Health insurance should be compulsory, with the NHS being financed by insurance, not taxation, according to the recommendations of the Health Policy Consensus Group.
The cross-party group, chaired by David Green of think-tank Civitas, concludes that the NHS has a lot to learn from systems based on social insurance, such as those in Germany, France and Switzerland. “Current policies are self-contradictory,” says Dr Green. “The Government increasingly advocates customer choice and yet the NHS remains a highly centralised public sector monopoly.”
The group states that the internal reform planned by the Government will not be enough. It adds that reform of the method of financing is vital so that people can decide how much of their own money to spend on healthcare, and simultaneously determine the standard of care to be enjoyed by less fortunate members of society. Also, services should be provided by competing hospitals with a mix of private and public ownership, the group adds.
“Paying for the NHS through taxes makes it impossible to know how much we are paying, let alone how the payment translates into the standard of care available where we live. No rational person would be willing to pay more without being able to tell whether the price was good value for money,” the report states.
The group – which includes NHS consultants, journalists, the Labour peer Lord Desai, Professor Nick Bosanquet of Imperial College London, and several representatives from Civitas – suggests that health insurance should be compulsory, that there should be no charges at the point of use, and that patients should have freedom to choose between competing healthcare providers.
It believes that this objective could be reached by “evolution, not revolution”. One option suggested is that some people might choose to become “mutual members” of the NHS, contributing more and taking responsibility not only for themselves but for less fortunate people as well.
“The new system would help to build a real sense of social solidarity, based on the conscious knowledge that we were contributing to a system that serves as a system of insurance for rich and poor alike,” said Dr Green.