Texas freezes over (while Ted Cruz flies to Cancún)

[Caliga]

But you don't need any form of ID to access it. When I go for an appointment I have to provide month and day of birth and my surname. I suppose there is a fraud risk - but I don't really know what anyone would get out of it given that they could get their own free treatment if they wanted.

Like Yi is saying, the financial risk would be that people who aren't entitled to NHS services could pretty easily steal them, from the sounds of it.  If you don't mind funding the services of people who aren't entitled to them, then that's on you all collectively as UK taxpayers.

Keep in mind that I think your system, and systems like it, are great and I wish we had one here, but were we to have one here I'd want to be sure it was being used appropriately.

Also, please don't take my comments to mean that I think healthcare should be denied to illegal immigrants, because I don't think that at all.  I think access to healthcare should be treated as a basic human right.  But if, say, we had such a system here and 2 million people were coming here for treatments yearly, I'd want to know that so I could try to determine why.

[Sheilbh]

The basic principle of the NHS isn't based on entitlement or not. It's that it is available free at the point of (medical) need. It's not like other bits of the welfare state where there normally is an element of entitlement or eligibility or not. That's why, for example, you are not required to show your immigration status to register with a GP. I think that aspect is a fairly key difference with the social insurance models in much of Europe (which I quite like).

My understanding is that the NHS works a little bit like tax and it's mainly based on residency - so if you're in the UK for 183 days in a year then you are considered resident for the purposes of paying tax and the NHS (which makes sense given how the NHS is funded).

There are scare stories of health tourism been scare stories of NHS health tourism. From studies it's pretty small - so £1-300 million is the estimated cost from people coming to the UK for treatment, there's also £1.8 billion on people who are visiting the UK and require treatment (I imagine mainly in A&E). They are big numbers but the NHS budget is about £150 billion so it's not a huge issue and it is partially offset by recover of about £350-500 million from individuals and there's also money that the NHS recovers through the European Health Insurance Card.

[mongers]

Cal, what happens in the background is the physicians bill the government's medical plan using that number as the patient ID.  The patient never sees any of that because, they don't pay anything.

Yeah, I understand that nobody pays.  I am just surprised you don't have to present an ID, because even though I understand that the program is fully government-funded, I assume they are still expected to track services provided by patient, if for no other reason than to be able to track comprehensive plans of care for each resident.

Cal I'm gonna guess your job or a job you used to do in part involved that function, which is perhaps why you're finding it so hard to comprehend that we don't really have 'Cals' over here.

[Richard Hakluyt]

The principal guardian against fraud by medical tourists would almost certainly be the GP. In order to access expensive medical care at hospitals one would need a letter of referral from him/her. The problem for the potential fraudster is that the GP will have met most of their patients, he/she will be especially familiar with patients with complex and expensive medical needs.

The NHS counter fraud authority reckons that health tourism fraud is only £35m a year https://cfa.nhs.uk/fraud-prevention/reference-guide/nhscfa-thematic-fraud-areas/fraudulent-access-to-NHS-care . Which is simply not big enough to justify heavy-handed checks on all patients.

I reckon that a better way to cheat the NHS is to supply them with faulty goods and services; for more details on that contact your nearest tory MP 

[Richard Hakluyt]

One way, perhaps the main way, would be for a Brit to move to a foreign country and not inform the NHS. So, for example, I could retire to Florida and skimp on my medical insurance; then, if a costly illness occurred, fly straight back to the UK and claim that I had never left. Yes, i can see that working.

[crazy canuck]

Cal, what happens in the background is the physicians bill the government's medical plan using that number as the patient ID.  The patient never sees any of that because, they don't pay anything.

Yeah, I understand that nobody pays.  I am just surprised you don't have to present an ID, because even though I understand that the program is fully government-funded, I assume they are still expected to track services provided by patient, if for no other reason than to be able to track comprehensive plans of care for each resident.

Indeed, and as I and others noted above, it is an individual's medical health number that is used to track services provided to an individual patient.

As an aside, one of the big benefits of that is it provides a treasure trove of data for medical researchers assessing the benefits/risks of various treatments.

[crazy canuck]

Yeah, I understand that nobody pays.  I am just surprised you don't have to present an ID, because even though I understand that the program is fully government-funded, I assume they are still expected to track services provided by patient, if for no other reason than to be able to track comprehensive plans of care for each resident.

So they have medical records - from my understanding the NHS' patient records is the gold mine for health research because it's single records, from a single provider for almost an entire country. Edit: And as RH says normally across people's entire lifetime - I certainly know Google have a lot of interest in working with the NHS on analysing their data which has, so far, been largely resisted (thank God).

But you don't need any form of ID to access it. When I go for an appointment I have to provide month and day of birth and my surname. I suppose there is a fraud risk - but I don't really know what anyone would get out of it given that they could get their own free treatment if they wanted.

In terms of government services I've accessed I don't think I've ever had to show ID. I've no doubt that's probably less likely to be the case especially if you're a minority given May's time as Home Secretary and the hostile environment.

Also relevant is that we don't have a national ID that people have so there are people with no form of ID and, in this country, they are disproportionately the elderly who are probably likely to use quite a lot of government services: pensions, NHS, free bus pass etc. So any ID requirement would discriminate against the elderly (unless there's a mandatory, free ID card).

I think you and Cal are talking past eachother.  He is wondering how a patient is identified.  Their individual medical plan number is the identifier.  You are talking about confirmation that you are who you claim you are, which is a separate issue.

[Grey Fox]

I think Cal is asking both.

[crazy canuck]

I think Cal is asking both.

Then he got an answer to both 

[Caliga]

I was, and I did.  Thanks guys.

[mongers]

...snip....

I reckon that a better way to cheat the NHS is to supply them with faulty goods and services; for more details on that contact your nearest tory MP 

I entirely agree.

[HVC]

I guess it makes sense that the power companies couldn't handle the cold, but now they can't handle the heat either. Isn't that what Texas is know for?

[Valmy]

I guess it makes sense that the power companies couldn't handle the cold, but now they can't handle the heat either. Isn't that what Texas is know for?

Struggling during peak summer heat is normal, happens all the time. Just now people are paying more attention.

[HVC]

Non peak power consumption doesn't justify investing in greater capacity, or is there another issue?  GF and Viper have plenty to sell you. Open your grid

[Valmy]

Non peak power consumption doesn't justify investing in greater capacity, or is there another issue?  GF and Viper have plenty to sell you. Open your grid

Rapidly growing load mostly. Every summer is an adventure. The winter is usually the easy part.