as its a serious issue in itself for the service and ther person.
People suffer from anxiety and genuinely debilitating panic disorders in ever increasing numbers. They refuse to accept they have psychological/psychiatric disabilities so are often 'treated' by doing diagnostics, a reassurance for them so maybe in some way a part of treatment but overusing the service as there is an inevitable moving the goalpost and bounce back. There are some people who dont have any mental health issues who claim to have signs and symptoms to engineer being given diagnostic - there is an argument for say everybody at a certain age getting a full health screening, even head to toe scan as preventative measures and cheaper in the long run but yeah people lie to get scans and won accept that they are unnecessary eg little will have changed in 12 months.
Ive worked for 3 different services in 3 different countries, NZ, Ireland, and UK (2 different Trusts of populations not far off this entire country) and I have found significant variance in doctors ordering diagnostics, from reasonable to all the time every time in fear, both of litigation and some self belief issues occasionally. Not so bad here but cant speak for every region. One Trust in the UK, rep was awful, under direct management of Ministry of Health, patients had zero confidence so everything that was not a good outcome litigation was threatened or happened. To cover their own backs doctors over tested, it caused serious waiting lists which itself caused poor outcomes which led to litigation, cycle got worse. It was a sh1t show where I watched staff ignore pagers until eventually someone with a conscience responded, night nursing staff in the Operating Department grabbing pillows and blankets from recovery and going in to offices, pulling chairs together to make a bed and locking the door and sleeping until about 5am when some rounds would start so they'd be up looking busy - these were Band 6 so like the old ward sister, boss person. Switched to a neighbouring Trust 20km away and it ran like alsmost like clockwork, not perfect but by comparison felt like perfection, civil patients and helpful colleagues who, if got quiet time on nights, would set up for staff coming on duty in the morning as a helping hand rather than sit about - really basic stuff like putting through pharmacy orders for scheduled drugs
Finally EDs would be a lot less of a logjam if people didnt used an ED for GP issues, believe it or not even with waiting times. I'll give benefit of the doubt that some people really dont know what is an emergency. Id advocate for a 24hr GP in each ED and if you are triaged there you pay a private GP consult fee or referred to your on GP if on a medical card.
Minor bugbear, I dislike the use of the term free healthcare!! It costs people, the taxpayer, the vast majority of people will all pay toward the healthcare system at some stage. So if we quit calling it free and it might change some attitude, the sense of entitlement that is used to justify abuses of the service. Havent figured out what term should be used but its not free it just may not cost directly out of pocket before being treated as some countries do and ship of to the charitable service if you havent it covered....
@@rocksock7999 Excellent post rocksock. I knew people years ago working for pharmacies that would go around collecting all these unused meds from peoples houses, repackage them and sell them again. It's definitely a long running issue. Putting even a token charge on everything would give all the abusers of systems and the mentally ill reason to second guess their waste of critical resources.
“Picking our pilots based on who is best at serving tea and coffee” is a great way to describe our election process that I haven’t heard before. Good example of the knock-ons of local / regional government disempowerment!
I first visited Singapore in 2000 and I've been back a dozen times since. I learned about their tax and pension structures and their public housing initiatives on that first visit and I've spent the past 24 years boring all around me about how we in Ireland should adopt their system of housing and enriching the populace over their working life. People look at me as if I'm daft.
It's not a perfect society they assure me (where is?) but it's amazing to see a country that's almost crime-free and where everything, including their hospitals and public transport, works like clockwork. We could do with some of it but our parish pump politicians with all the vision of a dung beetle on the make will ensure that it never happens.
Many dafts are getting into Parliament. 😂
You're spot on about the parish pump politicians
Well... most countries only look to the next election and not the long far term.
SG's development is essentially based on the Master Plan published every 5 years in outlook to the next 10-15 years (there was a plan to develop Pulau Ubin, place to one of the last kampong in SG and the untamed nature at Chek Jawa, a wetland, but was changed after some “protest”.)
காசிவிஸ்வநாதன் “கா [/கே]” சண்முகம் - then the world’s highest paid foreign affairs minister - mentioned in New York City (NY) that Singapore is “a city, not a country”.
That probably explains why the daddy-cum-paternal-uncle-SELLOUT DOCTOR ஜனில் ஆருஷா புதுச்சேரி does not have to know what the abbreviations “NSF” & “NSman/NSmen” stand (no pun intended) for.
Más cuid den Limistéar an Béarla í Poblacht na hÉireann, is iad iompróir í pasanna na hÉireann-cum-Eorpacha-Aontas na duine bréagchráifeacha is mó san Limistéar an Béarla.
From the thumbnail I thought Co Louth would be like Singapore with shitty weather......but the UK got that one covered.
The fundamental problem with the Irish system is that every stakeholder has power except the patient.
It is too bureaucratic and not patient focused
Ireland had this type of health care but changed it to suit private sector...the irish Government made a mess of things...
You actually equate the positions of Beveridge and Goodman. That's like equating Pèle and Jason McAteer. They are not equal. Beveridge thought about the morality of care from the "cradle to the grave". Goodman thinks about Cash. He's a neolib, pro Thatcherism, Trump supporter who was fired for paying off an employee he sexually assaulted.
You really should elaborate on guests background before giving their positions to dismiss the work of a historic figure.
I didn't know this, but having an American "expert" on the video when the US has the most expensive and ineffective healthcare systems in the developed world and don't even critique them I just found bizarre.
The other thing I'd question is whether Ireland does have too much money than it knows what to do with? I know having big global companies like Apple and Microsoft have their headquarters here but do so because the tax rate for them is so low, but does this really provide so much money the government doesn't know what to do with it? I just don't believe this to be the case at all.
Forget Beveridge and forget Goodman. Have you compared the outcomes of the UHI vs Beveridge systems, and if so, do you still prefer the latter? If you can’t bring yourself to charge for healthcare, are you comfortable with making people wait instead? Singapore’s layer of healthcare savings is just an extra layer on top of UHI. It would be better if arguments were based on outcomes, not ideology or ad hominem attacks
@polysee Ireland is not Singapore, the only metric you seen to have is population size, but every time I see Singapore suggested as the model to follow it just makes me cringe.
Singapore has unique circumstances that are just impossible to follow. For every Singapore health system that you think may want there's the American model that following what the American neocon in the video purposes either lead to.
By all means suggest going down the European path, I don't know enough about it to know if people who aren't able to pay for visiting the doctor are supported to be able to do so, they might be a better system, but you're not suggesting this (I don't see any expert in the video giving evidence from this point of view).
What I do know is the system your American friend is proposing will mean big profits for big healthcare providers, probably still funded by tax payer money, which you seem to be wanting (more Ryanair type companies, right?), and a lot of people not able to get the healthcare they need.
I'm not saying certain reforms aren't needed, again I think, even though it isn't pushed in this video, that centralisation and political meddling is the main problem and not there not being a market for healthcare.
If you go down the free market, Ryanair healthcare that you seem to want, then you end up with what they have in America, which is the most expensive healthcare in the world with there not being competition lowering prices, just big companies making a lot of money through insurance scams. If you don't want this and want a more European model why have this American "expert" taking up so much of the video?
Why aren't you more popular. You make such good points. People need to see these ahead of the election
I appreciate this channel, but I think a lot of the solutions proposed address the wrong problem.
In this case the government pensions and savings must be paid for, just like healthcare. You say Singapore spends very little on healthcare, but really they give money to citizens which they spend on healthcare.
Also, with this method I don’t see how hospitals can’t charge as much as they do in the US. I understand competition in price, but US hospitals are free to compete and costs are still ridiculously high.
Yeah, I agree - we currently live in a time of excessively growing corporate greed and unfortunately this video did not address any concerns regarding that. The US System isn't as expensive as it is because of Medicaid or Medicare, it's mainly shareholder profits driving up prices across the board.
Bizarre that a channel with some many videos criticising the high price of housing has an ad for investing in property that boasts about high returns. Seems like a conflict of interest.
Also, I would be very careful around anything offering 9% return on investment, that's double the standard rate, so if something sounds too good to be true, be careful.
The NHS has been severely damaged by the Tories. I don't think it is very accurate to say it hasn't functioned since its founding. It worked incredibly well at the start until the Tories took over. State healthcare does have significant benefits. The number of people who don't go to the GP in Ireland due to funds is incredibly high. I know so many people who after college couldn't afford basic healthcare as the college provided a GP.
Do you have any data on foregone care in Ireland? And on the NHS supposedly performing well versus European peers pre Tories?
This is flawed due to the difference in geography between Singapore and Ireland. Its much easier to shop around if you live a metro ride away from all the hospitals. Can't have that in Ireland, every hospital is too far apart, which stifles competition.
For elective procedures, you can shop around
Politician neglecting problem of potholes and tries to improve national healthcare... And gets told off by taoiseach. Yeah that is Irish politics.
Well worth a look ... I really like the idea of getting out from under the shadow of the UK. Switzerland and Singapore are well worth looking at. Thanks for the video.
Yes indeed. The Swiss decentralised model is much more democratic also. It would suit Unionists better. Also, in the sixties Gaeltacht native Irish speakers campaigned for greater autonomy, they wanted their own regional governments. The government pretended they were going to give them this and founded Údarás na Gaeltachta, which turned out to be just another regional economic development agency with no powers of local government in areas of housing, schooling etc. The folk who were involved with that (locally) popular campaign still express disappointment at how it all turned out. More recently sociolinguists have recommended the same for language maintenance purposes, so again a Swiss model of decentralisation an increased bottom up instead of top down version of democracy could benefit native Irish speakers as well as Unionists. (Switzerland is also one of the greatest model countries for maintaining varying language communities in a single nation, with regions strictly delineated by linguistic boundaries... something that could have been done here a long time ago, perhaps it is too late).
This is a really interesting concept and thanks for sharing it! Good luck convincing Ireland to stop copying England's homework though... I wish I could have gone on to do a masters in economics so I could have actually tested the feasibility of this myself, but even being able to mention it is amazing! Love your channel man, if you don't already you should look at working for somewhere like the ESRI or NESC ❤
There is no way you called King Billy “wise”
Haha. He is to some
To some y.eah like loyalists who are entwined with neo nazis @@polysee
Great insights into this comparison, it's pertinent to allude to the Oregon randomised trial, a landmark in health economics which very well demonstrated that having free access to healthcare doesn't strictly improve health outcomes (sadly). However, Goodman with his neoliberal views unfortunately would be a terrible candidate for the broken HSE we face if we aspire to become like the Netherlands or the Nordics. As mentioned, free healthcare at the point of access poses many problems like the NHS, to the limited healthcare budget. Very starkly we have different treatment paradigms (that is HSE vs NHS) in terms of medications offered to mention only one example. I would conclude with the importance of social cohesion extensively discussed in literature which Goodman would simply demolish. For-profit KPI driven facilities (Goodman's option) like the nursing home market for example we have in Ireland poses significant challenges in terms of output and standard of care. It is well documented that publicly-funded (government owned) nursing home models deliver better healthcare. Furthermore, Goodman's ideology would be detrimental to Slaintecare Healthy Communities initiative. It's reasonable to point to Arrow and Grossman where we learn that healthcare is inelastic in many ways and not a typical economic model and hence shouldn't be treated as one due to it's multifaceted nature.
Thanks for the thoughtful comment. Will look into some of the stuff you mention 👍
Shame. I was expecting to hear about Singapore.
Conscription-cum-lifelong-reservist-liability in Singapore, like the Irish language in the Republic of Ireland, is an industry.
The example of cosmetic surgery is a terrible one. Cosmetic surgery, particularly the kind that is referenced around 11:00, is almost *always* elective. People have *time* to pick and choose and shop around. It’s not at all in the same category as standard or emergency healthcare. I think this expertise was entirely misguided and very poor.
We say that the shopping around in healthcare happens mostly for elective procedures, hence the comparison - as you say - is valid
Another great video lads fair play. Would love to see a video about deemed disposal tax and how it affects residents compared to foreign investors. Also could mention capital gains tax and how retail investment incentives are some of the worst in the world. Really blows my mind how hard and complex the government has made it for us to become financially literate and build genuine wealth.
Thanks for that, will have a think about those topics 👍
Irelands health system is one of the reasons i left Ireland
😂😂😂😂😂😂😂😂😂 are you for real Dude? You need to travel.....lots.
i call bull5h1t.
What a video!
Ireland is really more of a hybrid due to high level of private health insurance and having the 3 types of hospitals
This is so beautiful ❤
Opening healthcare as market might work for the more densely populated areas. I'd worry however, about it having a negative effect in more remote areas were less population will mean less potential for profits. So there will either be less competition in those areas or just no real services at all (which is what is the current case now)
Yes, we do say that Ireland’s lower population densities would mean that public hospitals would likely remain in public ownership
This is a bright, breezy take on a dictatoship and a reason to unsubscribe.
Do they not have free and fair elections?
@@polysee According to the economists Economic index not a proper democracy "Singapore Is considered Flawed democracy With an overall score of 6.18" Just below Moldova and just above Sri Lanka. en.wikipedia.org/wiki/The_Economist_Democracy_Index
I'm always curious what think tanks he's inspired by there's definitely a open up the hounds of free market capitalism and let that guiding hand all up in there. An interesting thing he's deliberately neglected is Singapore tryed a completely open Market health care system and it was an absolute disaster so the government was forced to intervene. A great video own Singapore's health care system ruclips.net/video/WtuXrrEZsAg/видео.html
@@polysee”free and fair” is subjective. The USA describes their election as “free and fair” but it’s never working class people winning, is it? Only one I can think of is Truman.
They have free and fair elections but the who can run in those elections and how they allocate seats in the parliament are weighted towards the ruling party. Also, they scored very poorly on media freedom. All the main media organisations are owned or funded direct by the Government.
Very interesting
Such a complex topic tbf
I'm American attending University in Northern Ireland, when I talk to people my age here, they're way more likely to mention healthcare and housing as reasons for or against integration with the Republic compared to allegiance to religion or ethnicity.
Interesting, thanks
The age of Freebee is over, in the Rep of Ireland our Health System Works for us....What do they have in N.I. a very broken system that is collapsing because they want everything free, good luck getting that gig in the future, as for the Doctor who went to N.Z. because of overcrowding in a Hospital in 1922....I hope you do not miss family or culture when you are older and so far from Home......P.S as I write this...... there are mass Demonstrations in Sydney by Health staff because of low pay....
No but we could learn from its justice system
Problem is Sláintecare was a cross party initiative...no ones ever going to back away from it now
Eventually the evidence will become overwhelming I think - but yes - I don’t expect things to change anytime soon
Singapore has lots of good ideas. Its not Shangri-la, but pragmatic.
IRL must get away from.following the UK lead kn major social issues like health care. Laudable as the British idea of tbe NHS is, it isn't working, and will bankrupt the state in time. The idea of personal health, retirement accounts, higher ed as well makes 100% sense. It works, for most in employment. It won't work for the chronic unemployment though, as you need to feed the garden, fkr decades. There will need to be a two tier system, with basic provision for those disabled in particular. Scroungers are inevitable here, but they can be weeded out.
Re. 'identity matters', Irish people are more concerned with the economy and less concerned with identity, in my experience. Plus the Irish-born children of economic migrants who will be voting on a future Irish unity referendum may be less interested in the historic struggle for national identity as they have no personal connection to it. Many of my son's college friends with foreign parents have told him they plan to leave Ireland after college as they think their future prospects are better elsewhere. A Polish friend on his engineering course told him he feels sorry for him as he has relatives in Poland and knows the language and the country which makes it easy for him to move there after his degree
This type of content would be appreciated on linkedin too i feel. Do you have a page?
Really good video. As a British person, i despair at the cult around the NHS and wish we could follow the likes of Singapore to a system that provides better care through economic incentives.
Thank you!
This video was basically just for unification lmao
Singapore is a beautiful country, but the bad thing is their dictator government.😢
exactly
Does it not have free and fair elections?
@@polysee they have elections, like putin or orban LOL
Just because 1 party has won every single General Election since independence in the end of the 1960s, that does not mean that they are a "dictatorship". The US has effectively been ruled by 2 major parties (Republicans, and Democrats) since independence in 1776, but no one (except Libertarians, and Anarcho-Capitalists, but they make up only ~3% of US legal Electorate) call the US a "dictatorship".
But they do have free elections, albeit probably not very fair when the rules change so often; It's unlikely that they have Electoral Fraud in SG due to photo ID requirements to vote (I do not live in Singapore, so take as a pinch of salt, based on quick search result).
@@wclifton968gameplaystutorials the US has open primaries so no, it hasnt been ruled by "just" two parties. Literally Republican elites hated Trump in '16 and wanted Jeb Bush or Rubio to be nominees, but Trump won, for example: candidates are also chosen by the people, not the party, down the ballot, with the Squad (AOC, Ihlan Omar) winning against established democrats in the '18 midterms
Tá iomaíocht réalaíoch in áit atá chomh mór le Contae an Lú, ach má tá tú amuigh i gConnacht ní bheidh trí nó ceithre ospidéal thimpeall ort chun go mbeifeá ábalta an ceann is saoire a roghnú. Níl a fhios agam cad é an saghas margaidh a bheadh ann.
Agus an bhfuil fianaise ann gur fadhb suntasach é overconsumption in Éirinn? Nuair a smaoiním ar an Roinn Timpiste is Éigeandála i Luimneach ná ar na liostaí feithimh d'obráidí droime ní fheicim an bhaint atá ag overconsumption leis. Tuigim an ról a bheadh ag overconsumption ag leibhéal an Dochtúra Teaghlaigh, is é sin go rachadh daoine isteach chun comhairle a lorg ar eagla na heagla - ach níl a fhios agam cé atá suite istigh in ospidéal nach gá dó a bheith ann
Thanks. We acknowledge that point on lower population densities and say that public hospitals would likely stay publicly owned, but they could be given more autonomy
@@polyseea hospital can function as a campus with numerous locations. It can have branches across the West. If there is a private system & publicly funded versions
@@LeMerchI don't see how that would help. I agree with more autonomy for healthcare providers but if you're not careful you would end up with a system like in the US where big corporations make a lot of money and only treat those who can afford to pay.
In the end healthcare services are either paid for through taxation or by the individual. The problem is, as many who have private healthcare already claim, if there is only private healthcare people would want to pay less tax because they now aren't being provided a service they were previously getting through their taxes, which in the end means that if you have a low salary you probably wouldn't be able to afford to go to see your GP, something serious doesn't get picked up early on, you get sicker, and by the time it gets diagnosed you need expensive scans and operations costing you even more money you can't afford, or it has to be picked up by the remaining public service, which raises the question why you changed the system in the first place.
This video seems to be wanting to create a system to create millionaires, but that money has to come from somewhere, you don't just magic it out of thin air, so it would be coming out of money that would otherwise be spent on healthcare and probably still heavily subsidized by the public purse, nice money if you can get it
By the time there's a referendum on reunification, health care won't be an issue. The new UK labour government will bring in so much means testing that the NHS will look just like the HSE without the high Irish pay. The only strategic bribe that would work is to offer Belfast civil servants the same high pay as Irish civil servants in Dublin.
Maybe yes, but means testing in the NHS would be a major political challenge for any political party
If you think the NHS will be worse under Labour than the Tories, you need to get your head checked.
What started off as interesting and valid takes on empowering local government these guys have since been sliding more and more bizarre takes on expanding neo lib policy which landed us where we are in the first place.
What do you mean by neoliberalism? Nobody ever defines that word, it seems to be a catchall pejorative used to shut down discussion. Do you have other data disputing the findings that UHI performs better than tax funded systems?
What about the 350,000 Malaysians who commute to Singapore?
As Irish man down south. I'd leave them crowd up North with Brits. They only cost country money.
There are very few countries in the world that the health care works for the working class. All countries should look to copy working health policies.
As for the United Ireland, why does there need to be one? If ROI are doing well then why do they want/ need the North and vice versa?
If there was a united ireland under their own steam, it would be the first time it was a united island. As it's never been under one banner but a collective clans.
As for the issues that concern NI people voting for a united ireland, there is a lot that would need to discussed:
Defence security
Language
Education
Health
Infrastructure
Energy
Social services
Pensions
Flag
National anthem
This is by no means a full list, but as you can see, some will be around cost, changes to national identity (both sides), and quality of life.
People don't like change and uncertainty. People from all nations have politicians that promise x but deliver y and surely that would be the same for this matter.
So again, my question, aside from blind pride, is why should an all Ireland be discussed? Why risk a 2nd round of the Troubles?
I'm a middle aged family man and open for a good open mind discussion. As I know there will be pros and cons to each side of the argument.
1922 was the time N.I. should have joined with the rest of Ireland, now Ireland is not interested in the spoilt brat, it needs to learn many lessons now the Empire is over and bankrupted....real will take another 15 years.......
You spelt FLEG wrong.
No way should we be taking advice from Americans on health care. $70 for an inhaler I’d personally would have struggled as a child if this were the case. No thanks keep us style insurance of of medical care please. The Canadian model looks good to me.
And their queues?
@@polysee better on a trolly than wheeled out of a hospital and dumped for lack of insurance coverage.
The first thing a free state government would do in a united Ireland is close daisy hill hospital, Downpatrick hospital, Dungannon hospital, antrim hospital and erne hospital. What would happen to these empty buildings? Filled with unvetted migrants
You're right about British attitudes though. I always found it when talking to friends and family who live there. Its sacrosanct and can do no wrong. Any problem? Just not enough money of course. I always found it funny when talking to an aunt of mine over there when she'd complain that "we should do X like in Germany or Switzerland" and then rant on about private companies in healthcare. You cant have a rational discussion on this sadly and so in the event of a united Ireland the people up there will just have to put up and shut up. If they dont want it then they can always vote no. Let us focus on making the best system for Ireland
Thanks for that
Cheers Polysee. God bless
Anytime you give away for free something that costs money you will get waste. It doesn’t matter if it is plastic bags, water, drugs or free travel. There should be nothing for nothing.
so people without money for life saving healthcare should die?
But healthcare isn't free, it's paid for through taxes. If you charge for people to go to see their GP many of those who could be treated fairly cheaply just don't go, like in the US, and then health outcomes get worse, treatments get more expensive, and you either have more people dying or it's more expensive to stop them from doing so.
One thing that might be useful is people get a yearly report on what their healthcare costs to provide it to them on a personal basis. Maybe it could just be available on an online system that gets added each time you use a service. I'm not really sure if this would deter anyone though, but are we really saying you want to deter people? I mean you go to see the doctor because you're sick and because you're not a doctor you want to be assessed by one in case it is something serious. We already get triaged by the GP surgery as to whether our symptoms are serious enough to be seen by a doctor anyway so I think those turning up every other day are a thing of the past in most cases.
I have a problem with the whole premise of this video though, which basically says let the market decide and then wheels on an American "expert" from the one country that had failed at affordable healthcare, whilst big healthcare corporations make billions from overpriced services that bankrupt a lot of people.
@@mattpotter8725 if you are not charged at the point of use it is seen as free. The video is advocating for a Singaporean style system which has better outcomes and costs less to run. It is not advocating for the US system which is expensive with poor outcomes. Just like water & free travel, Healthcare should be heavily subsidized but not free as those leads to excessive waste and is ultimately unsustainable.
@paddieland I do get where you're coming from and my Irish grandpa, who passed earlier this year at the age of 104 who came to the UK during the war, had the attitude that he'd paid into the system all his working life so was entitled to everything, but I don't think he ever overused the system, he accessed it when he needed it, when he had problems he thought were serious or potentially serious.
I'm the same so even though you're right you don't have to pay in the same way you would if you were buying a new car or a new TV, I think you're aware, especially now with healthcare the way it is, that you should only use the system when you really need it, that's been drilled into us for years now.
I also get what you're saying about having a system where you pay into an individual health insurance pot (that's topped up by the government depending on your income) sounds great, but you know what this does, it means that instead of progressive taxes where when you earn over a certain income the money over that tax band gets increasingly higher, so now money is collected from those with the most money, money is now equally paid into your individual healthcare pot whether you are a road sweeper or a billionaire (I get this is slightly exaggerating things because billionaires will go private anyway, but the point stands for those below this threshold of being asked to go private).
Surely if this system was introduced you would expect tax cuts to be able to afford to pay for the individual healthcare you would now have to self fund. So the government now would get less money in taxes, especially from the wealthy who aren't using the system anyway (and I get some make the argument that if you're not using something then why should you be paying for it, but without this principle the rich, who are generally more healthy, get richer, and the poor get poorer, just like in Victorian times).
Putting all this aside to me this is just semantics, it just shifts who is paying and when. I'm not sure how this at all affects the healthcare provider, whether public or private, that's a completely separate issue in my opinion. If you want true competition then there would have to be a way of having new innovative entrants to the market to make sure competition is high and prices as low as possible and I just don't see how this is possible.
GP surgeries here in the UK are privately run businesses that are contracted by the government to provide a service. It's very difficult to shop around and change from one to another unless you move where you're living because it's just not viable for a new surgery to open up just down the road because it could never gain enough of a patient base to make it viable, plus it creates slack in the system, it would most likely make both businesses not viable concerns. I'd love to be able to switch but there is no option. The same would be true at the hospital level where startup costs would be even higher.
I'm not totally across the demographics of Singapore but economically they have huge wealth mainly from where they are geographically situated as it is on the Strait of Malacca where a huge portion of goal trade passes through. I suspect it has a younger population than either the UK or Ireland and so demand on healthcare isn't as high and it is probably healthier as well with its population eating healthier diets whilst exercising more, but some of this is a bit of a guess. The main problem we have in a lot of Western countries is that we have aging populations due to the baby boomer generation born just after WWII. This is what is causing the problem and putting increased demands on healthcare without any extra money coming in through taxes.
@@mattpotter8725 your grand dad is the exception rather than the rule. People with long term illness get free medication when some of these people pass away there is refuse sacks of medication that need to get destroyed this doesn’t happen when the medication isn’t free. Over half the tests carried out are also needless. The children’s hospital is being designed on the fly with zero foresight. This is all just pure waste of money. I’m happy enough with the taxes we pay but for the cost our health system should be so much better. This video shows us a better way. Willful waste makes woeful want and there is willful waste everywhere you turn in the HSE.
Another fantastic, well researched video. The stats are clear which system works best. Let's hope our politicians listen.
Cosmetic surgery is not healthcare!!
Like eye laser surgery, it is similar to elective procedures in that it is a non urgent procedure on the body. It is marked by price and quality competition.
1. Terrible clickbaity title that is essentially a privatisation lesson from a right wing yank. A nursing colleague of my sister in law (in Florida) got fired from the hospital she worked for because she was taking too many days off to get chemotherapy, and without the income she couldn't afford the drugs, so she died. I suggest Goodman look at the inequities of American healthcare before preaching to everyone else.
2. The entire premise of the title and the end of your video is that we're somehow desperate to get NI to unite with us. We removed articles 2 and 3 of the constitution to move on from the old republican propaganda of the previous 80 years. We can certainly be open to a shared island without dealing with the fall out of a shared Ireland. Indeed, NI is as, if not more sectarian than ever, with well in excess of 100 "peacewalls" compared to about 20 at the time of the GFA. Plus it's an economic basket case.
3. I love visiting Singapore but I doubt you would EVER get as ordered a society here, to match them, to allow us to make big policy shifts. You wouldn't last long in government, the healthcare unions would tear you down.
4. The size of Singapore is not much bigger than Cork to Bandon to Kinsale to Cork, with 20 Acute Hospitals in that footprint. This just isn't a realistic comparison. Also the dutch always complain about the cost of their model of healthcare.
The title is admittedly a bit clickbaity; it’s primarily a video about healthcare. Any thoughts on the substantive issue of UHI vs state funded systems? Specifically how many fewer Irish people would die each year if we had Dutch outcomes? Never mind Swiss outcomes. Just because Goodman is American it seems harsh to hold him accountable for the shortcomings of the US system, without giving him any credit for healthcare savings accounts - and therefore Singapore’s success. You have a strong negative reaction to markets, but you have little to say about waiting lists or poor outcomes in IE/UK vs European UHI systems - forget America. As for comparisons to Singapore, we mention public hospitals would likely remain due to lower population densities. To say you can’t compare X to us because of Y seems limiting - one always can and should compare one’s country to the best in the world, not necessarily copy them. This video just seeks to offer an alternative to Sláintecare groupthink
You put this idea across very well. This would work in Ireland.
I hope Irish politicians are listening to you!
They need to hire these guys as consultants
wont see much british identity walking around belfast city center..,
This channel has really deteriorated into cheap neoliberalism
Why do you never mention British governments relentless defunding of NHS with a view to privatisation?
The NHS has underperformed continental UHI systems for decades
Maith thú!
Tiocfaidh ar lá 🎉
Free Market healthcare is an idea that needs to expand globally.
It's been well known for decades among non-Communist and non-Keynsian economists, that free-er economies are richer ones, and that the most economically free country in each region, is also the richest country in that region (e.g. Botswana is the Free-est & richest country in Southern Africa).
As for healthcare, before the socialisation of healthcare, Welfare, and other social services in Western countries, such as in the UK, rich people would fund/subsidise healthcare through hospitals, or living costs in terms of housing for poor and/or elderly people through almshouses (many still exist in England), but due to government, rich men no longer feel insecure about not helping poor people anymore, and too many people are reliant on the state, with costs soaring, and no competition in services where technology is consistently improving over time (e.g. Healthcare, Transport).
Did not realise that Polysee was being run by Irish Free-Market "Libertarians" LOL.
Ha I don’t think we’d sign on the dotted line of libertarian, some sectors like energy we probably need more state involvement. But in healthcare, the death march to the Beveridge model needs to be seriously questioned, based on the evidence from around Europe
Are you seriously trying to suggest that the 19th century healthcare model (even allowing for technology) had better outcomes than socialised healthcare because of almshouses and charity from the super-rich? LOL! The rich help the poor a lot more today than they did in the 19th century... because it's not a choice for them anymore. If this utopia existed as you say then the NHS would never have been created.
@@polysee based on the cherry picked evidence*. I guess the Singaporean example is not valid anymore when it tells you that public housing is the solution for the housing problem, though.
@@asier_getxo Very good point on housing. Singapore is an outlier in so many ways that simple comparisons are very problematic
@@asier_getxo Too right. We're a country with a housing problem first and foremost, and the Singaporean example shows a solution and proves that 'common good' should be placed above 'right to perpetually hold or alienate property' in Article 43 of our constitution.
32 Eiré 🇮🇪🇮🇪🇮🇪🇮🇪
This was a wonderful watch, thanks @Polysee . It's so great to see content that is specific to Ireland, particularly with unification in mind.
Very interesting. Having been to Singapore I was amazed at how well things ran. The benefits of having the same government for decades, but also planning and good ol' common sense, something the Irish government seem remarkably short of on occasion.
PS : I'd love to see a video about the government institutions that have been setup to plan for unification, their progress, considerations and what other groups (eg: civic forums) would be beneficial in planning.