There should be more partial-private options in health and education

[Middlelanehogger]

People often say that for social mobility reasons we should abolish private schools or private hospitals as it's unfair that there's "one system for the rich, one for the poor".

However I think this thinking is backward. We should encourage more gradual step-ups that enable people to slowly inject more of their own personal money into the system as they move up the income ladder and become able to do so.

For example, currently I have the choice to go to my underfunded, busy NHS GP, or a completely private GP and pay the full costs. Likewise I could send my kids to state school or go completely private.

Great if you can afford the "completely private" option.

But there isn't an intermediate option. In Australia for example, you get a govt rebate of say $30 for every GP appt. This covers a basic GP, or you could apply it towards a more expensive GP with a nicer waiting room or late operating hours etc that costs say $50 (i.e. you only pay the $20 difference, vs $0 in the free option).

In the UK you either pay £0 or £50. There's no £20 option.

In the Australian system, the health system overall gets an extra $20 that wasn't there before (from the extra top-up), and more people are able to access the nicer services (because more people can afford $20 than $50).

There's a similar argument to be made for private education. Why can you not "move" your state school funding to a private school to offset the costs? It would allow a smoother mixing along income levels instead of the harsh cutoff/separation we have today.

Eliminating inequality is completely impossible due to human nature, but keeping a harsh separation between "the rich" and "the poors" also isn't the answer. It just keeps "the rich" even more in their bubble.

@AP5Diva

If you had to pay for an appointment it would be payment after the appointment so, there wouldn’t be a situation where you’d pay £20 to book and then lose the money if you no show.

Why? I have to pay in advance for all kinds of appointments, such as for earwax removal/hearing aid consultation, private physiotherapy, vet consultations, etc. Not sure why you'd automatically think that payment upon making an appointment wouldn't be the norm at all? It's happening more and more these days, especially now that most people pay by card.

Actual spending per capita is actually higher in London (£3,811) than other parts of the UK (average £3,236). It'd be interesting to know why spending in London is 18% higher than the UK average!

https://www.statista.com/statistics/651514/uk-health-spending-per-person-by-region/#:~:text=In%202021%2F22%2C%20health%20spending,per%20capita%20in%20East%20England.

You need an account to see that chart. My guess is that spending in London is a combination of specialist hospitals and London weighting.

London always gets more money because cost of living is so high. The wages for all the healthcare professionals has to be higher and that is what is driving a higher per capita spend.

Disgraceful idea. Reducing social mobility. Everyone has the right to decent education and healthcare, tax the rich more and get rid of the loopholes now.

I like this idea in theory. But would it cause a really hierarchical system where people with choice get better service and people with no choice get none and get the worst service?

Could we instead get a thing where we can donate as box/ randomly whatever towards the NHS? Schools? Choosing certain parts of it? but maybe not a certain geographical area?

We have a hierarchical system today (it just only has two levels, very far apart).

@Kazzyhoward my ideal scenario would be public services used by everyone, and good enough that there is no perceived advantage in going private

I understand that in eg Denmark, private schools exist but aren't widely used as public system is so good

Unearned income for starters, quite why Sunak gets away with paying 20% CGT on millions from investment income is beyond me.

The UK had very low levels of Corporation tax for over 7 years, we attracted little to no new FI, political stability matters and the UK suffered during that time period, not great now.

ROI has excellent infrastructure, educated workforce and most importantly, has a certain romantic connection with the USA.... then there is Brexit, which made the ROI the only English speaking country with full access to mainland Europe, something we used to enjoy.

Its not their CT rate alone that has driven the economy.

a really hierarchical system where people with choice get better service and people with no choice get none and get the worst service

by choice, you mean money - right? Because the bottom line is that money buys advantage - whether that’s more choice, better education, better healthcare. And more money = more advantage.

what we are doing here is arguing about how much advantage should people with money be allowed to buy, and in what circumstances.

we are already in a hierarchical system, and the hierarchy of choice is set by how much money one has.

Disgraceful idea. Reducing social mobility. Everyone has the right to decent education and healthcare, tax the rich more and get rid of the loopholes now.

How do you define the 'rich'? Those people already paying 45% tax on their six figure salaries? Or the multi millionaires that are internationally mobile and likely to head elsewhere if the tax rate is any higher?

The top 1% pay 30% of all income tax revenue according to LSE, the highest in 20 years. That equates to 300,000 individuals paying 30% of all tax revenue. And that's before VAT, CGT, IHT and the rest.

At what point does higher tax act as a disincentive to work or an incentive to move to another country? Or earns less than it costs to administer, as it did when George Osborne introduced the top rate?

We need to look beyond 'taxing the rich' as it's too simplistic and some of our public services need fundamental change to support a higher population.