Failing to understand the NHS's problem

Another of these attempts to diagnose what is wrong with the NHS and then fix it. Failing, as usual, because it's looking at the wrong thing. For example, let's do this:

We suggest the following principles should apply to sourcing new revenue for the NHS and care system. A new tax base for the gig economy needs to be created. The older population should pay a fairer share of the costs. Lifestyles costly to the NHS and care system should exact a premium. And tax-reduction schemes should be tackled.

Our suggestions adhere to these principles. The UK-derived sales revenue for Amazon, Google, eBay and Apple was some £29.4bn in 2016-17 (according to our analysis of their published data). Yet very little tax is paid. A 10% revenue tax on UK sales would yield £2.4bn minimally. Revenue in these companies has achieved double-digit annual growth, and the tax take would rise in parallel.

Three hundred thousand retired people receiving a pension are higher rate taxpayers; they are relatively well-off. Yet they also receive winter fuel allowance and other state benefits. If they did not receive basic state pension or winter fuel allowance, £1.95bn a year would be generated annually, which would also be index linked.

A turnover tax like that is akin to a VAT. It's the consumers, us, who pay it, not those companies nor their shareholders. And seriously? People who have paid in for 40 years for their pension won't get it just because they're rich b*stards?

But much more than that they're looking at how to increase the revenue available, not at the important thing:

Moreover, in themselves they will not reduce by much the unrelenting increase in demand that the health and care system will face over the next two decades. The approximate annual cost of that demand increase is in the region of a 3-4% annual real-terms increase in funding. 

It's not just the next two decades though, is it? The NHS has near always had a higher inflation rate than the rest of the economy. Meaning that, unhindered, it will eventually become the entire economy. That's the serious problem that needs solving. Whatever we do in this short term, the NHS simply must become more efficient. That means more internal markets and less central planning as that's how efficiency is improved.

Sure, the NHS isn't perfect and certainly we can make it better. But increasing the fire hose of money isn't the way to do it, improving the NHS itself is.

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