@Kelvin - true, bolstered by constant and hugely unbalanced narrative about wasteful public sector, welfare scroungers and lazy fatties. Not about massive systematic tax avoidance. The narrative promotes individual self serving rather than collective benefit.
In terms of healthcare the fact that private healthcare is less efficient is lost in the "I'm alright jack" attitude promoted
Application of fair progressive taxation - and a coherent cooperate tax regime - to fund public services.
Then an then honest discussion about how much needs to be spent ( not just health, but social care education policing etc which are all really struggling)
No, the NHS is not worth an extra £100 per month.
true, bolstered by constant and hugely unbalanced narrative about wasteful public sector,
also factually incorrect narrative, every study looking into efficiency concludes that the NHS is very efficient compared with insurance based schemes like the USA.
Then an then honest discussion about how much needs to be spent ( not just health, but social care education policing etc which are all really struggling)
The main reason they are all struggling is Austerity, which is a political decision to starve them of cash based on two beliefs: one, that public spending is a sin and two, the best way to recover from a recession is to cut back investment and starve the country back to health.
The costs could be controlled if the government were prepared to do something about diet and obesity by tackling the food industry. About 10% of the NHS budget is for treating diabetes largely caused by obesity and apparently 1 in 6 NHS beds are occupied by diabetes sufferers.
Please be careful how you word things...this refers to Type 2 diabetes, not us poor buggers that have Type 1 which is not self induced.
As for tackling the food industry, how about being draconian and making people responsible for their own health, obesity has **** all to do with genetics, just self control.
A £100 a month is more than my NHS “Pay rise” over the next 3 years.
They need to close down tax loopholes before they start hitting the public.
I’d be interested to see if you happened to change your view on that, cinnamon_girl, if someone you cared about was denied treatment on the grounds that it was too expensive
They need to close down tax loopholes before they start hitting the public.
They need to do both. We all will have to pay more in the long term.
However, the current Hard Brexit direction is also starving the UK of investment, so we're reducing GDP at the same time, which is a strange political decision.
<div class="bbp-reply-author">scotroutes
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<div class="bbp-reply-content">Surely it wouldn’t be £100 each – it would be a sliding scale based on ability to pay, just like any other tax.
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What truly progressive taxes have we? Income tax, and that's is surely. Thatcher and subsequents made sure of this...
They need to do both. We all will have to pay more in the long term.
“Before they start...”
😀
If you think the NHS isn’t worth it then sit down with a cuppa for a little while and watch this.
https://www.bbc.co.uk/iplayer/episode/b0b3gfth/heart-transplant-a-chance-to-live
what do you class as a "loophole"
is the ability of a company to register in another EU country, in order to avail itself of a lower corporate tax regime, a loophole? I mean, its guaranteed by EU treaties, so is it really an abuse of tax laws?
I mean, its guaranteed by EU treaties, so is it really an abuse of tax laws?
Except for all the ones the EU has ruled break the rules and have forced extra payments eg
http://europa.eu/rapid/press-release_IP-17-3701_en.htm
Plus, you can always change the rules, or though post Brexit we won't have any say in that now we've chosen to go it alone, nor would benefit from any EU rulings; and have a much weaker bargaining position.........
Footflaps - I fully agree the austerity programme is wrong headed ideologically driven nonense.
Any attempt to have a sensible discussion about the levels of spending to deliver good quality services is constantly undermined by the "wasteful, scroungers" narrative from the right and most of the media. Let's see how long before the push back comes on the IFS proposals from the right...
@kelvin - no, it's for a panel of experts to decide that. If it means something that I have is not on the list then so be it, I'll either go private via insurance or cough up the cash myself. If I cannot afford to do that then I will let nature take it's course, no-one is immortal.
fifo - I'm currently funding two health conditions, one of which is life-long. Oh and I also funded diagnostic testing for said conditions. That's your question answered.
If I cannot afford to do that then I will let nature take it’s course, no-one is immortal.
Let the poor die, and the rich live on. Nice.
All the short journey motor vehicle users, heavy smokers/drinkers that do less than two hours aerobic exercise per week… Please form an orderly, very long queue here.
These are the people that are crippling the NHS
..and not the people who don't turn up for very expensive appointments such as NM, CT or MR scans??
A heavy smoker pays at least £100 a month more in tax than I do and is likely to die sooner so claim less of a pension than I will. Get puffing.
Let the poor die, and the rich live on. Nice.
the american dream
fifo – I’m currently funding two health conditions, one of which is life-long. Oh and I also funded diagnostic testing for said conditions. That’s your question answered.
Bit of a difference between open heart surgery and what you have. AND you will most likely have been seen under the NHS before your crusade anyway.
First port of call before people who don't like what they heard head off k owing better.
Get puffing.
Cost to the NHS is not only related to length of life, but also to the amount, and cost, of treatment, while alive. Do you really think it follows that a smoker dying at 60 will use fewer, or cheaper, NHS services than a non-smoker dying at 70?
Do you really think it follows that a smoker dying at 60 will use fewer, or cheaper, NHS services than a non-smoker dying at 70?
Only an anecdote, but a chap in my office is a 60 yr old ex smoker (stopped as it nearly killed him). He's in and out of GP / hospital monthly now until he dies, which could be another 5-10 years. He stopped before it killed him, but with enough major damage to his body that he's dependant on regular medical intervention all of which seem to have side affects which means he has more issues to deal with etc. In fact he's in hospital today, for the 2nd time this week...
Kelvin - point is not always as simple as people like to make out. However, a smoker dying at 60 will not claim a pension, a non-smoker dying at 80 can claim 13 years of pension and will probably have a few costly conditions requiring medical treatment. I'm not aware of any cost comparison studies between early death smokers and longer life non-smokers
knee and hip replacements for joggers
Running doesn't cause increased joint wear. Even if it did, a one-off treatment is far cheaper in the long run than treating lung cancer / chronic obesity / diabetes etc in a population that's not ageing well.
You could fund the extra through the motorist, anyway. Have a per-mile charging scheme that penalises you for going 2 miles or fewer - automatic £20 penalty every time you do. You could also have £500 fines for driving with lights out / parking in bike lanes / speeding / stopping past ASL at traffic lights / parking outside schools etc etc.
Get enough people walking or onto bikes and you go a long way to fixing the problem without needing to increase taxes.
philxx1975 - I answered the q, didn't realise it was about open heart surgery. Yes, I was seen under the NHS but was misdiagnosed by a number of doctors and left to rot. Crusade? What's that about?
Knowing nothing about your condition CG, I’m glad that through one way or another you have a means to fund its treatment/management. Others may not be as lucky.
fifo - who said I have the means? I've resorted to selling my bikes and bikey stuff in Classifieds, other stuff has gone on Ebay and have also down-sized my property. I feel like sh*t every day, life is just peachy.
The most effective, efficient, consistent, predictable way to raise revenue is to tax everyone a little more. Yes clamp down on avoidedce but that will never bring in the consistent, predictable revenue required.
Have a per-mile charging scheme that penalises you for going 2 miles or fewer
I would like to do something like this but I think it would need a clause of "if a time >n hours at destination" as it's easier to motivate people to walk or cycle 2 miles to work when they spend 8 hours there but if you are traveling some where for 10 min or driving 2 miles pick up some thing, drive another 2 pick up again etc until you are ,10 miles away it's harder to achieve or motivate people to do.
This will only ever work as a nudge rather than a revenue raising method though.
The most effective, efficient, consistent, predictable way to raise revenue is to tax everyone a little more.
The problem is in a "me, me, me" society such as ours has become people tend to vote for low tax policies.
On the PFI point – the Govt can borrow at very low rates – certainly less than 2% – whereas PFI has commercial capital costs built in – so has to deliver efficiency over public capital worth more than the difference in capital costs. This is the irredeemable economic flaw in PFI
You are forgetting that government borrowing has to go on the balance sheet as national debt/deficit and so looks bad. PFI is off the books and so you get shiny new facilities without it hitting the national accounts.
What truly progressive taxes have we? Income tax, and that’s is surely. Thatcher and subsequents made sure of this…
Is VAT not actually progressive? You pay based on your ability to buy. Your audi driving, santa cruz riding middle class bloke with a high level of disposable income is going to be paying a shed load more VAT than someone who's pay packet goes no further than rent, food and leccy bill.
Ultimately healthcare is really expensive - the link I posted above shows we are relatively modest spenders as an economy.
All the stuff about deserving or not deserving care is nonense to distract from the fundamental point that a large chunk of GDP will be spent however funded and a big chunk of that is always public
Even the most extreme version of insurance based healthcare in the US spends huge amount of public money on healthcare for the elderly who could not afford the premiums.
I believe it's more efficient to have a comprehensive and coherent NHS funded from taxation.
Is VAT not actually progressive?
No, are you kidding?
VAT is fairly progressive given that most 'essential' items are zero rated/exempt/lower rate.
.
There is still a load of waste in the NHS. Wife works in a PFI hospital. To change a lightbulb the contract says they must get the company to do it, they have to send someone from Glasgow and it cost £147. In any other organisation the janitor would have a cupboard full of bulbs at £3 a pop or whatever and just do it themselves in five minutes.
This is just one example, coupled with the fact that most of the £100 a month extra, plus a fair chunk of what we already pay, is paying for fat people who've eaten too much. I'm voting against any party who wants to increase tax to pay for the NHS,. Quite how we differentiate between deserving and undeserving is an interesting topic but it really needs addressing, we can't go on paying at this rate for self inflicted issues.
VAT is fairly progressive given that most ‘essential’ items are zero rated/exempt/lower rate.
That's what I was implying. And thereafter the more you are able to spend on non essentials the more VAT you pay. It is also much better than income tax at extracting monies from those with disposable wealth not gained through conventional or declared means. The self employed that are creative with their tax return, the wealthy retired folk with in theory a small income but a lavish lifestyle and the 'failure to launch' brigade living with mum and dad and spunking the lot on a big lifestyle all pay heavily on VAT.
Oh goodie. A nice simple one 🙂
Sure, more money could pay for more stuff. However, would it make it leaner, quicker, more efficient?
It's a pretty well know statistic that asprin (for example) costs the NHS 20 times more than it costs to buy at tesco. #facepalm
I'm not suggesting that we privatise healthcare but there are obviously things that the NHS can learn from industry. They should be incentivised to do that IMHO.
If it was my money, I would suggest taking a step back and targeting more of the extra funding at education (which I also think needs a radical rethink). Surely, it is the building block of our whole society. Get that right and we save billions from NHS through avoided costs, have more doctors and we win all round.
This however is a long term fix and governments only last a few years so this is unlikely to fit their agendas. Oh well, as we were..
If we are discussing whether VAT is progressive or regressive - then are we agreed that the NHS needs significantly more money and this needs to come from taxation?
I'm not sure why the non-expert nhs bashing experts always default to the 'not until it's sorted and more efficient' line. Is it not possible to imagine that both increased finance and increased efficiency in parallel is not an option? It would be naive to both believe the NHS is the last word in spending wisely but also that it would be possible to eradicate waste in any large organisation.
So yes, I'd be up for increasing our taxation if it went to the NHS. But then also an advocate about looking for improvements, educating the public about what is realistic and putting some pressure on those bring poor health upon themselves to sort their lives out.
all pay heavily on VAT
Erm...at 20%? = the lowest rate of Income tax.
A few zero rated categories means it's barely progressive - uselessly so in fact - when combined with the above.
PFI removes the procurement shambles of NHS building projects + they get maintained and will be in very good condition at the end of the concession compared to most NHS estates which are backlog maintenance disasters
A few zero rated categories means it’s barely progressive – uselessly so in fact – when combined with the above.
Has to be seen in association with additional taxes though - eg, petrol/diesel, alcohol, tobacco, sugary drinks etc - all of which punish less healthy options
The NHS doesn’t spend 20 times more on Aspirin than Tesco. ‘Well known statistics’!
The Daily Mail says it does and it’s all immigrants fault.
Erm…at 20%? = the lowest rate of Income tax.
Currently it is 20%, that could be changed. I was talking about VAT as a model of taxation.
Also as VAT is taken after income tax it which is progressive it gains income taxes progressive status.
A few zero rates is a bit disingenuous. Mortgage? Rent? Food? Then Gas/Electricity on a low rate. That means someone living on the breadline pays virtually no VAT.
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ade9933 wrote,
It’s a pretty well know statistic that asprin (for example) costs the NHS 20 times more than it costs to buy at tesco. #facepalm
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It may be well known, but it's also horseflops. Just completely made up. They arrived at that statistic by dividing the average cost of all prescriptions by the cost of asprin at tesco.
The actual average costto the NHS of a prescription for asprin is £1.28 per prescription for aspirin, compared to 30p in Tesco. But that's still not a correct comparison, because a 30p packet of asprin is 16 tablets, but a prescription can be for larger amounts, and often will be because people who're prescribed it, like my dad, will be taking it for the long term.
Cocodamol is another one that they do this with- the average cost of a prescription of cocodamol is £5.59, whereas cocodamol is usually about £2.50 a packet in a chemists. But that's 500/8 strength whereas prescription strength goes up to 500/30 so each tablet can contain 4 times as much codeine. And that's 32 tablets whereas my prescription was for IIRC 200 tablets.
