Texas freezes over (while Ted Cruz flies to Cancún)

[Richard Hakluyt]

Native-Brits are literally born into the system. You get your NHS number assigned more or less from birth and are registered at your parent(s)'s GP. When you move you change GP and your records follow. Your GP will correspond with specialists at hospitals, clinics and so on if you get specialist treatment. You tend to get asked simple security questions at various points; the pharmacist asks me for the first line of my address when I pick up drugs for example.

[crazy canuck]

Native-Brits are literally born into the system. You get your NHS number assigned more or less from birth and are registered at your parent(s)'s GP. When you move you change GP and your records follow. Your GP will correspond with specialists at hospitals, clinics and so on if you get specialist treatment. You tend to get asked simple security questions at various points; the pharmacist asks me for the first line of my address when I pick up drugs for example.

Yeah, that is the efficiency of a Unitary system.  You never really have to worry about where in the country you are, your one number follows you and so it seems like you don't even have or need one.

In Canada, where the provinces administer health care, it is a bit more involved as each province wants to makes sure it is only paying the costs of its residence.  As a result, typically when we go to a new health care provider, we present our health card and that is recorded.  But we don't need to present it after the initial visit.

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.

[Valmy]

Aaah, the joys of an unleashed and unregulated energy market.

Needless to say nobody is going to paying those bills. No regulations and the power of the free market all sound great until the mobs with torches show up.

And of course only a tiny percentage of rate payers have variable rates like that. I cannot imagine how you would win much, the prices always go way up in the summer, right when your usage would go up.

[The Larch]

Aaah, the joys of an unleashed and unregulated energy market.

Needless to say nobody is going to paying those bills. No regulations and the power of the free market all sound great until the mobs with torches show up.

And of course only a tiny percentage of rate payers have variable rates like that. I cannot imagine how you would win much, the prices always go way up in the summer, right when your usage would go up.

Let's say that mobs with torches are an inherent, indirect regulator of the market that is always part of the equation. 

So will those bills be voided? Recalculated? A top prize established?

[Valmy]

Let's say that mobs with torches are an inherent, indirect regulator of the market that is always part of the equation. 

So will those bills be voided? Recalculated? A top prize established?

I suspect recalculated to an earlier rate.

[The Larch]

Let's say that mobs with torches are an inherent, indirect regulator of the market that is always part of the equation. 

So will those bills be voided? Recalculated? A top prize established?

I suspect recalculated to an earlier rate.

Do you think that this will make Texan authorities change the way they've been letting the energy market be controlled by the private sector? Or increase regulations regarding maintenance and winter-proofing, and the like?

[DGuller]

I cannot imagine how you would win much, the prices always go way up in the summer, right when your usage would go up.

I think having variable rates makes a lot of sense, logically, but you do need some limits to handle corner cases like natural disasters, and there has to be transparency (or the whole point is lost).  Having variable rates would encourage people to use energy in a counter-cyclical manner, which would lower the need for capacity in the network. 

It would also reward people who can handle it for not blasting their AC as much during the summer.  If you're the person who can tolerate the heat well, or you have a house that naturally keeps cool in the summer, you can probably benefit from fair variable rate pricing.  You'll also have some incentives to make sure that your house can keep cool without AC.

[Valmy]

Let's say that mobs with torches are an inherent, indirect regulator of the market that is always part of the equation. 

So will those bills be voided? Recalculated? A top prize established?

I suspect recalculated to an earlier rate.

Do you think that this will make Texan authorities change the way they've been letting the energy market be controlled by the private sector? Or increase regulations regarding maintenance and winter-proofing, and the like?

The two places that have done this with regards to the energy market are California and us (we basically copied them with a few additional rules to correct some problems that had been having). And I suppose people have noticed we are the two states that seem to have energy problems, thus the continued existence of centrally planned communist energy systems in most of the rest of the states.

But I suspect some adjustments will be made, new rules (we don't call them regulations, they are RULES...even though that is the same damn thing but it plays better) will be introduced and basically we will try to make the current system work.

[Valmy]

I cannot imagine how you would win much, the prices always go way up in the summer, right when your usage would go up.

I think having variable rates makes a lot of sense, logically, but you do need some limits to handle corner cases like natural disasters, and there has to be transparency (or the whole point is lost).  Having variable rates would encourage people to use energy in a counter-cyclical manner, which would lower the need for capacity in the network. 

It would also reward people who can handle it for not blasting their AC as much during the summer.  If you're the person who can tolerate the heat well, or you have a house that naturally keeps cool in the summer, you can probably benefit from fair variable rate pricing.  You'll also have some incentives to make sure that your house can keep cool without AC.

Well in any case only a tiny number of customers even have the option.

[Caliga]

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.

[Sheilbh]

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).

[Admiral Yi]

Can people from visa waiver countries sail in, ring up big medical bills, and walk away?

[Sheilbh]

Can people from visa waiver countries sail in, ring up big medical bills, and walk away?

I don't think so. So if you're moving to the UK there is a surcharge of £4-650 a year for the NHS for the duration of your visa.

But if you're just a visitor/tourist from the US, say, who gets loads of NHS treatment then, as mentioned, the hospital will take your details and bill you for it at a rate of 150% NHS rates (so the rate the NHS internally mark the treatment as costing). That's still probably lower than the cost of treatment in the US based on the bills I've heard about.

However there are exemptions and no-one is charged for A&E, family planning, sexual health, treatment relating to genital mutilation or covid (testing, treatment or vaccination - though you'd need to be registered with the NHS for that).

[Admiral Yi]

I don't think so. So if you're moving to the UK there is a surcharge of £4-650 a year for the NHS for the duration of your visa.

But if you're just a visitor/tourist from the US, say, who gets loads of NHS treatment then, as mentioned, the hospital will take your details and bill you for it at a rate of 150% NHS rates (so the rate the NHS internally mark the treatment as costing). That's still probably lower than the cost of treatment in the US based on the bills I've heard about.

However there are exemptions and no-one is charged for A&E, family planning, sexual health, treatment relating to genital mutilation or covid (testing, treatment or vaccination - though you'd need to be registered with the NHS for that).

OK, but let's say I travel to You Kay, get run over by the Grenadier Guards, and tell the NHS that I'm you?  Maybe slip you a fiver for the trouble.

[Sheilbh]

OK, but let's say I travel to You Kay, get run over by the Grenadier Guards, and tell the NHS that I'm you?  Maybe slip you a fiver for the trouble.

If you get run over that's A&E (accidents and emergency) - you don't have to pay unless you're admitted into hospital for an overnight stay.

But in principle there's nothing to stop you saying that you're me. They may notice some differences between us though.