Letter: Time to means test NHS treatment?
Saturday 3rd July 2010, 9:04AM BST.
Letter: With the current cuts taking place, two areas have been ring-fenced: the NHS along with foreign aid and development. Why?
We are told on a daily basis that the NHS is top heavy and always has been, and you do have to question the volume of administrative staff and wasted money, etc. It may also be time to take a long, hard look at the NHS and perhaps it may be time for a change.
We should actually start to look at charging people who can afford it.
For minor procedures it is time to means test people who use the NHS in the modern UK.
It is also very odd how when the UK is in such a financial crisis we still send millions in foreign aid and development abroad. Why? It is doubtful that much of the money actually gets to its final destination.
If we take a good look at the list of the countries who receive it, we have Pakistan — a country that has nuclear weapons but needs to put the begging bowl out for aid from the UK.
Cameron has also said in the big scheme of things that the amount of money that goes out in foreign aid is small so should continue.
Well, if the country is in the terrible financial situation that the Con-Dems tell us it is in, then any good saver will tell you to rebuild your nest egg.
You have to account for every single penny and ask yourself: “Do I really need to give away or spend that money and do the recipients who are asking me for money get it from other areas or can they get it from other areas?
“And, finally, can we afford to give it?”
If we can’t then we do not give until we can afford to.
Andrew Finch
Shrewsbury
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Means testing NHS treatment will leave the middle class in the same situation as they experienced when they tried to sign on as unemployed during the recession: slightly too much “capital” (i.e. money prudently saved for a rainy day), to qualify, not enough money to avoid suffering and they will be the ones who get caught in the trap.
In the same way as income support, NHS charging will see inequalities arise: health care a viable option only to those on benefits, (and an inducement not to come off them), and the rich.
Dentistry is a classic example of where this proposal would lead us. On a limited income which goes on council tax, mortgage and the other costs of living and working, (such as National Insurance contributions to pay for the NHS), I am judged ineligible for benefits, so I cannot afford to get the NHS treatment I need, so I opt for removal rather than repair of teeth.
Claimants who contribute ZERO to the system are entitled to the best treatment as they don’t pay for it.
This is an area of “fee at point of delivery” NHS treatment which has become too expensive for me; as I get older, I shudder to think what the situation would be if the idea was transposed onto the whole NHS.
Apart from more sophisticated treatments and higher expectations, a reason why the NHS is under-funded is the fact that a large majority of uses have never paid into the system. Benefits claimants and non-workers don’t pay NI, but have the same rights as those who currently do.
Even “socialist” countries such as France and Greece, (etc, etc), don’t allow this. In broad terms, treatment is based on contributions. Two years after your last contribution to the health care system and the unlimited free treatment stops, to be replaced by emergency care which treats genuine emergencies only, not the routine things like sore throats and tattoo removal. From the day you return to work and contribute your NI, you get back into the broad treatment category. As a consequence, no-one dies, but everyone values the system. More importantly, they don’t take it for granted, as is the tendency in the UK.
I agree with the comment on foreign aid being stopped being given to countries who don’t need it. In addition to Pakistan, we also give to India and China, both super-economies who would have more then enough money to provide decent standards for their people if they decided to put it to that use. We do not need to be giving money to rich countries like that.
A solution to the ring-fencing problem, (that Cameron created himself by trying to look voter-friendly), would be, for example, to declare the Afghanistan situation as aiding a foreign country, (building schools and other projects would not be possible without a military presence, after all) and aid and fund it from the foreign aid budget rather than the defence budget – killing two birds with one stone.
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Sorry: in the above comment, when I said “nobody dies”, I meant of course that nobody dies through inability to access the necessary treatment.
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Rodney a few corrections anyone working class or middle class what ever that is these days?? if you lose your job and your partner works you get nothing , has nothing to do with saving a few bob.
The Unemployed have their NI paid by the guv even if they are not in reciept of any other benefit while signing on their NI is paid. Whether the unemployed make use of the NHS more than others no evidence of this unless of course we are talking incapacity claiments again I hear a lot of talk they are non genuine and it is up to the guv to deal with that and prove it.
But most people with average plus income could afford to pay for a minor procedure or pay in to private health care as many of us do now with the dental service my only complaint about the dental service, prices are not clearly displayed
I also question if all work is actualy needed.
All emergency treatment should be free but the NHS is now in 2010 Britain more people, more living longer, more treatments available now is the time to modernise and update the NHS.For those who say they cant afford it they the majority still have 2 cars a few holidays a year, and all modern gadgets british people now want all but give nothing to ensure they get the best treatment around if ever they should fall ill..private health care and life insurance are two of the hardest insurances to sell and yet both protect you or the family should they ever be needed and lets be honest both will be needed just depends on when.
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Means test the NHS eh, want to end up with healthcare like the US, then keep writing these letters. You may complain about the NHS but at least you know you have healthcare when you need it. Its the best system in the world, its just run by people who have no accountability.
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NHS as it was set up was for a UK that no longer exists, time to modernise.
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I was always bought up that charty begins at home and one you have sorted out your own affairs then you are to help others.
I say stop foreign aid until we can afford it and keep the emergancy services.
I think that there should be a public (non-profit) review of management structures in our services so that these top heavy institutions are correcty reorganised. As we all know if it was done internally then all management would cover their own backs thus allowing the average ‘low paid’ worker to take the fall effectivily lowering the service for the tax payer.
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Means testing the NHS would defeat the purpose for which it was introduced and destroy one of the last bastions this country has to be proud of, health insurance fraud in the United States is out of control as people more frequently cannot pay for treatment. I work full time for a living on a wage that would deem me too well off to receive benefits for anything yet I cannot afford a dental check up. Are you seriously telling me a system whereby if I get seriously injured in a hit and run I should be left to die if I can’t pay the bill is the way to go? Wise up! Sack the top level managers being paid to count paper clips and there would be no need for cuts anywhere else in the NHS. Means testing the NHS is a preposterous idea.
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Of course you can afford the dentist take out a denplan very modest monthly payment plan. It all depends on what people wish to pay for.
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Obviously, Andrew, you’re not aware of what a part time worker on minimum wage actually earns. Single people on minimum wage are unlikely to be able to afford Denplan after paying council tax, rent / mortgage, travel to work, food, etc.
Your basic ideas are worth considering, but Astonished! has a more realistic view of things – again,those on benefits and the very well-off would love this system but those on even an average wage with average outgoings would have problems with affordability. It would be a great incentive for those unemployed or on any benefits to not look for a job because once working, they would lose their right to free health care.
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Rodney if the benefits bill is dealt with and benefits given to the true needy then those on benefits are the genuine article, I would not begrudge help to them would you??.
The wealthy would pay no problem there how would they benefit ? they do not like spending money that is why they are wealthy.
Minimum wage earner well they are entitled to working tax credit that has not been withdrawn also if the insurance was on a pay as you earn basis we would not have a problem would we?. The pay as you earn basis should in my opinion be applied to the council tax also again this would help the low paid.
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why on earth would I work 65 hour weeks, pay 40% tax, pay back my student loan, pay more substantial localised taxes and STILL not qualify for the nhs system I arguably contribute a disproportionate amount towards??… and they wonder why upwardly mobile young professionals are emigrating at a fast rate on knots…!
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And these so called other countries would be any better?????.Student loan your choice, and having listened to a so called expert on the radio the other day 60-70% of student loans are spent on booze and enjoyment .
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Good idea Mr Finch, perhaps we could take this thought a step further and have a means tested licence of some sort, those who are earning too much to qualify for the National Health Service, would perhaps then not then be expected to pay for it and would then become exempt from NI Payments and receive a reduction in their tax to correspond to the amount of general taxation that goes into the NHS.
A very good incentive for those who would then have to pay for private health care! Or perhaps you think some people should be forced to pay for something for which they are not eligible?
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Happy for those who choose to pay for private health insurance to have a reduction in NI contributions .As for reduction in their Tax No we all in work pay tax and our taxes go to many things that some of us are not happy with. I can name a few that I am not happy with but we cant pick and choose we have to be realistic.
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The victims of your plan would not pick and choose to be excluded from the NHS they would be forced out by dint of their earnings, or worse their savings, they would be forced to enter the private system whether they wanted to or not, whilst still being charged for the privilege.
Do people on higher earnings actually owe more to society than those who earn less, I do not see the logic, we are talking about those who have studied hard and worked hard and long hours to achieve their present earnings, they have also therefore already contributed more to society by way of extra taxes ect.
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Sorry ken the high paid worker works no harder than the low paid worker, as for school and uni then they are lucky to be born very bright all can’t be .
As for contributing more? I assume you are saying via the tax system the low paid worker £24k or less I would say contributes more of their salary. The genuine wealthy do not use NHS anyway, WE ARE TALKING THE SO CALLED MIDDLE CLASS WHO CAN AFFORD TO PAY, The very same who have been claiming child tax credits over the last 5 years example a guy who was on 49 k a year with 3 children claiming and getting the same in tax credits as a cpl on joint income of 26k a year not fair is it ?.
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I do not accept that there is an argument for means testing NHS provision. The only result will be that those of us who contribute in tax will be paying twice.
There is an argument that all those who use NHS facilities should contribute.
Hospital in-paitents receive board and lodging free of charge. Together with laundry etc. Additionally the provision of drugs to in-patients has no prescription charge.
If hospitals charged patients a contribution to the “hotel” costs, and after all what ever a persons means they would be paying for food, heat, light, laundry etc if at home, this would enable more resource to be directed to medical treatment rather than bed and board.
Similarly with prescribed drugs in-patients should pay the relevant prescription charges. Those with appropriate exemptions remain exempt.
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Andrew Finch I don’t agree with anything you’ve written – you write (and probably talk) a load of nonsense – are you bored or something?
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Karen I can assure you I do not care one jot if you agree with me or not. We however do live in a democratic country where people are oooh surprise surprise… I dont believe it realy but they can voice an opinion. So I am happy for you to have yours even if you wish to deny me mine.
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Andrew, I haven’t denied you your opinion have I? I was just stating my opinion and asking a question – you just seem to be at war with the UK in general and appear to patronise everyone who doesn’t have your opinion. I’m asking are you bored or something (with this country)?
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Well said Karen K, Andrew is a Troll on this forum, best to ignore him
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I’m sorry but a means tested NHS is just as unfair as means tested anything. I have worked hard all through school and employment and saved hard and now you want me to subsidise the health care of the people who mucked about and got poor jobs or no job at all.
The only people who should get help are elderly and disabled. Everyone who is fit and healthy should pay the same, regardless of how much they earn. Drill it into school children that unless you want to be poor, you work hard at school. Means tested this that and the other is completely counter productive.
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Julian you sound a bright chap but are you????. You are saying anyone on poor pay 24k or under never worked hard at school?? perhaps they were not bright but all are clever at some things. However if we did not have all manner of abilities in school then we would not have people doing the important low paid jobs in the UK . IE you would not have refuse collection, hospital porters,cleaners etc, and should you get old and end up in a old folks home and needed help to clean yourself and help to go to the toilet what would you say if that employee says get stuffed you should not of got old.It is not your fault is it.?
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I accept my reply probably does have gaping holes in it. There will be plenty of people on £15k who worked hard to get where they are. I accept that. And just to put it in context, I am not rich, indeed I earn less than a bin man (according to my salary.co.uk) but I have saved almost every penny I have ever earned, and I am constantly penalised for doing so.
If you think of means testing in terms of a millionaire who inherited their wealth having to pay while a pensioner struggling to survive despite having paid national insurance all their life, not having to, then yes, but means testing does not work like that.
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The state increase taxes on ALL the people in order to provide universal services available to ALL the people! It cannot then make those services accessible to only some of the people without recognising the partiality of the situation and doing something to address that bias.
The “middle classes” are already more likely to use private schooling for their children and take extra insurance for their health cover, many are doing this voluntarily whilst still being prepared to pay their full contribution for state services they have no intention of using, now you want to make it mandatory! Well if that is what you want then you have to look at the reduced income that will result when all those “middle class” people no longer contribute, because I see no reason at all why someone should be forced to pay for state services they are prevented from using. What next I wonder, private police forces, private Fire Service, for the “middle classes” how dare they presume to earn more than Mr Finch thinks appropriate.
Unless the person to whom you refer was breaking the law then the Labour government obviously thought he had the right and that it was fair, in fact 9 out of 10 families are entitled to claim child tax credits.
In any event I do not see that there should be any need to make such severe cuts in the NHS when there are so many other areas of government spending that we could well do without.
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Ken speaking as one of the selfemployed who gets access to very few freebies I can see where you are coming from. However the NHS was set up many decades ago when few could afford medical treatment apart from the rich.
It is now 2010 times have changed the burden on the NHS is massive. Many of us earn a good living, many of us have savings because we earn enough to save, many are low paid and work hard but can’t save because it is all spoken for .I am speaking having been at both ends of the scale not some oik who now earns decent money so stuff the rest.
What I am saying people who can afford it should pay for minor procedures and should get a reduction in NI contributions to reflect this . People who cant afford it get it for free not all low paid people are wasters it is only a small minority .
As for middle class issue I do not realy no what that is ? only what the powers that be say it is going on their opinion most people who see themself as MC are not.
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Actually Andrew, is it not fair to say that the pressure on the NHS comes not only from the amount of people it has to serve but also the level of procedures it now undertakes. The advancement in medical science during the past 60 years is enormous (joint replacements for just one) and the NHS has to now try to balance its funding with the level of cover it can offer and to be frank it never can have enough money, I think Bevearge said something like that.
I don`t think this is really a “class” issue, rather one of political priorities, it for instance, might be argued that it was in our interest as a nation to invade Iraq (T Blair obviously thought so) but perhaps not in the real interests of the peoples of this country to have so much of their money being spent on such an adventure.
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you must be joking
seriously people who say earn 100k as a director pay about £35-£40 K per annum in TAX and you want to deny them NHS access for that!
THATS AN OUTRAGE – all people are equal in the eyes of the NHS if anything those who contribute most should be at the front of the Q
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No I never ever said I wish to deny any sector from the NHS . What I said was if you earn a good living you should pay for minor procedures .As for the comment “those who contribute more should be at the front of the que” they would be as they are paying.
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Just to add to the discussion.
The WORKING class
A “live for today” attitude; believe that income is the best measure of social status; borrow to spend on treats earnings 10k-25k
The MIDDLE classes
Invest in shares and ISAs; believe that education is the best measure of status; live in a detached house earnings 25k-125k
The UPPER classes
Generally describe themselves as middle class; avoid taxes; universally disliked
earnings 250k plus
Some info I gathered also 45% now see themselves as middle class compared to 10 years ago .
A thought if it was only the working class that believed in the live for today attitude and borrowed for treats etc how come the country is in the state it is in??
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Andrew,
Where on earth did you get those absolutely disgraceful definitions????
A person’s position in, (the now largely irrelevant), class system does not denote their attitudes.
I am lucky enough to be a bit better off than my working class parents – hard working folk who strived for the best for their children – and in “the best” I mean support for our education, prioritising expenditure to the advancement of their offspring, (certainly not gadgets and “treats” unless they were directly contributing to the best possible start for us), and find the “live for today” line outrageous and demeaning.
Perhaps you ought to open your eyes and look to the good parents in the class that you exude such contempt for.
Even if you transplant “working class” for the “underclass” of those who have lived their lives on benefits there are still good parents following their biological imperative: to do the best for their offspring!
An ill-considered, poorly thought through post, unless your aim was to advertise yourself as a bigot!
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Yet again Mr Finch, your posts beggar belief, stereotype to the point of being offensive and are bigoted.
You have a point of view which you believe to be the right one as far as you are concerned. You do not read and digest others points of view, but twist them to ensure your viewpoint is indeed the last word.
The NHS is the envy of the world and a model of it’s ethos is now being copied by President Obama, enough said!
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Some of the figures ie wages from a uni study description of classes see link below
http://www.timesonline.co.uk/tol/news/uk/article713386.ece
So a bigot gives an opinion debates with a person who disagrees, OBserver stop being a bigot and stop making asumtions.
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Andrew,
Quote from you:
A “live for today” attitude; believe that income is the best measure of social status; borrow to spend on treats earnings 10k-25k
Quote from your reference:
“With people who describe themselves as working- class, the emphasis is on saving up for, or borrowing for, specific purchases or treats”
A clear case of misquoting to further your own argument. You not only deride possibly 60-75% of the population of the country, you then try and drag legitimate press, researchers and academics – through deliberate misrepresentation, to support your, quite frankly, detestable hard right arguments.
Something a bigot would do? Let the posters decide.
But if I were you I would give it a rest, you are doing your cause no good with such inept attempts at manipulating the words of others to further your own cause.
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Andy I have not as you are aware changed nothing the only part i added was the earnings taken from another study.You it seems have added a bit to the end , did you actualy read the article to the bottom of the page??.Not guilty of manipulating the words at all.
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And you must be flustered, “asumtion”?
Hardly the level of literacy one would expect from our self appointed superior is it? Or maybe you arent quite as clever as you think you are…
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Mr Finch, the definition of a bigot is “a prejudiced person who is intolerant of any opinions differing from his own”.
Therefore, where did I put an opinion differing from your own? I merely stated what everyone else thinks of your diatribes on the subject and your “mother of all assumptions” when describing the class system, based upon one news item as a reference.
In previous posts on other subjects in the Shropshire Star your stance and opinion remains the same…. BIGOTED!
Take the blinkers off mate and look at the bigger picture, one which is achieveable, fair, tolerant, whilst being open to compromise. You can’t “pigeon hole” people, everyone has different circumstances.
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Added the times article to the debate not my opinion on the class system at all.
The bigot tag is a little silly If a person who thinks people who can afford it should pay, this country should sought out the problem of broken britain, help the poor areas of the UK etc etc all which I have called for over the years through the shropshire star letter pages i could go on if that is a bigot then yep give me the tag.
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Stop googling, Andrew. Just stop. You’re only confusing yourself. You can find support for any opinion you want on the internet, it doesn’t help your case. (Oh, and not everything you hear on the radio is true either).
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It is clear some have taken offence at my opinion they can not debate it seems . I did not google kath I knew it was in the Times bcause I read it, just chose to show another opinion/description via the link.
As it has been pointed out to me Perhaps NHS,F AID, the so called class system and a few other issues erks some people to the point seeing only their point of view as I am accused of .
What i am pleased to note however with regards Foreign AID my MP has also questioned which countries should be getting it although he stopped short of stopping it all.
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So, according to your Tory letter-writer, we can’t afford the NHS these days?
Funny that we can still afford to keep a huge number of the Royal Family in the manner to which they have become accustomed. To take a random example, what’s Prince Andrew actually for?
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I think Prince Andrew’s role is two fold:
1/ To make Prince Charles look like he works hard for his money, and let’s not just think of the cash he gets through the list, he also owns most of Cornwall, a present from Mummy.
2/ To keep Edward out of the news completely!
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Promote business abroad could be a clue, ask the big and small business of the UK does he do it well.I think the answer you will find is yes and the freebies he gets are worth the work he gets for them.
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I work in a small business and we’re keen to export more, but Prince Andrew has never done any promotional work for us. If he could draft a few press releases or volunteer to man the stand at a few trade exhibitions in France for us, then I might be interested.
Given Britain’s appalling trade deficit, it doesn’t sound like he’s doing a very good job of ‘promoting business abroad’. Really, to make things more efficient, Prince Andrew ought to be privatised.
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I also run a small business and he has not doen anything for mine .However that does not mean he is not doing anything for others.
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