PPRuNe Forums - View Single Post - A somewhat misleading headline from the, Telegraph...
Old 6th Jan 2015, 11:24
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Not_a_boffin
 
Join Date: Apr 2006
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Sorry to hear you've been unwell, glad to hear you're getting treatment.

However - chucking brickbats about Tory links to insurance companies is a slogan not a solution. UK Government spending is currently of the order of £720Bn or so, or which around £140Bn is spent on the NHS (plus £31Bn on "social care"), according to the Grauniad, albeit with 2013 budget figures.

Budget 2013: the government's spending and income visualised | News | The Guardian

There's nearly £100Bn on education and well over £200Bn on welfare, which includes pensions, another demand-led expense. That's a total of about £450Bn (63% of all spending) on those three departments. All parties are guaranteeing to ring-fence at least two of those.

The "income" from tax etc is £612Bn. That's a gap between spend and income of over £100Bn - the deficit - which incurs an interest payment of £51Bn pa to service.

Now - what is incontrovertible is that people are living longer and that there are more people in the country both as a consequence of this and of immigration. That means the demand on the NHS is going to inexorably rise.

The ageing element of that population is also going to require proportionately more health services, not least because the expectation is that people can be cured or "fixed". Trouble is that some of those treatments are ever more expensive, which adds yet more cost. Whether they should be as expensive is a legitimate subject for debate - we've all had the conversation with the chemist that goes you could have these for X, but as it's on scrip, you'll have to pay Y. Blame "Big Pharma" if you're that way inclined, but don't then complain when they stop investing in new drugs if their shareholder returns are reduced. Then you've got dementia, where otherwise healthy folk need near constant care.

All of the above points to a significant increase in health care cost (and knock-on in pensions etc). It's inexorable. However, we already spend much more (>10%) than we bring in taxes etc. So where is that money coming from?

"Soak the rich" is the usual cry, but "the rich" are mobile (as evidenced by the French influx to the UK atm). "Soak the evil US corporations" is the next one, but they too are mobile and if they relocate, they take their jobs and the associated income tax with them. "Alright cut everything else then", is the last resort. Unfortunately "everything else" that is not ring-fenced is pretty much bottomed out in any case - DfID budget of £11Bn would stave off issues for a year or so - which means you've got two options.

1. Find alternative sources of funding
2. Limit treatment

Both the above could take numerous forms - don't have to be insurance -based, could actually penalise the likes of those who call ambulances for a bad headache. It doesn't matter. What matters is that the debate is had and had properly. The current level of debate could be encapsulated as :
  • "Evil Tory cuts"
  • "Tax and spend labour"
  • "It could all be fixed if they just brought back Matrons".

None of which are helpful or will fix the problem.

Last edited by Not_a_boffin; 6th Jan 2015 at 11:55.
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