Funding health care in England - Has the case been made for changing the NHS model?
25 September 2023
Clarke was at pains to state that he was not converted to the idea, and that either proposition would require much research before implementation.3 Which somewhat illustrates the point that what the advocates of new charges, or of a switch to social insurance, have yet to do is spell out just what such a move would involve – and how far, if at all, it would meet the challenges facing the NHS. [...] In the US, which among developed countries relies the most heavily on private health insurance, half of all expenditure is in fact tax-funded through Medicare (the system for the elderly), Medicaid (for the poor) and the Veterans Benefits Administration (for former members of the armed forces). [...] And when the tax relief was abolished in 1997, the Institute for Fiscal Studies calculated that the Treasury saved more from its abolition – £135 million – than the likely extra NHS costs of treating those who gave up their private cover.12 More recently, in 2018, there was a flurry of interest, led by a group of Conservative MPs, in switching the funding of the NHS to National Insurance – using t. [...] Full hypothecation – switching the whole of NHS spending to a modified form of National Insurance, for example – would mean that in any given year, chiefly depending on the state of the economy, the tax would raise either more or less than was judged 5 FUNDING HEALTH CARE IN ENGLAND necessary to be spent on the service. [...] He is also the author of The Five Giants: A Biography of the Welfare State, and an honorary fellow of the Royal College of Physicians.