A few points on healthcare

If you want the actual truth about UK private health insurance, here it is: Private hospitals are very good at routine. Routine is predictable and the costs are therefore easier to forecast. It's in their commercial interests to see as many patience as possible and to keep costs down and especially not kill patients. You don't stay in business if you do. They have smaller hospitals, each with private rooms which massively reduces risk of infection. In fact getting you back home to recover as soon as possible where your immune system is used to the bugs in your own home, you have a better chance of survival recovering at home.

More to the point, it's affordable, with policies that cover most instances for less than £50 a month. It's cheaper than the NHS and everybody could afford it if they weren't paying massive taxes.

The problem with it is that some ailments are not routine and private healthcare does not like surprises. If it can kick the complicated stuff back onto the NHS it will and will even pay patients cash bribes of £2000 to do so. In short, the private health sector could not exist in its current form without the NHS. That said, it performs so well, it's actually cheaper for the NHS to pay for patients with routine illnesses to go private. The logical conclusion of this is that the NHS becomes a healthcare procurement operation running essentially a nationalised insurance scheme to ensure universality. That could come in much cheaper and more effective than a fully state owned NHS.

The less routine ailments make ideal cases for training hospitals which are said to be the best care you can get anywhere. I see these as being self financing by turning all major city hospitals into university hospitals so that we become the number one global producer of doctors and nurses.If we actually enforce student visas properly we could be the health engine of the world. And why not since we already spend a vast proportion of our GDP on health. Why not make it a global export?

We need to get over our collective allergy to private health, but hard-right libertarians also need to acknowledge that the fully private system is no more efficient than a state system and a poorly population has externalities that business ends up paying for one way or another. The truth is that the NHS cannot survive as is, but a hybrid system of public and private (and I don't mean PFI) is probably the only way to ensure we continue to have universal healthcare.

The reason A&E is so badly clogged is thanks to Labour's GP contracts that pretty much pay doctors for nothing. That is where we need a government to do to GP's what Thatcher did to the miners. There is no justification for GPs to be making over £100k at our expense for working as little as thirty hours a week. At that end of the spectrum we do need market forces to drive down wages because we're being fleeced. Let's not pretend that paying GPs top whack means we get the best of the best. I don;t know very many people who have a good thing to say about their local GP. It's hit and miss.

That, in truth is the biggest problem with the NHS. The inconsistency of service. Those with the best education and the sharpest elbows will always get the best treatment. The vulnerable who can't assert themselves within the system will always get the sort end of the stick. That dynamic changes when they are paying customers, paying from their own health budget. That's why I favour personal health budgets - which is not a new thing at all. The friendly societies that existed before the NHS used a similar deposit account system where half of the monthly payments were put into a a risk account while the other half was held as a deposit to be drawn on or even repaid if the policy was cancelled. That is how sick pay was covered.

It is a myth that the poorest had no access to healthcare before the NHS and trusts and societies used to function quite well. We need these as much as we need AXA and Bupa, but the NHS is the glue that binds it all together. Apart from the obvious PFI scandals, the hybrid model we are drifting toward is not nearly as bad as the left would have it. Where there needs to be greater transparency is in the awarding of contracts which are as shady as ever they were. Or that's how it seems to me.

If we're honest, private health is essentially queue jumping, but I don't have a problem with that if it means better service, shorter queues for everyone and a system that works rather than the NHS in its current form where the chief beneficiaries of it are those who work within it. As is it's the biggest blackmail scam ever known to exist and to keep it "free" it will take everything we have.