The whole concept of the Social State was to assist those less able to assist themselves.
So far so good. Most other Western states followed the British lead, thus it is perhaps convenient to use the historical data as a benchmark.
In fact, healthcare was indeed private in the UK, prior to 1948, when the Labour politician, Aneurin Bevan created his then wonder of the World, the NHS (National Heath Service).
Prior to this, people paid a weekly subscription to belong to a local "Panel" and GPs were contracted to this panel.
The better off, paid privately each and every time they saw a doctor.
Certain charities built and maintained so called "Charity" hospitals for the benefit of the poor.
Many important hospital facilities ( e.g. Asylums for treating the mentally ill), were mutually built by local funds raising and again, maintained by donation.
Fast forward: As the scope and impact of the Social State expanded, rapidly post 1960, thanks to Liberal and Socialist thinking, Social Security (which these days tends to include heathcare) became a sort of Western government "Must Have", with the expected impact on fiscal budgets.
When it started of, by Harold Wilson's Labour government from 1964, the reasonable concept was that people would contribute, via the state, for their future.
As is always the way, along the path to primrose sweetness and light, somehow, the contributions failed to keep up with the ever-expanding expenditure!
France enjoys probably the best public heathcare system in the World. It is much criticised, mainly by external commentators with no real knowledge of either the French system or how it actually works! Much of the French way of life, economy and political structure is criticised in a similar fashion!
In France all heathcare is private: nothing is operated by the state,
However, there is no such thing as "Private Health Insurance": people pay significant contributions (cotisations) which can even continue in retirement!
Everyone is issued with a green plastic smart card (A Carte Vitale), which is used to pay all doctors, prescription ambulance and hospital bills.
The state, however does not pay 100% of the cost, unless the complaint is seriously life threatening. What is paid varies between 65% and 85% of the total cost. To fund the rest, people join a non-profit making mutual (Mutuelle) insurance society which pays the balance of costs, depending on the cover taken.
Thus the French system is far more aligned to the profile suggested and recommended by most economic analysts and commentators.
There is a myth (propounded and encuraged by institutional investors!), that private insurers are far more effective at managing heath insurance and etc than the state.
Try telling this to those who have lost their pensions in the past 15 years: have had claims for health benefits rejected on dubious grounds!
The trouble with insurers, is that want to load the premium if a proposer varies from an ideal candidate living in Utopia: and then reject claims on top. i.e. they want their cake and eat it too.
Now, I particularly object to these practices, when life cover is concerned.
All life cover premiums are based on expected mortality tables, calculated by actuaries.
OK so far. So the insurer stands to make a profit if the insured dies within the range of risk.
However, the range of risk takes into account everyone! Sick and healthy! That's how mortality tables are calculated!
Thus having coppered their bet once, then the insurance company want to charge a proposer even more premium if they show any symptoms which might make them die early and thus accord to the mortality tables which are the basis of the original premium anyway!
So, you see why you can't use private sector insurers to run any social security or heathcare system on behalf of the state!
As people become older, then they become much more likely to become claimants on healthcare; logical huh?
However, private healthcare insurers want to front end load cover, as people become older: despite the fact that they have been paying in for perhaps 40 years with no major claims! And quite obviously, with a state system you can't start excluding people.
Probably, the ideal compromise is to have the state run the benefits system and have the funds managed by a consortium of the largest funds managers with strict controls on management fees.
The alternative to a social state, is a pure market-driven system.
This would mean either paying everyone, skilled, unskilled, lunatics, ne'er-do-wells, the unemployable, the mentally challenged an annual income sufficient for them to afford access to the market system for heathcare and etc.
Quite obviously, that is untenable: the only remaining option, of course, is putting down the sick, the halt, the lame and the mentally ill.
Hitler tried this, as did Stalin.................................
Paq
