This weekend’s edition of the Financial Times contains a letter that repeats a common, but erroneous argument levied against universal healthcare. Why insist that everyone receive the same standard of service, even those who able and willing to pay some portion of the higher standard of service they desire?
Sir, It is about time someone in an influential position raised the issue of other forms of revenue for National Health Service funding. I and many colleagues of mine who have lived and worked in The Netherlands and France are tired of hearing about the NHS funding problems, which continue to arise because of the ideological obsession of all our political parties with their belief that medical care must be free to everybody. This is no doubt because of their fear of losing votes if they suggest otherwise.
Those of us fortunate enough to enjoy a reasonable level of private income would be well prepared to contribute to this important service through, for example, GP attendance fees and top up private insurance arrangements as occurs in the Netherlands. It would not be difficult to determine an individual’s private income through the tax authorities and fix an appropriate level above which he or she must make some form of private contribution to the NHS.
Michael Speer, “Obsessed with idea that healthcare must be free“, letter to the editor, Financial Times, 14 November 2015 (metered paywall).
Britain’s National Health Service (NHS) is financed entirely with general government revenue. No-one is forced to use NHS, but if a taxpayer chooses to go to a private clinic or hospital, he or she must pay the entire expense out-of-pocket, either directly or by purchasing private insurance. This is the system that Mr Speer dislikes.
I was about to write a letter to the editor asking why, if people like Mr Speer are willing to contribute to the cost of their own medical care, they are not also willing to contribute to Her Majesty’s treasury in order to alleviate the chronic under-funding of the National Health Service?
I then saw that there was no need to draft a letter, for the Financial Times published the following response from another reader:
Sir, …. Are those people who are reluctant to pay more tax happy to pay into expensive private health insurance, their contributions covering not just healthcare costs but shareholder profits? Are they happy to discover that certain pre-existing conditions are excluded from cover? And if, taking all that into account, they feel better off than paying the extra taxes, are they really content to see the poor, unable to afford the insurances, appointment charges or other suggested costs, receiving only some basic treatment?
Peter Cave “Why is paying tax worse than paying premiums?“, Financial Times, 14 November 2015 (metered paywall).
I did not include the first part of Mr Cave’s letter, as his argument is clear without it. I would emphasize even more, however, the point that allowing the wealthy to pay top-ups for better treatment inevitably lowers standards for treatment of the poor. It is the interest of the poor that the wealthy not be excluded from Britain’s NHS nor (with the same reasoning) from government-funded schools.