Well in my post of 10:02 I told you about my experience of being given an exemption certificate as part of getting my cancer diagnosis, and your wish to "kickstart a discussion" clearly isn't strong enough to bother to engage with that post. At the time I had a reasonably paid job and would not have qualified for benefits but I certainly didn't have a magic money tree to rustle up a spare £115 for a prepayment certificate on that horrible dat. If you genuinely think a mum like me, in my 40s, should immediately on being given news like that either have to fork out a sum.of money like that or cope with the process of means-testing admin, whilst in mental freefall with no idea how long she will be capable of working, or how long she'll be alive - well there's something seriously wrong with your humanity and empathy.
I also made a suggestion for how the government coukd tackle and reduce a current expenditure of £66bn per year but you haven't bothered to respond to that either.
So I do not believe you actually want to kickstart a discussion, you just want to punish sick people for getting sick.
Illness is not a sin to be punished, nor a failing that wise people avoid. It doesn't matter whether someone is rich or poor, no one deserves to have to purchase access to their healthcare. Healthy people, whether rich or poor, don't deserve to keep more of their money than sick people in the same income bracket. 3 million people per year who don't qualify for an exemption certificate buy a prepayment certificate, which indicates that they need more than 12 prescriptions per year. Most people need fewer than 3 prescriptions per year. The government would get more money by abolishing all prescription charges for everyone, and raising taxes by £30 per year per person (£2.50 per month) so that these costs are shared by everyone rather than specifically being paid for by those who are most sick.
Here's another idea that would save huge amounts of government expenditure - pass a law that all the privately-owned rental properties where the landlords continually fail to meet their obligations to ensure the property is a healthy and safe place to live while charging extortionate rents - which cause high government expenditure on dealing with health issues from living in cold damp mouldy properties as well as pushing up expenditure on Housing Benefit - should be forfeit and taken over by social housing providers with no compensation to the exploitative former owners who so thoroughly failed to meet their obligations. These non-profit organisations can then sell some of the properties to developers to be fixed up and sold to First Time Buyers (with a clause in the title deeds that they must only be owned by single-property owner-occupiers for 20 years) and use the money to fix up the remainder to be rented to people who need to be in rented accommodation for any reason rather than buying at a fair and reasonable rent thus slashing the housing benefit bill by way more than your nasty let's-attack-ill-people idea.