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September 14, 2007

A Little Convoluted, Surely?


The paper also included a plan to give people money to buy their own healthcare.

Why not just tax them less in the first place so that they can buy their own healthcare?

September 14, 2007 in Health Care | Permalink


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Because then you can't ensure it goes on healthcare, and also unless you find poll taxes to remove it's going to mean vastly differing amounts of money.

The CBI which you advocate usually has something set for healthcare provision - that was certainly in that American guy whose name I can't remember's plan.

Tim adds: Charles Murray.

Posted by: Matthew | Sep 14, 2007 9:52:25 AM

The headlines say the Lib Dems will charge drunks for treatment. They really must hate Charles Kennedy, eh?

Posted by: Mark Wadsworth | Sep 14, 2007 10:26:35 AM

"Because then you can't ensure it goes on healthcare"

Giving people choices on how to spend their money - unthinkable.

Posted by: Kit | Sep 14, 2007 10:30:24 AM

It's not unthinkable, is it, but Charles Murray is hardly a raving socialist, and as the government would have to pick up the tab if someone didn't have health insurance, then it makes sense.

Posted by: Matthew | Sep 14, 2007 10:48:46 AM

Why not the obvious and sensible course of comparing what provision is made for healthcare in other EU countries? In independent surveys, France is often rated as having the best national system of healthcare:

In America:

"Some 158 million people have health insurance through their employers. Sixty percent of companies offer health insurance to their employees, about the same as last year but down from 69 percent in 2000, the survey said.

"Nearly all companies with 50 or more employees offer coverage, with firms with more than 200 employees particularly stable over the years, Kaiser said. But only 45 percent of firms with three to nine employees offer health care, down from 57 percent in 2000."

Despite that, why are an increasing number of states in America making provision for universal healthcare for their residents?

The latest is California:

"Gov. Arnold Schwarzenegger on Monday proposed extending health care coverage to all of California's 36 million residents as part of a sweeping package of changes to the state's huge, troubled health care system.

"A total of 6.5 million people, one-fifth of the state's population, do not have health insurance, far more than in any other state. At least one million of the uninsured are illegal immigrants, state officials say.

"Under Mr. Schwarzenegger's plan, which requires the approval of the Legislature, California would become the fourth and by far the largest state to attempt near universal health coverage for its citizens. The other three states are Maine, Massachusetts and Vermont."

One possible - and understandable - reason why more states are making provision to fund universal healthcare for residents in response to electoral pressures is surely this:

" . . in 2004 about two million men, women and children were swept through the bankruptcy system in the fallout of a medical problem. Good educations, decent jobs, and health insurance were no guarantee that a person wouldn't be wiped out by an illness or accident. We believe the current policy debates are overlooking a critical problem: A broken health care finance system is bankrupting middle class America."

"A study published Wednesday in the policy journal Health Affairs found that approximately half of people in the US who file for bankruptcy cite medical costs as a significant reason for their financial troubles. Based on a survey of 1,771 personal bankruptcy filers, the researchers extrapolated that between 1.9 and 2.2 million people were driven into bankruptcy because of health care costs in 2001."

Posted by: Bob B | Sep 14, 2007 11:36:06 AM

"Despite that, why are an increasing number of states in America making provision for universal healthcare for their residents?"

Dead simple; so that people can vote for the politician who promises to give them some of other people's money, rather than the politician who wants them to spend their own money.

Posted by: Ian Bennett | Sep 14, 2007 12:15:33 PM

Better to leave the chronically sick to die in the gutters, eh?

Posted by: Bob B | Sep 14, 2007 12:19:02 PM

> Better to leave the chronically sick to die in the gutters, eh?

Don't talk about NHS waiting lists like that. I know NHS hospitals are as dirty as gutters but it's a bit rude.

Posted by: AntiCitizenOne | Sep 14, 2007 3:43:57 PM

"Don't talk about NHS waiting lists like that. I know NHS hospitals are as dirty as gutters but it's a bit rude"

The obvious and sensible recourse is to look around other west European countries to compare which have better national systems of healthcare:

If anyone cares to check back on my messaging, they won't find me extolling the wonders of the NHS. Years back, I was saying the NHS was a huge Stalinist system but it doesn't follow from the failings of the NHS that there is therefore no case for state schemes of social insurance to pay for personal healthcare services.

Try the seminal paper by Nobel laureate Kenneth Arrow: "Uncertainty and the Welfare Economics of Medical Care" AER 1963. Sadly, I cannot find an online link but this illuminates why Arrow's paper became a much-cited classic:

There are powerful reasons why competitive market solutions for healthcare lead to inefficient solutions. For a start, there are massive information asymmetries. Next, the administrative costs of private personal insurance cover is significantly higher than with employment or occupational schemes and even more so compared with state national schemes. Also, those with personal insurance who become chronically sick run out of cover and become uninsurable - do we just let them die in poverty? Universal risk pooling through national schemes minimises the overall risk of providing for healthcare.

What makes the NHS unusual is that it combines the features of a national scheme for social insurance to pay for personal healthcare services (as in France) with the features of a nationalised industry that has a near national monopoly in the supply of many healthcare services. We need to consider those two parts separately. The NHS goes around boasting that it is the largest single employer in weastern Europe - which is a clear indication that other large European countries (like Germany and France) haven't adopted the NHS as a model to emulate.

Posted by: Bob B | Sep 14, 2007 10:03:37 PM

Why not just tax them less in the first place so that they can buy their own healthcare?

In a word: "slavery"

The slaves now dependent upon the state's generosity might start getting ideas like "why do we need such a big government?"

And the slaves currently kept to administer the system would have to be let go. Once freed, many of them might start to question the state's right to meddle, as well.

Posted by: The Remittance Man | Sep 15, 2007 12:03:01 AM

This may come as a terrible shock here but the outcomes of the general elections in 2001 and 2005 don't suggest that the electorate overall is very impressed with promises of tax cuts. It rather looks as though most voters are apt to interpret the promise of tax cuts as meaning sweeping cuts in public spending and that worries them because they want better public services. It seems to me that a more persuasive line could be to show how the boost in public spending by New Labour has in fact lead to a great deal of waste of taxpayers' money, which is what the HoC Public Accounts select committee keeps saying.

As for the NHS, I think this piece by Nick Bosanquet, prof of health policy at Imperial College, makes a lot of sense:

Posted by: Bob B | Sep 15, 2007 1:00:13 AM