Reading this on the peasant wagon home I've stopped to mention one surefire, simple way of getting people talking about real reform of the NHS.
First what are the main wildly wrong views people have of the NHS?
- That it is free.
- That it is fair.
- That it is the envy of the world.
Now I won't try to fisk these particular points about the NHS; they have all been done better elsewhere and by smarter people, and I'm sure that, for it's faults, it does still do it's job as good as it can, however all the points made above do not address one aspect; that the current free at the point of entry scheme need be collected as it currently is.
So my suggestion is this: National Insurance should be collected in the same way any private insurance policy is: by going direct to the consumer with an invoice/bill*.
Would you really be as disinterested in how much your national insurance premiums were value for money if you had a bill came through your door or a debit left your account at month end?
People forget where they should look on their pay slip; it's not the "Net" box at the bottom right highlighted but the "Gross" pay amount normally hidden above.
Can you imagine what would happen if they did this to income tax?
* = Taking it further why not have a part-fund mechanism for NICs? Your unemployment and pension become linked with a minimum annuity guarantee on the pension- if your unemployed the fund kicks in to pay for it until you find work whereby it fills back up again; if you drain the fund it defaults to your pension pot - if you live a life on benefits you drain your pension pot to it's insurance backed minimum which provides a lower annuity threshold than would be got for paying in normally - if the unemployment pot fills you pay a lower rate of national insurance than you would filling it.