It appears as though the effective privatisation of the NHS in England is moving forward, at least according to this post on The Green Benches. Furthermore, it is claimed that the Chairman of the Health Select Committee (Stephen Dorrell) has predicted the end of the NHS providing healthcare that is free at the point of use. Essentially it seems likely that there will be certain procedures that the NHS will no will longer provide for free.
Here are my basic thoughts on the issue. Firstly, I think we simply aren’t spending enough in the UK on healthcare. We spend about 9-10% of GDP on healthcare, or something like $3500 (£2200) per person. Many similar countries spend between 11% and 12% of GDP on healthcare. There are some who spend a similar fraction of GDP, but spend more per capita. If we want to have a healthcare system similar to that of France, Germany, Switzerland, Holland, etc, we should be spending about 20% more than we are today. Equivalently, we should be spending about £500 more per person. Given what the NHS currently provides, it is actually quite impressive that it can do so for 20% less than many comparable countries.
The one solution is to simply invest more in the NHS. Given the current government’s view that reducing the deficit is the main priority, this is clearly not going to happen. They’re also going to keep telling us that the NHS is unaffordable because of our aging society and other social problems that are costing the NHS money. What I suspect that they will do is keep the public funding of the NHS at a minimum. This will allow the NHS to provide basic healthcare and some kind of emergency care. As I mentioned above, to have comparable spending to other similar countries will require spending about £500 per person more than we are today. Those who can afford it, could therefore top up their healthcare through some kind of insurance type scheme. Assuming that one-quarter of the families in the UK could afford to do this, this would add about £7.5 billion to healthcare spending in the UK, but it would only provide coverage for about 1/4 of the population. Everyone else would be left with basic and emergency coverage through the NHS.
A very scary prospect is full free-market, privatisation of the NHS. The only country that really has this kind of model is the USA where total healthcare spending is 20% of GDP, but only about 60% of the population is fully covered. This would essentially result in a healthcare system twice as expensive as we have now but only covering half the people currently covered. Not only would this be morally repugnant, it also doesn’t make economic sense. Who in their right mind would think it a good idea to change to something twice as expensive that only does half of what it did before.