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“Care in Europe is safer than NHS, death rates reveal” The Times 2.4.2015 page 35 – WHY NO COMPARISON WITH GERMANY, SWITZERLAND AND THE NETHERLANDS?In 1948 when the NHS was created, no-one foresaw the future of health care and its escalating cost.  No-one anticipated what it would be like today.

1. The number of people in 2018 alive, well beyond retirement age. Life expectancy for one in three born in 2015 to live to over 100? A growing demand dual-registered residential care for the elderly along with social care. Our NHS is a victim of its success.

2. The range of new treatments and drugs available every year, their cost and the cost of the scanners and conformal radiation-therapy supporting them? Extending life does not come cheap, nor prolonging mobility. I know. I have been a beneficiary.

3. At a time of food rationing did anyone anticipate that obesity and consequential diabetes would be a major health problem along with alcoholism and smoking, and that on a Friday and Saturday evening 60% of admissions to A & E would be alcohol related?

4. Did anyone expect that the overall cost would be in the region of £100 billion annually, not very different from the entire tax receipts from employers’ and employees’ National Insurance payments?

It is far too simplistic to say that more money will solve today’s problems or that ending private sector involvement will improve health provision.

“Free at the point of need” is a great concept. It should not be abandoned, but it should be tweaked. It should be insurance based, not taxation based, self-funded by those able to pay the premiums and by the State for those unable to do so.

Don’t look at the USA to validate this, look to Germany, France, Holland & Switzerland. You don’t have to invent the wheel, just find it.

Compulsory National Health Insurance would replace National Insurance, with the State offering a basic insurance package with other insurance companies competing, together driving down costs in their market place.

People would continue the premiums after they stop working, their demand for it increasing with age; and you could include insurance for residential care in old age to head off having to find money to pay for it at the time.  Sadly, there will always be some who will need that.

Those who keep themselves fit and healthy with exercise, weight control, cycling, &c. could reduce their premiums with no claim bonuses. Those who are obese, smoke, take drugs, cycle carelessly, are taken by ambulance to A & E at a weekend sozzled, would pay more. Why should others foot all the bill for their self-indulgence?

Those who want to choose their surgeon, their hospital, the date of their operation, or a private room could pay more. Those who don’t, don’t.

If everyone can’t have these options that is no good reason why no-one should have them. Beware Equality when it is the selfish self.

Your health. You choose.

On the other hand, as now, when you need the best, for say heart surgery or cancer therapies or critical care, all insurance packages must offer the same top standard of care. Equality where it matters.

This requires a new five-way partnership between health providers, patients, their employers, Insurance companies and the State.

You would share responsibility for your own health with the State and it would pay you to keep healthy and ease the pressure on the NHS.

The NHS would no longer be a political football, with the Treasury measuring funding against competing demands and the exigencies of the times. And all the better for that.

Other countries on the Continent of Europe adopt something like this policy. You never hear about their crises, do you?

The future must not be the day before yesterday.

NEW THINKING FOR A NEW CENTURY