The NHS should not be the only option for the middle class

Guido is covering punch and counterpunch in a party political puppet show involving Cameron, Harriet Harman and Ed Milliband. Cameron is trying to make Labour look like a silly high-tax party (while not exactly promising to be a sensible low tax one). Harman, perhaps cleverly, seeks to justify progressive taxation and side step the argument thusly:

“But I would say Henry one of the things that I would argue that might, should probably make a really big difference to you is having a really good health service. Because you don’t want to have to pay for health insurance. You don’t want to have to pay to go private to get really good healthcare system. And I think that is not just for working class people it’s for middle class people as well.

We, as nerdy politicos, know that this is self-justifying, but Harman is wielding a powerful narrative. 80% of spending has nothing to do with health but as long as the NHS is the public’s only means of getting access to doctors then, due to the popularity of doctors, people like Harman have a club to beat down free-market reformers, reformers who might take away the affordable doctors because they are evil and hate you.

We could talk about how the Government makes private health care expensive by crowding out players from the largest market segments, and raises regulatory barriers to entry. We could talk about quality of care, the moral status of a system built on aggression, incentives and social breakdown etc but people will be “practical” and will want to keep the doctors, even even they are not as effective or not as cuddly as they could be.

This is why I’m going to keep on banging about the possibility of building a direct care system in the UK. GP’s are paid about £100 a year to look after a wide range of needs. I’d rather pay several times that value and stay well for longer, and get better quicker with the help of better more personal care. Not everyone will be able to make that choice, just as many aren’t able to afford gym memberships and nutritious food, but gyms and healthy food are everywhere available in great quality and quantity. GPs are not, it’s time we change that.


  1. At least private individual health cover should be tax deductible – one should not have to pay tax on income that one has used to pay for health cover for one’s self and family.

    Indeed this might well save the government (i.e. the taxpayers) money – as more people would take out private insurance policies, or join mutual aid fraternal societies.

    But no, even this is “too radical”.



  2. I am working on a ‘solution’ for some of the problems, and uncertainties, of insurance that lead people to stick with what they know in supporting state coersive health coverage. Write up should be due in September …



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