Reforming the NHS

I\’m not sure about the way that Dan Roberts seems to admire the Massachusetts health care plans: reading the US blogs it seems to be a wildly expensive and bureacratic approach. Still, on the matter of reforming the NHS he says:

The trick is to tap into that desire for self-improvement while making sure everyone gets a decent minimum standard of care for real illnesses.

Indeed: after the basic point that there\’s absolutely no good reason why the State should both pay for and actually provide the health care services, the latter can be better done by private enterprises, what we want is to try and harness the desire of some people to spend more upon their health and allow them to do so.

This means allowing them to top up their NHS treatment, instead of the at present system whereby if you try to do so you lose the NHS treatment you\’ve already paid for through the tax you\’ve paid.



5 thoughts on “Reforming the NHS”

  1. I agree with you that the state is a bad provider but it is also a awful buyer as well. The tax payer should only pay for the healthcare for the poor and uninsurable.

    Tim adds: I go a stage futher, differentiating between health insurance and health assurance. Scraping you up off the road, treating some vicious cancer, these are insurance issues where the (to my mind) correct risk pool is the entire population. Assurance is things like Viagra, a knee joint, vaccinations (althougth there’s a public health influence with that last), where the correct risk pool is probably the individual.

  2. “I agree with you that the state is a bad provider but it is also a awful buyer as well.”

    You could create lifetime health accounts, that the State co-pays into, and can be used to cover illnesses. As Tim says, some of the rare-but-huge eventualities can be covered from population-wide risk pool.

    With an individual in control of their own budget they will seek value for money far more effectively than the State. And I’m sure that the healthcare industry would respond as effectively as any other industry does. There will be pockets of shite, for sure (after all, British Gas still exists), but with the current NHS we can only talk about pockets of excellence..

  3. Find the cost of insuring a healthy person for both sexes and all ages and subsidise up to that level.

    Anything more than that will be moral hazard.

  4. BlacquesJacquesShellacques

    Like the American candidate for governor said: “My health care plan is that you plan your own health care”.

    What is so hard about understanding that the government is incompetent at nearly everything?

  5. According to reports in American media, 46 million Americans have no insurance to cover healthcare costs and healthcare costs are the principal reason for personal bankruptcy in America.

    From OECD figures, it seems that America spends a larger percentage of GDP on healthcare than any other affluent, industrialised country. Curiously, despite that average life expectancy at birth is lower than in Britain – which is lower than in France and many other west European countries – and the infant mortality rate in America is lower than in any other OECD country except for Turkey and Mexico. And Bush is proposing to cut medicare costs in the recent budget he put to Congress in order to pay for the tax cuts he wants to make to stop the American economy sliding into a recession.

    Seems to many observers that, on the evidence, Americans know fuck all about how to run a government but then, as someone wise once said, you can never underestimate the collective intelligence of the American electorate.

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