One important fact that I dont think I have seen mention anywhere is that when it comes to national health care systems all socialized nation medical systems have permanent capacity overload problems by their very nature. Its a design feature. They have no surge capacity. So every winter at peak load they partially collapse and go into crises mode. Whereas mixed nation medical systems, paid for mostly by health insurance, not only have surge capacity (due to the profit motive) but as in the cases of Germany have ludicrous levels of overcapacity due to the peculiarities of its hospital billing system.

Which is what we have seen so far. The fully socialized national medical systems like Italy and Spain partially / totally collapsed very early on in the March surge whereas mixed systems like Germany, France, Netherlands etc sailed right through without any huge problems. Some localized ones though. Despite all the political propaganda the UK actually has a semi mixed system. The private health service in the UK actually provided more than enough excess capacity during the case high point in April / May. Which is why all the "Nightingale Hospitals" were never used. They were never needed due to the large excess capacity provide by the private hospitals. They were a media stunt.

So the whole "Save the NHS" was a purely political stunt. There never was any danger of the situation in the UK getting like Spain or Italy. But the NHS political special interests could never admit that the country was saved by the private health system capacity. And if it had not been there and the country had been completely dependent on NHS infrastructure the UK would have had a catastrophic hospital situation in April just like the Lombardy etc in March and Andalusia etc later.

It may come as a shock to people in the UK given the unrelenting propaganda but the NHS is not a terribly good way of providing national health care. Which is why so few countries have a national health care system like it. It was always about politics, never about provided the best health care at the lowest cost.

To those of us who are familiar with the workings of the health care systems in a whole range of countries I'd have to say the NHS comes close to bottom (but not the worst) when it comes to which system I'd want to deal with when ill. I'd rather pay the health insurance up front and get an immediate first rate service (and have a choice about where to go) than pay indirectly through taxation and deal with the NHS which is is basically a civil service dept with hospitals. An often truculent dept. Like all civil service institutions.

I love the whole the "NHS is Free" lie people tell themselves. You pay hundreds of pounds per month in tax to pay for the NHS. The total cost of the NHS last year was equal to around two thirds of all income tax receipts. Calculating just how much of your income tax goes to pay for the NHS gets a bit complicated but around 20% is the best estimate I've seen. Which is about how much health insurance costs in the countries with much better health systems.

The NHS does not need saving it needs to be abolished and replaced with something that is not based on some half baked Fabian collectivist ideology of the 1930's. The French system is far from perfect but might be a good model. Although something like the Dutch system (again not perfect) is probably the best way to go if you want to get from where you are to somewhere much better.

One important fact that I dont think I have seen mention anywhere is that when it comes to national health care systems all socialized nation medical systems have permanent capacity overload problems by their very nature. Its a design feature. They have no surge capacity. So every winter at peak load they partially collapse and go into crises mode. Whereas mixed nation medical systems, paid for mostly by health insurance, not only have surge capacity (due to the profit motive) but as in the cases of Germany have ludicrous levels of overcapacity due to the peculiarities of its hospital billing system.

Which is what we have seen so far. The fully socialized national medical systems like Italy and Spain partially / totally collapsed very early on in the March surge whereas mixed systems like Germany, France, Netherlands etc sailed right through without any huge problems. Some localized ones though. Despite all the political propaganda the UK actually has a semi mixed system. The private health service in the UK actually provided more than enough excess capacity during the case high point in April / May. Which is why all the "Nightingale Hospitals" were never used. They were never needed due to the large excess capacity provide by the private hospitals. They were a media stunt.

So the whole "Save the NHS" was a purely political stunt. There never was any danger of the situation in the UK getting like Spain or Italy. But the NHS political special interests could never admit that the country was saved by the private health system capacity. And if it had not been there and the country had been completely dependent on NHS infrastructure the UK would have had a catastrophic hospital situation in April just like the Lombardy etc in March and Andalusia etc later.

It may come as a shock to people in the UK given the unrelenting propaganda but the NHS is not a terribly good way of providing national health care. Which is why so few countries have a national health care system like it. It was always about politics, never about provided the best health care at the lowest cost.

To those of us who are familiar with the workings of the health care systems in a whole range of countries I'd have to say the NHS comes close to bottom (but not the worst) when it comes to which system I'd want to deal with when ill. I'd rather pay the health insurance up front and get an immediate first rate service (and have a choice about where to go) than pay indirectly through taxation and deal with the NHS which is is basically a civil service dept with hospitals. An often truculent dept. Like all civil service institutions.

I love the whole the "NHS is Free" lie people tell themselves. You pay hundreds of pounds per month in tax to pay for the NHS. The total cost of the NHS last year was equal to around two thirds of all income tax receipts. Calculating just how much of your income tax goes to pay for the NHS gets a bit complicated but around 20% is the best estimate I've seen. Which is about how much health insurance costs in the countries with much better health systems.

The NHS does not need saving it needs to be abolished and replaced with something that is not based on some half baked Fabian collectivist ideology of the 1930's. The French system is far from perfect but might be a good model. Although something like the Dutch system (again not perfect) is probably the best way to go if you want to get from where you are to somewhere much better.

Absolutely all of this. When all this is over we need to have a proper national conversation about whether the 1948 funding model is still workable in 2021. My money's on no. But there won't be, because it's R NHS and is a national religion, and any attempt to reform its funding is smeared as turning it into an American style system and selling it to DISASTER CAPITALISTS.

Absolutely all of this. When all this is over we need to have a proper national conversation about whether the 1948 funding model is still workable in 2021. My money's on no. But there won't be, because it's R NHS and is a national religion, and any attempt to reform its funding is smeared as turning it into an American style system and selling it to DISASTER CAPITALISTS.

As the whole subject has been so thoroughly politicized, in fact turned into some kind of secular religion act of faith, I think the best way of dealing with the NHS beast is to make the actual cost of it explicit. Split out its cost and make the tax burden a separate line on people pay slip. Just like National Insurance.

Do it such a way as to give people the option of paying a voluntary NHS Solidarity Tax of say 2% extra for those who keep saying - The NHS should get more - would kill two political birds with one stone. Firstly the whole NHS is Free myth would be killed dead. People would see the true cost of the "Free" NHS. And the low take-up of the voluntary NHS Solidarity Tax, maybe 5% max, would kill once and for all the myth that spending money on the current NHS is popular. When people have to put money where their mouth is there is not going to be that much money forthcoming.

Once you have a NHS Tax and the Solidarity Tax established then you can start allowing people to opt out, use their NHS Tax as credit for private health insurance. Not BUPA style but something more like the Dutch or Swiss style state mandated private insurance pools with private add-ons if wanted. The Swiss seem to have the most efficient system but it think something like the system in the Netherlands is probably a more practical goal.

The biggest problem is not so much the brain-washing of generations of people that the NHS is great but the inevitable fight to the death resistance by the Labour Party. Not because its their baby but because since it was established the NHS is the single most reliable vote-getter the Labour Party have. By quite a large margin. So as long as the Labour Party survives as viable political party there will be no substantial reform of the NHS. Its just politics, nothing else.

Last year I asked the question if the NHS had unlimited resources, capacity and funding would we still be in the situation where we have our civil liberties suspended/terminated to "save the NHS".

I know it's an irrelevant question and nonsense situation to raise in reality. But I'm interested to hear your thoughts.