VAT on private health

I agree. I used that scenario to highlight the fact that what seems small is not small to some. It feels arrogant for someone to say because you can pay £4k, you surely must be able to pay £4.8k.

The Australian system seems the fairest - a basic NHS core funded and accessible to all but private system paid for by private insurance/small self payments and government insurance.

The economy needs to grow in the UK for any of these sorts of ideas to work but the current funding and delivery model simply doesn't work. And even with double the funding, which the country can't afford - it will still be substandard without significant reform

Exactly this. I work in private healthcare - in the past 10 years it has gone from being something reserved only for the very wealthy to people using their life’s savings to fund hip replacements as they simply cannot wait any longer on the NHS. The misconception that only ‘rich’ people go private really bothers me - the demographic has massively changed in recent years and it is all due to our failing NHS.

I think it’s a terrible idea to pay per appointment. We would end up with people not seeking medical care because they don’t have the money.
Again, I could afford this so no bias, but it would potentially cause more problems than it would solve. It would hit the most vulnerable in terms of wealth and health.

17k doctors left the NHS last year. There are approx 350k doctors in the NHS. You will be surprised what highly educated skilled people who know their worth will do when pushed. They predominantly left due to poor working conditions and poor pay. If their private sector work is strangled - far more would leave

As it is, there is now a shortage with a rapid proliferation of non-doctors to do jobs traditionally reserved for highly skilled medics.

Lovely theoretical discussion but VAT on private health are would never happen because the people who would suffer significantly would be those without funds.

quite frankly if you can afford private healthcare then there should be no problem in paying an extra 20%.

You’re quite wrong. Such is the dire state of the NHS these days that many people who are not at all well off are using private health care out of desperation and getting into debt or severely scrimping to do so. An increase of 20% would be prohibitive for a chunk of private healthcare users.

Of course, the NHS should d be far, far better than it is. Thousands of people die unnecessarily every year because it’s so shit. People are desperate and will beg borrow and steal to pay privately. It needs to be improved so there’s fair access to decent healthcare for all. Pulling the rug out from under people before it’s improved to a decent standard, however, helps no-one. It simply disadvantages more people when we should be looking to disadvantage less.

Indeed - I suggest £10 per GP appointment; £15 per hospital appointment. These are nominal amounts but given 200,000 ENT outpatient appointments a year in a single hospital in London - think how much it could raise for the NHS.

And everyone pays so not tokenism - real funding and impact.

These are tiny amounts - why burden those already bearing the bulk of the burden?

But why ban it? If people want to pay, the income can fund the waiting lists in the NHS. The doctors won’t be affected as their private sector work will continue and the people waiting longest will have shorter wait times?

I also can’t see half our doctors upping sticks and moving to Australia! People have families, houses, kids in school etc

Why, so even more children have to suffer and wait in pain?

Won't happen - for all the reasons discussed. Fairness is everyone paying more tax (everyone, not just the 'rich') and more people becoming net contributors.

And ultimately a new model for the NHS, where users pay towards use at point of care

I don’t think that anybody is saying private healthcare (which has created a two tier system) is fair. Due to the state of the NHS significant amounts of people are however being forced into using it. It has become a necessity rather than a luxury in many cases and unless things in the NHS rapidly improve (which they won’t, it’ll take time) all a rise in VAT will do is make it prohibitively expensive for many people and increase the load on the public system.

Precisely. The ability to pay to get your health (and often livelihood) back is of course far more important and crucial. So equity there is of the utmost important

Twas Martin Luther King that said 'of all the inequalities, health inequality is the most inhumane' and he is correct.

However- precisely for that reason and others - no political party will float banning private healthcare/VAT or private or be seen to squeeze it. Especially in the current climate

It isn't about equity - just smart political choices

Always a race to the bottom.

Ok, so you’re saying tax on private healthcare would be unworkable whereas tax on private schooling is workable in practice.

At least that makes sense as an argument!

Some PP are trying to argue that private healthcare is fair, because health is much more important than school. This makes no sense. If health is much more important (and of course it is) then private healthcare is more unfair, not less.

Well I think most people recognise that the NHS is in need of more funding which will be difficult to achieve without major tax increases. VAT on private health insurance would not raise that much but it would help fund the NHS a bit.

On an equally basis why should rich people with private health insurance have an earlier diagnosis and better chance of success in treatment than someone whose need might be greater or are in more pain have to wait months and months for a diagnosis and treatment.

Lastly it's only 20% on a private health insurance cost of around £4k a year and quite frankly if you can afford private healthcare then there should be no problem in paying an extra 20%.

My child is in private because I wasn’t prepared to wait 3 years for a diagnosis followed by protracted battle for appropriate support in state. Ultimately I wasn’t prepared to submit my child to unnecessary trauma when we have the resources to provide otherwise. I imagine you felt the same when you chose private medical care.

Good point. Things can never be fair. Far fewer people can access private schooling and those who can and are forced to state clearly have more means than most - so can tutor, homeschool, send to beautiful camps and nurturing ECAs. Their kids will still thrive above the average.

A far larger demographic - especially now - are accessing private healthcare. You also have a strong medical lobby who only came into the NHS on the condition they can practice privately. It will be a very brave government that messes with that. Doctors are mobile and wanted all around the world - there would be an exodus. It is a non-starter

As I said before - doesn’t this make private healthcare much more unfair than private schooling? If one person can pay for something that means life or death, and another can’t, that contributes far more to inequality than different schooling, surely.

How is it equitable? They are already paying tax for public healthcare, at a rate appropriate to their income level. If they are high earners that means they are already paying more than those who are struggling, by quite a lot.

Then instead of taking up space and money in that system, they are paying extra for their own care.

This saves the NHS money as it is, but aside from that, how is it "equitable" to make them pay more than anyone else, beyond their tax bracket? What does equitable actually mean in your mind here?

IPT- Insurance premium tax has gone from 6%in 2011 to 12% now.

Medical inflation- the costs of drugs and operations have risen massively too

The cost of private insurance is becoming so high that many individuals and companies are forgoing it, I work in this industry...sales on a downturn!

You might die from one if you're not treated sooner enough but you definitely won't from the other. Are really trying to compare life and death to going to a private school?

Yes it's IPT and it's 12%

Yes!