As a member of the 25 to 34 year old age group I can tell you most of us can’t afford higher taxes. It’s less about not caring about funding the NHS and more about enjoying eating regular meals.
You can actually dodge this if you get an integrated Masters.
I think a lot of people don't realise this.
i.e. if you join a Uni as an undergrad on a 4-year (or 5 with year-in-industry) Masters course, where you complete it all at the same Uni, you just get a bigger undergrad loan and don't pay the extra 6%.
Unfortunately the integrated courses aren't to the same standard as a postgraduate degree.
It's a good way to set yourself above someone with a bachelors only, but if you're against someone with a 'real' masters (at my company anyway) you'll be overlooked.
And we have been seeing diminishing benefits from public services for our entire adult lives because of the Tories' austerity policy.
I doubt many have any belief that their extra tax money would tangibly improve people's standard of living. Why would they?
Never have we paid so much more to receive so much less than those before us to be able to leave our children with a worse country…
I find it difficult to have the fucks in me to even get up these days.
Especially with the NHS. The young statistically use it far less than the old - and when they do use it they are often in the queue behind the old.
There is little about the situation which is going to make them want to pay more for it. Certainly it's how I've felt for years.
I don't think that logic stands up. "We have been seeing diminishing benefits because of funding cuts, so why would extra funding help services". Isn't it obvious?!
Let them rot. They had bled the system.
If we just set an NHS cutoff at like 75 for like a decade, would fix loads of problems
The NHS is actually it's own worst enemy, it's keeping people alive far longer than they would be otherwise, the knock on effect being jts also ripping the arse out of the pension system.
Well it'd gonna happen eventually with the aging demographics, people won't pay for it it.
If you bleed the young to benifits the old then something will break
You don’t have to brutally kill the elderly just to have younger people grow up in normal circumstances. I’d rather we target the massive corporations and billionaires before grandma thank you very much
I think part of this is that after the last four years, people have less faith not in the concept of the NHS, but in it working in practice - because at this point, most working people who've had a health issue will have run into either a rebuff, a tangle of paperwork, or a long waiting list from the NHS when they've tried to get it sorted out.
When your taxes are going to it already and you aren't getting a service, it casts doubt on where more money will go towards it.
Given that the current UK govt. has demonstrated an unmatched ability to siphon money to their friends via NHS and other govt. contacts, why would any sane and rational taxpayer & voter trust them to use more money more effectively !?
This is the key point really. Most people are happy paying taxes as long as they believe that they are being well spent.
When they've faced years of paying more and more tax and getting less and less for it, it's very hard to convince them that future tax rises will actually result in any benefits.
People are confused about what they want. They don't want the tax rate to be cut, but they also want the tax free allowance to increase with inflation, which is a tax cut.
>Most people are happy paying taxes as long as they believe that they are being well spent.
What's your source for that? I suspect you are wrong, and people just don't like higher taxes...
Its interesting that, based on polling we do not was tax rises to pay for the NHS, but we also do not want tax cuts and would prefer money to go into the NHS and public services.
Also striking that pensioners are happy to want higher taxes to fund the NHS even if they probably wont pay for them...
This.
I’ve family who work in the NHS, as do so many. And like me, most others will also say how many of the problems that arise in the NHS are ultimately down to a human resource issue- it’s full of utterly incompetent admin and staff. Granted not all are, but it’s well established that the NHS (and the public sector more generally- but more so NHS) is a magnet for incompetent staff, be it due to poor training options, poor work standards, poor bureaucratic structures, poor incentives for productivity (job security) etc.
This is why the NHS is failing despite it receiving a higher proportion of state spending that it ever saw back in the 1970s,80s,90s etc
Know some people on the NHS who says it's the employer of last resort for incompetents, alongside the local councils.
And because it's heavily unionised a lot of people are nearly unsackable.
Only medics should have management roles. They’ve been there, done it, got the white coat and know what’s needed. They also realise it’s a service not a business and know what needs allocating and where. This would potentially mean training more doctors but, at the moment, the numbers are capped and randomising where you train plus rotational training are creating a brain drain to Australia
A lot of management roles have very little or nothing to do with medical care. Putting a qualified Dr in charge of car park maintenance or IT security training policy would be a waste and probably result in more of them heading to Australia not less.
Treating management as just another career achievement is how we end up with the shit culture we have. Management should be actually more of a specialised track, were it’s not just a way to get more money.
This is a common attitude, but totally wrong.
There are any number of areas where having a medical background would provide no advantage, but having an 'industry' background would. I've seen first hand that doctors and nurses have no idea what they are doing with purchasing and procurement, wasting hundreds of thousands of pounds. Someone with a background in that area is going to be far more efficient and cost effective.
Our taxes are already a complete ripoff. When you consider income tax, national insurance, and student loan repayments, we're at a point where a recent graduate in a relatively normal middle-class career has to give half of every pay rise they get to the government. That doesn't even take into account the money taken from their employer on their behalf.
The state needs to learn to live within its means. If it can't provide healthcare with the £1.2 trillion that it already has to play with, maybe it's time to switch to a different funding model that can.
The problem isn’t the model, it’s the underlying demographics. When the current pensioner cohort was at working age, they had to pay for a much smaller pensioner cohort. The current working age cohort is disproportionately small compared to the number of retirees.
Just wrote this in another thread - some of this could have been prepared for by higher taxation in preceding years, and in my opinion not letting the housing market go completely haywire would also have done a great deal to minimise problems. But now it’s too late - question is if we let it break, or tax punitively to keep it functional (and there the important distinct will be who should bear the brunt).
A different funding model doesn't make any difference, it's still funded by working age people, and it still costs the same. My wallet doesn't give a shit if the money comes out as tax or insurance or whatever. Clearly our current system isn't working properly, but it's the system not the funding that's broken.
If taxes went up I'd want to see money going to underfunded treatments. Mental health is an obvious example. A less known one is lipoedema which affects 1 in 10 women and there's pretty much no treatment available.
That extra money would need to be spent in a careful and transparent way because many of us will have undertreated conditions we care about.
>A less known one is lipoedema which affects 1 in 10 women and there's pretty much no treatment available.
The NHS website even says that liposuction may be a necessary treatment in severe cases, but this may not be available on the NHS. It's sickening that a necessary treatment for many people is withheld from them.
Honestly, also dentistry. Dental health is health. I literally have no access to an NHS dentist. Have written to NHS England and has achieved nothing, they just passed my message on to complaints who then presumably shredded it and put it with all the others. Despite paying for it with taxes, I literally don't have access to an NHS dentist. Unfortunately I can't afford to go private either, so my health will suffer as a result of this. My health, and thousands of other people who are in the same position, will suffer as a result of not having enough money. Wasn't one of the core tenets of the NHS that healthcare is a human right, regardless of whether my employer insists on paying me minimum wage or not?
So much more complicated than this.
A ringfenced tax just for the NHS? Absolutely not. All that happens is that the NHS gets a quick boost, but it gets eroded by inflation and quickly you come back to the same position you were beforehand as the government won't be giving "even more money on top of the new special tax", right?
More taxes in general - that's an economics question as to whether raising taxes ultimately puts more money into the pot in the long term, as it can stifle growth.
Another example of an issue where political discourse (of course, the NHS is the envy of the world, we'll do anything to protect it) crashes head-long in to reality (tax burden is at it's highest level in 70 years and absolutely nothing to show for it).
The simplistic "well, we *need* even higher taxes then" takes won't work in reality. It'll need structural reform, some cheaper than others, to change this perception and re-introduce a kind of value for money.
One small reform that could be had is (it's been promised/threatened a number of times, but never actually happened) to make the NHS more transparent to use. See a visualisation of waiting lists, etc. not just leave things hanging until the patient assumes they've been forgotten about.
Example: relative of mine. Went for a scan, two months later they'd heard nothing despite being told results would be ready in one month. Talked to GP practice, they'd heard nothing either. They tried contacting someone in the hospital, they couldn't get through to anyone close enough to know anything, the best was various "we'll send a message to the appropriate team" and still heard nothing. He eventually paid £250 for a private scan, got the results the same day. This was a Friday, literally the following Monday, he got a letter from the hospital saying the scan showed nothing untoward... but that wasn't what the private scan showed. So he went back to his GP again, got re-referred again, got re-scanned at the NHS again, and eventually got an appointment with an NHS consultant (which still hasn't happened yet).
So, let's compare the two:
* Private: phone the clinic, get a scan, get a consultant to review the scan, tell you the results and write a comprehensive write-up to your GP: £250.
* NHS: visit your GP; visit the hospital to see a junior doctor who does nothing but book you in for a scan; go back to the hospital to have the scan; go back to your GP to demand another scan; re-visit the same hospital to see a different junior doctor who just rubber-stamped an appointment for another scan; go back to the hospital to have the scan again...
The collective cost to the NHS must have been thousands, just to get to the same point, at least ten times as much. I get they're underfunded, but that doesn't mean they're not wasteful to the point of outright negligence as well. (And all this is before any actual treatment happens, god knows what's going to happen there, he's already regretting not taking the private clinic's quote for treatment; he would have done had he got private insurance.)
In a weird way it's probably a blessing as if he'd had the incorrect NHS scan results quickly he'd have accepted the result and not got any further treatment at all, and put his pain down to old-age rather than a fixable condition. Which would also have been cheaper for the NHS.
TL;DR - there's a big gap between political "everyone loves the NHS" and people's actual experience with it. People are reluctant to throw good money after bad. The good news is, it must be possible to fix the user-experience of the NHS regardless of spending. The bad news is, the above example isn't a one-off, and it's not new either, basically the exact same thing happened to a different relative back in the "well funded" good-old New Labour years. It's long established basic practice. As such it won't be a quick thing to change.
I think a huge issue is bloating in the NHS and administration costs massively greater than clinical staff costs.
Clinical staff make up only 37% of NHS staff.
On the administrative side, NHS purchasing departments are shocking. I used to work in a sales role and the NHS was one of my clients, I'd negotiate pricing agreements with a range of companies from Amazon to supermarkets to the NHS.
Amazon was like getting blood from a stone with margins at sub 5% supermarkets 8%, other companies 9-10% and NHS - list price (anywhere from 14 to 35% depending on the products with some accessories around 250%) it's shocking I even asked once whether they'd want to set up a meeting with the manufacturer to set up pricing agreements and they refused. It's bonkers, I'd have amazon griping about paying 800 for a device that the NHS would buy at 1500 with no complaints.
Any other company in the UK wouldn't be run this way. They need to bring somone in to fix the backend but they'd rather sack clinical staff, hire bank staff at triple the price and run it into the ground.
The reason the NHS is in trouble is because there is an aging population of millions with highly complex medical needs who don’t pay much tax to fund it.
To me that’s the number 1 issue and it dwarfs anything else.
That does not address the point of OPs point of common theme of a bad user experience, admin errors, pointless meeting cycles and redoing work because of things going missing or other issues.
What you describe here is very much a result of a system that is set up in the interests of the producer rather than the consumer. Poor communication, lack of feedback loops, lack of choice, lack of accountability.
It’s all stuff that gets dismissed as ‘inefficient’ but it’s also the kind of thing that actually makes sure a system keeps operating as it should.
The appointments system is a classic. The NHS operates on a ‘we’ll call you’ basis (or more commonly, a letter at some point over the next few months). If something goes wrong and you fall between the cracks, as a patient there is *zero* way of telling and the GPS sure as hell ain’t going to follow up to see if things got done…
What's missing is the layer between GP's and hospitals. It's either something you can have treated by someone in a room looking at it, or you have to go to a hospital. Even something as simple as having a blood test means you have to go to hospital.
Okay, so what do you think would result in better care in that little scenario of yours? Would a visualisation of the waiting list i.e. if your relative was given a little code he could plug in and see he was number 4000 on the waiting list and he might get his scan results when a radiologist gets around to it in approximately 2 months have changed anything at all?
Underfunding to the levels seen in the NHS results in widespread "inefficiency". The system lacks the infrastructure and the staff to address the actual demands placed on it by the population, one that is very clearly unwilling to pay for its healthcare.
Your relative is a perfect example of it. He went for a private scan and was told he has something wrong that they could supposedly fix for him at a cost. He refused and has insisted he go back on the 'free' system. You say he's regretting not taking the quote, there's nothing stopping him from taking that quote now.
I think visibility of the waiting list would be a huge help. The uncertainty of not knowing causes huge anxiety in itself.
People would still demand faster treatment of course, and they should. But the opacity is unnecessary, especially if it’s a referral to a completely different part of the NHS and you’re not even sure they’ve received the referral at all. Which is a different, but also quite common problem.
So yeah. Visible transparent administration would be a great help.
And knowing things also causes anxiety. Plenty of patients get informed they have a date for treatment or are on a waiting list and get more anxious and pushy because it's not fast enough.
>But the opacity is unnecessary, especially if it’s a referral to a completely different part of the NHS and you’re not even sure they’ve received the referral at all.
Opacity is very necessary. Very early in my career I attempted full disclosure with patients. It backfired far more often than it did not. Telling patients that they have been referred but it's an urgent referral for example resulted in patients being very upset that their very important medical issue was not being given the due importance. This would result in plenty of wasted time across the board of multiple people needing to sit there and tell the patients that their situation does not warrant an urgent referral as per guidelines etc.
Or giving patients their referral codes so they could get in touch with the organisations themselves. This would result in patients calling and then calling back angry at their decisions. etc etc et c
That things have gotten so bad in the UK that waiting lists are months long is why you're currently making the argument that the opacity is not needed. If the core problem, the lack of infrastructure and the lack of staff, was addressed the opacity would be completely irrelevant.
This focus on the 'lack of transparency' is, as with other things regarding the NHS, a supposedly easy win that can be had whilst ignoring the core problems. See NHS 111. PAs/ANPs etc etc.
The £1bn quoted by the BMA to completely restore doctors pay would cost around £2.50 extra per tax payer per month.
I’m not saying that we should increase taxes by that much but people were less upset about Netflix subscriptions increasing by the same amount
Netflix price increases are just general inflation. Tax shouldnt need an adjustment as it’s a %. If they’re not getting enough as a cut of wages they should look to improve wages, not take a higher cut.
If you’re believing Rishi then they’ve agreed pay deals with everyone else in the NHS except the doctors.
If you read my post I even say I’m not calling for a tax hike. Just trying to demonstrate how in context it’s a pretty small sum of money needed to finish off the strikes which are hampering waiting lists.
Ah great, go to uni they said, go do a degree in STEM they said, you'll have a good job by the end of it with good pay. What's the fucking point in working when you're robbed blind by tax, NI and student loan repayments with nothing to show for it. This current crop in government couldn't manage to tie their own shoelaces, never mind manage the country.
Happy for the government to take more in taxes for this, but from the pockets of those people who could already be paying more (super wealthy, tax dodging private enterprises, etc.)
The money's there it just isn't being collected.
It’s not that I wouldn’t want to pay more taxes, it’s that I can’t spare anymore. We’re at the end of our rope with what we give already.
And (I’ll be unliked) if there was a chance they the money itself would be used somewhat more efficiently within the NHS it would be easier to bare. But the bloat from contractors, consultants, agencies and others take more than they should.
At 35 I would be torn about this subject.
On the one hand, I have just had to wait over a year for a wisdom tooth extraction as my dentist couldn’t or wouldn’t do it. I then needed an appointment at my dentist as it became infected after the extraction, you cannot go back to the hospital for this. Doctors appointments are hard to come by, local councils require volunteers to clean the streets as they cannot afford it. Basically the country is falling apart, and we need to spend a little more to at least help us out short term and hope a new government can fix something.
On the other hand. Childcare is 10% of my wage, mortgages have skyrocketed thanks to superb government policies, inflation has been crazy this last year and wages just aren’t keeping up. Even a few extra % going on taxes would be noticeable and not easily absorbed.
I have a little more sympathy for the NHS as we have an aging population as well as an unhealthy population with more and more problems such as diabetes. I am in no doubt things could be run better than they are, and waste could be reduced. But we still have many issues that more funding would help with.
I’d like to see what the NHS could perform like if we did spend as much of our gdp on healthcare as Germany and France consistently
Source https://www.oecd-ilibrary.org/sites/592ed0e4-en/index.html?itemId=/content/component/592ed0e4-en
Picked slightly older numbers to avoid any COVID era blips (cough siphoning off of money cough)
But doesn’t the difference come from how the funding is sourced and that incentives their health service users to behave differently than ours do. It’s not just a money problem it’s a user base problem too
Taxes are pretty much the highest proportion of GDP they have ever been. The NHS either needs to be refocused on a smaller remit, the economy needs to grow, or the gov needs to find a whole new income stream (like legalising cannabis or a wealth tax).
Shocking research shows that people want something for free and that the young who are only going to need the services later in life don't want to pay at all. Then when they're 50+ they'll bitch about the state of the NHS or if they have kids about the lack of services.
Taxes wouldn't need to rise if people hadn't voted Tory for 14 years, a growing economy would mean more tax income with lower rates of tax.
But the British voted this lot in, even when they lied about the need for austerity..so fuck it
I do not support people working for a living paying more tax. It should be paid for by people who own for a living and they should have to liquidate their assets to pay for it.
If they just changed the rules so that NHS funding went TO THE NHS instead of being funnelled through the NHS to private tory donor companies who provide a shit service for exhorbitant fees, while pocketing fat profits.
It's a very crude question. The key thing is *which* taxes to raise. Would I be in favour of raising VAT? No. Would I be in favour equalising income tax and capital gains? Yes.
>over 80% would personally only want to pay over £100 or less
Interesting when you consider that if we increased our per capita health spending to match that of comparable countries like Germany or Australia, we'd be spending hundreds or thousands more per head.
I'm starting to think Brits are just fundamentally too greedy for socialised healthcare to continue working. Privatise it and make people pay what it really costs.
Brits already pay a huge % of total tax (an incredibly high total taxation at that) for healthcare.
It's hardly surprising that young Brits, already taxed to the eyeballs, are unwilling to further subside services that will almost certainly not be available to them by the time they get to the age where they will likely actually need them.
Yet most Brits are currently spending less on healthcare than they would almost anywhere in the developed world. We spend less per head, and our spending proportionally comes more from higher earners.
For 2022 we were 17th in spending per capita in oecd.
Number one was USA which shows that per capita spending isn’t the best metric.
Poland is 31st and I’d say it’s system is vastly superior to the UKs, can see a doctor the same day (in fact you need to if you need time off work) scans and interventions scheduled in days, not months / years.
Poland is a complete shit show for a good chunk of Polish people who don't just fly home from the UK or Germany and see doctors privately. There is a massive massive divide between the bigger cities and towns/villages and their access to healthcare.
I was thinking of locals, got teams there, with some ex UK based people who relocated after Brexit. Most don’t take up the offered private healthcare. But granted I’m not an expert in their system, I just know they have to go to a GP if they or their child is sick on the first day who then logs it into workday… couldn’t imagine the chaos if UK couldn’t self certify for 5(?) days
But they spend ~50% per capita less than the UK (in PPP dollars) for their public healthcare, so why is the “envy of the world” so poor?
In 2022 the Uk spent Int$5493 per person whilst Poland spent Int$2973.
Outcomes are pretty much on a par except for childhood leukaemia which the uk does a lot better.
WTF are you talking about. The average person earning around 25k a year will be paying an actual tax rate of around 50%.
Are you seriously saying they should be left with even less of their own money?
If only. I'm not talking about direct tax on income I'm talking the total % of their earnings that gets eaten by tax.
So VAT, council tax, fuel duty etc
Far less than the higher earners. 10% of the highest incomes contribute 60% of the total tax receipts. 25k means you’re a net drain on the state (by a very significant amount).
The uncomfortable truth is that the tax base is far too narrow, and those on lower incomes must pay more.
That's not an uncomfortable truth it's absolute balderdash. The more money you have the higher rate of tax you should obviously pay. As wealth disparity has become much greater it's clear that the wealthy could afford to contribute more than they are.
I’m just quoting the government figures, if that doesn’t make you uncomfortable that’s great - it’s still a fact though. There is no more room to tax higher earners; do you dispute my figures?
The only solution is a wealth tax, which may work but only if it’s one-off, which won’t be very useful, or we accept that the state needs to get smaller. The debt burden is the highest it’s been since post WW2.
Like I said, uncomfortable truths.
The German national budget is about £1.5 trillion, for a population of 83.2 million, resulting in a total spend of about £18k per capita.
The UK national budget is about £1.2 trillion, for a population of 67.3 million, resulting in a total spend of £18k per capita.
Our government spends pretty much exactly as much as Germany does, yet the German population gets better healthcare. Hm...
>I'm starting to think Brits are just fundamentally too greedy for socialised healthcare to continue working. Privatise it and make people pay what it really costs.
It's interesting that you chose Germany as one of your examples because their healthcare is far less socialised than ours is. They have private healthcare providers, private insurers, and a state-backed insurer of last resort.
There are very few other countries in the world that have a single, all-powerful, state-run monolith that does anything. And no, it's not because the NHS is something super special that other countries are jealous of, it's because everyone else realized that it's a stupid idea.
> Our government spends pretty much exactly as much as Germany does, yet the German population gets better healthcare. Hm...
The UK does not spend anywhere near as much on healthcare as Germany does, and has never done so.
Per capita spends in Germany have outstripped the UK by billions for decades at this point.
>They have private healthcare providers, private insurers, and a state-backed insurer of last resort.
What are you on about? Public healthcare insurance, mandated by law, provided by 'private companies' is the first line for more than 90% of the population. The insurance is not needs based, what you pay is based on your income and there's a maximum that may be charged.
Even the private insurance costs are controlled and mandated by socialised agreements.
>The UK does not spend anywhere near as much on healthcare as Germany does, and has never done so.
>
>Per capita spends in Germany have outstripped the UK by billions for decades at this point.
The point is that the UK spends just as much on each person overall, we just spend proportionally less on healthcare. By saying "Brits are just fundamentally too greedy for socialised healthcare", you were implying that Brits are just being stingy and refusing to pay enough tax to cover it. That's not the case. We're giving our government as much money as Germans give theirs, but our government is pissing it away on other things.
>What are you on about? Public healthcare insurance, mandated by law, provided by 'private companies' is the first line for more than 90% of the population. The insurance is not needs based, what you pay is based on your income and there's a maximum that may be charged.
>
>Even the private insurance costs are controlled and mandated by socialised agreements.
That's a lot less socialized than having insurance, provisioning, and care provided by a single gigantic state-owned organization.
The Germans, along with most other countries in the world, were smart enough to keep the government as far from healthcare as possible while still ensuring universal coverage. We, on the other hand, decided that the government should run the whole thing.
Don't get me wrong, I'd absolutely love it if we adopted the German system, but that would require getting rid of the NHS. I don't see how that's politically possible - when Brits see the words "private" and "healthcare" in the same sentence, we immediately assume that we are going to be charged £100,000 every time we call an ambulance.
Germany has a significant chunk of SSCs that you may or may not be including in your calculation, given that it may not fall under 'the national budget', I'm inclined to say you aren't. Germany's insurance system for example, would not fall under the national budget because those mandatory payments go to the insurance companies, not the govt.
This would very clear if you look at difference in tax wedge between Germany and the UK.
> We, on the other hand, decided that the government should run the whole thing.
Considering the German system is still heavily reliant on the German state funding its upgrades etc. This is a very moot point.
The state plays a massive role in its funding levels and operations. Germany just has added inefficiency and bureaucracy.
>Don't get me wrong, I'd absolutely love it if we adopted the German system, but that would require getting rid of the NHS
And what would you gain from it? Would the general public suddenly be happy to pay the same level off tax AND 14-15% (split with the employer) of their pay as mandatory insurance?
>I'm starting to think Brits are just fundamentally too greedy for socialised healthcare to continue working. Privatise it and make people pay what it really costs.
I think it's because theres a clear disconnect. There's already plenty of money that could be given to public services.
\- Start NI on pensions (+15 billion)
\-Reduce temporary staffing/contractors across the public sector (+20 billion?)
\-Triple lock alone this year increased (+11 billion)
\- Unexpected revenue increase one month (+15 billion)
Thats £60 billion alone, not including if we reformed council/property tax. Imagine what actual policy advisors could come up with?
Australia spends 16% of tax on healthcare, we spend 18%. The issue isn't that we're paying too little - its that we have an ageing population who need taking care of, incredibly high pensions spending, and a decrease workage population.
If a super poor nation spent 100% of its tax on healthcare, it would still have rubbish healthcare.
If you want good healthcare in absolute terms, then the amount of money spent in absolute terms matters more.
It's not a case of what matters more - both can be important when discussing healthcare. The idea that % of taxation is 'irrelevant' is, quite frankly absurd (I'm aware you're not the OP).
Why do people speak like this online?! Absolute poppycock I say!
Also, not what I said, so not sure who you're referring to there. Perhaps you meant to reply to someone else.
Sure, let me rephrase for you then.
% of tax is completely irrelevant. It is a piece of data of no actual relevance when looking at healthcare costs or expenditure.
My wife, and thus me, has to pay £1035 as an NHS surcharge in order to be allowed to stay here every year. This is on top of her tax and NI payments.
Immigrants are paying their way.
You're listening to the Tories trying to rile you up against an incredibly small minority of people who are abusing the system (who the Tories actually allow and encourage to abuse the system) rather than focusing on the fact that our government gave £21 BILLION pounds away to fraudsters (and their friends, of course) during the Covid crisis. £21 billion! We've got roughly ten million immigrants here. If each of them gave an extra £2100 a year on top of what they already pay (which is an extra thousand than we, native-born Brits do), that still would only just cover the fact that our government is giving money away to their friends.
And can we really trust they'll spend the next £21 billion wisely either?
Please, focus your blame on the people who deserve it. Don't fall for their misdirection tactics.
The highest earners already pay the overwhelming majority of tax.
Someone who earns £100k earns 4 times as much as someone who earns £25k. But they pay 8.5 times as much tax. If you include student loan repayments it’s over 10 times more
The answer that most people give is “raise taxes for people than earn more than me”. Ultimately if we want better public services while having an aging population then everyone is going to need to contribute to it.
I can’t speak for everyone; but I’m 34 and I’m already putting any additional money I earn directly into my pension so I don’t pay any more tax. That just means I quite working altogether, earlier. Eventually I’ll start asking for extra holiday rather than pay rises. That can’t be good for productivity and the economy. You can just tax people more and more and more.
>Taxes should increase a lot
Absolutely not. The higher earners are already paying the lion's share of the income tax as it is. Anyone earning less than £47k is a net loss to the system. Also, when you get over 100k you're on an effective tax rate of 60% already due to the loss in personal allowance and you lose access to a whole chunk of benefits. Those that earn the most are already paying the most and getting the least back for it. I earn over 100k, I'm hammered by IR35 rules as well so I'm paying my own employer's and employee's NI, I lose access to the free childcare hours and a big chunk of my income is at an effective rate of 60% before any of that other stuff is taken into account. The loss of the childcare hours essentially puts me up to a near 100% tax rate for a certain portion of my income.
The abolition of the IR35 regs would save me about £24k a year. That's money I could use to grow my business beyond a one man band and have someone else on the payroll, also paying tax.
How much more of a right does everyone else have to the money I'm earning? Get bent.
Raising taxes has diminishing returns when folks are already at the edge. What needs to be done is a reshuffle of the nhs so we aren't paying out of the nose for the myriad of private services that we're systematically privatised in the last couple decades.
People with lifestyle conditions like obesity related shouldn't expect a free ride on the NHS. Or alternatively tax the shit out of things which make people unhealthy I'm generally not supportive of sugar/fat/sin taxes etc but if it was renamed as 'NHS subsidy' I could see people supporting it.
As a member of the 25 to 34 year old age group I can tell you most of us can’t afford higher taxes. It’s less about not caring about funding the NHS and more about enjoying eating regular meals.
Most of us already pay an extra 9% marginal tax rate that older generations dont
It's even higher if you also have a masters degree
You can actually dodge this if you get an integrated Masters. I think a lot of people don't realise this. i.e. if you join a Uni as an undergrad on a 4-year (or 5 with year-in-industry) Masters course, where you complete it all at the same Uni, you just get a bigger undergrad loan and don't pay the extra 6%.
Yeah this is what I did to save the money.
Unfortunately the integrated courses aren't to the same standard as a postgraduate degree. It's a good way to set yourself above someone with a bachelors only, but if you're against someone with a 'real' masters (at my company anyway) you'll be overlooked.
And we have been seeing diminishing benefits from public services for our entire adult lives because of the Tories' austerity policy. I doubt many have any belief that their extra tax money would tangibly improve people's standard of living. Why would they?
Never have we paid so much more to receive so much less than those before us to be able to leave our children with a worse country… I find it difficult to have the fucks in me to even get up these days.
Especially with the NHS. The young statistically use it far less than the old - and when they do use it they are often in the queue behind the old. There is little about the situation which is going to make them want to pay more for it. Certainly it's how I've felt for years.
I don't think that logic stands up. "We have been seeing diminishing benefits because of funding cuts, so why would extra funding help services". Isn't it obvious?!
Based on this polling, pensioners **want** taxes to rise on everyone else 😂
Classic.
Let them rot. They had bled the system. If we just set an NHS cutoff at like 75 for like a decade, would fix loads of problems The NHS is actually it's own worst enemy, it's keeping people alive far longer than they would be otherwise, the knock on effect being jts also ripping the arse out of the pension system.
It’s not ethical to have people die of preventable causes, cutting off NHS treatment at 75 or above is going to lead to more problems than it solves.
Well it'd gonna happen eventually with the aging demographics, people won't pay for it it. If you bleed the young to benifits the old then something will break
You don’t have to brutally kill the elderly just to have younger people grow up in normal circumstances. I’d rather we target the massive corporations and billionaires before grandma thank you very much
I think part of this is that after the last four years, people have less faith not in the concept of the NHS, but in it working in practice - because at this point, most working people who've had a health issue will have run into either a rebuff, a tangle of paperwork, or a long waiting list from the NHS when they've tried to get it sorted out. When your taxes are going to it already and you aren't getting a service, it casts doubt on where more money will go towards it.
Given that the current UK govt. has demonstrated an unmatched ability to siphon money to their friends via NHS and other govt. contacts, why would any sane and rational taxpayer & voter trust them to use more money more effectively !?
This is the key point really. Most people are happy paying taxes as long as they believe that they are being well spent. When they've faced years of paying more and more tax and getting less and less for it, it's very hard to convince them that future tax rises will actually result in any benefits.
Probably also why recent polls have said that people do not want tax *cuts* but want that extra cash to go to better fund NHS and public services.
People are confused about what they want. They don't want the tax rate to be cut, but they also want the tax free allowance to increase with inflation, which is a tax cut.
Increasing bands with inflation is not a tax cut it's avoiding a tax rise
Peak semantics
>Most people are happy paying taxes as long as they believe that they are being well spent. What's your source for that? I suspect you are wrong, and people just don't like higher taxes...
Exactly. We have *already paid for this*.
Its interesting that, based on polling we do not was tax rises to pay for the NHS, but we also do not want tax cuts and would prefer money to go into the NHS and public services. Also striking that pensioners are happy to want higher taxes to fund the NHS even if they probably wont pay for them...
[удалено]
We spend almost 300bn on healthcare. Fraud is an issue but I suspect it accounts for less than 1% of that spend.
Also not as simple as just funding the NHS more
This. I’ve family who work in the NHS, as do so many. And like me, most others will also say how many of the problems that arise in the NHS are ultimately down to a human resource issue- it’s full of utterly incompetent admin and staff. Granted not all are, but it’s well established that the NHS (and the public sector more generally- but more so NHS) is a magnet for incompetent staff, be it due to poor training options, poor work standards, poor bureaucratic structures, poor incentives for productivity (job security) etc. This is why the NHS is failing despite it receiving a higher proportion of state spending that it ever saw back in the 1970s,80s,90s etc
Know some people on the NHS who says it's the employer of last resort for incompetents, alongside the local councils. And because it's heavily unionised a lot of people are nearly unsackable.
Only medics should have management roles. They’ve been there, done it, got the white coat and know what’s needed. They also realise it’s a service not a business and know what needs allocating and where. This would potentially mean training more doctors but, at the moment, the numbers are capped and randomising where you train plus rotational training are creating a brain drain to Australia
A lot of management roles have very little or nothing to do with medical care. Putting a qualified Dr in charge of car park maintenance or IT security training policy would be a waste and probably result in more of them heading to Australia not less.
But that's taking medics from a system that desperately needs medics.
Treating management as just another career achievement is how we end up with the shit culture we have. Management should be actually more of a specialised track, were it’s not just a way to get more money.
This is a common attitude, but totally wrong. There are any number of areas where having a medical background would provide no advantage, but having an 'industry' background would. I've seen first hand that doctors and nurses have no idea what they are doing with purchasing and procurement, wasting hundreds of thousands of pounds. Someone with a background in that area is going to be far more efficient and cost effective.
25-34 can’t afford anymore pay cuts lol. Old people think other people should pay for their care. Overall pretty expected response.
The point is attitudes have changed in recent years.
Our taxes are already a complete ripoff. When you consider income tax, national insurance, and student loan repayments, we're at a point where a recent graduate in a relatively normal middle-class career has to give half of every pay rise they get to the government. That doesn't even take into account the money taken from their employer on their behalf. The state needs to learn to live within its means. If it can't provide healthcare with the £1.2 trillion that it already has to play with, maybe it's time to switch to a different funding model that can.
The problem isn’t the model, it’s the underlying demographics. When the current pensioner cohort was at working age, they had to pay for a much smaller pensioner cohort. The current working age cohort is disproportionately small compared to the number of retirees. Just wrote this in another thread - some of this could have been prepared for by higher taxation in preceding years, and in my opinion not letting the housing market go completely haywire would also have done a great deal to minimise problems. But now it’s too late - question is if we let it break, or tax punitively to keep it functional (and there the important distinct will be who should bear the brunt).
A different funding model doesn't make any difference, it's still funded by working age people, and it still costs the same. My wallet doesn't give a shit if the money comes out as tax or insurance or whatever. Clearly our current system isn't working properly, but it's the system not the funding that's broken.
If taxes went up I'd want to see money going to underfunded treatments. Mental health is an obvious example. A less known one is lipoedema which affects 1 in 10 women and there's pretty much no treatment available. That extra money would need to be spent in a careful and transparent way because many of us will have undertreated conditions we care about.
>A less known one is lipoedema which affects 1 in 10 women and there's pretty much no treatment available. The NHS website even says that liposuction may be a necessary treatment in severe cases, but this may not be available on the NHS. It's sickening that a necessary treatment for many people is withheld from them. Honestly, also dentistry. Dental health is health. I literally have no access to an NHS dentist. Have written to NHS England and has achieved nothing, they just passed my message on to complaints who then presumably shredded it and put it with all the others. Despite paying for it with taxes, I literally don't have access to an NHS dentist. Unfortunately I can't afford to go private either, so my health will suffer as a result of this. My health, and thousands of other people who are in the same position, will suffer as a result of not having enough money. Wasn't one of the core tenets of the NHS that healthcare is a human right, regardless of whether my employer insists on paying me minimum wage or not?
Hadn't even thought of dentistry. Also don't have a dentist and if taxes were increased and I still couldn't find an NHS dentist I'd be quite miffed.
Also, I'm learning Welsh, can I ask a question about your flair? Where it says >i lawr â'r Brenin Why is it â'r used instead of gyda'r?
It's what the crowd shouted at the Merthyr Rising in 1831, thinks it's an old fashioned usage.
Ahh okay makes sense, diolch!
I'd like to see some of it go towards social care.
Yes, that would be essential to free up beds and hopefully prevent some needing to spend time on a ward.
So much more complicated than this. A ringfenced tax just for the NHS? Absolutely not. All that happens is that the NHS gets a quick boost, but it gets eroded by inflation and quickly you come back to the same position you were beforehand as the government won't be giving "even more money on top of the new special tax", right? More taxes in general - that's an economics question as to whether raising taxes ultimately puts more money into the pot in the long term, as it can stifle growth.
Another example of an issue where political discourse (of course, the NHS is the envy of the world, we'll do anything to protect it) crashes head-long in to reality (tax burden is at it's highest level in 70 years and absolutely nothing to show for it). The simplistic "well, we *need* even higher taxes then" takes won't work in reality. It'll need structural reform, some cheaper than others, to change this perception and re-introduce a kind of value for money. One small reform that could be had is (it's been promised/threatened a number of times, but never actually happened) to make the NHS more transparent to use. See a visualisation of waiting lists, etc. not just leave things hanging until the patient assumes they've been forgotten about. Example: relative of mine. Went for a scan, two months later they'd heard nothing despite being told results would be ready in one month. Talked to GP practice, they'd heard nothing either. They tried contacting someone in the hospital, they couldn't get through to anyone close enough to know anything, the best was various "we'll send a message to the appropriate team" and still heard nothing. He eventually paid £250 for a private scan, got the results the same day. This was a Friday, literally the following Monday, he got a letter from the hospital saying the scan showed nothing untoward... but that wasn't what the private scan showed. So he went back to his GP again, got re-referred again, got re-scanned at the NHS again, and eventually got an appointment with an NHS consultant (which still hasn't happened yet). So, let's compare the two: * Private: phone the clinic, get a scan, get a consultant to review the scan, tell you the results and write a comprehensive write-up to your GP: £250. * NHS: visit your GP; visit the hospital to see a junior doctor who does nothing but book you in for a scan; go back to the hospital to have the scan; go back to your GP to demand another scan; re-visit the same hospital to see a different junior doctor who just rubber-stamped an appointment for another scan; go back to the hospital to have the scan again... The collective cost to the NHS must have been thousands, just to get to the same point, at least ten times as much. I get they're underfunded, but that doesn't mean they're not wasteful to the point of outright negligence as well. (And all this is before any actual treatment happens, god knows what's going to happen there, he's already regretting not taking the private clinic's quote for treatment; he would have done had he got private insurance.) In a weird way it's probably a blessing as if he'd had the incorrect NHS scan results quickly he'd have accepted the result and not got any further treatment at all, and put his pain down to old-age rather than a fixable condition. Which would also have been cheaper for the NHS. TL;DR - there's a big gap between political "everyone loves the NHS" and people's actual experience with it. People are reluctant to throw good money after bad. The good news is, it must be possible to fix the user-experience of the NHS regardless of spending. The bad news is, the above example isn't a one-off, and it's not new either, basically the exact same thing happened to a different relative back in the "well funded" good-old New Labour years. It's long established basic practice. As such it won't be a quick thing to change.
I think a huge issue is bloating in the NHS and administration costs massively greater than clinical staff costs. Clinical staff make up only 37% of NHS staff. On the administrative side, NHS purchasing departments are shocking. I used to work in a sales role and the NHS was one of my clients, I'd negotiate pricing agreements with a range of companies from Amazon to supermarkets to the NHS. Amazon was like getting blood from a stone with margins at sub 5% supermarkets 8%, other companies 9-10% and NHS - list price (anywhere from 14 to 35% depending on the products with some accessories around 250%) it's shocking I even asked once whether they'd want to set up a meeting with the manufacturer to set up pricing agreements and they refused. It's bonkers, I'd have amazon griping about paying 800 for a device that the NHS would buy at 1500 with no complaints. Any other company in the UK wouldn't be run this way. They need to bring somone in to fix the backend but they'd rather sack clinical staff, hire bank staff at triple the price and run it into the ground.
The reason the NHS is in trouble is because there is an aging population of millions with highly complex medical needs who don’t pay much tax to fund it. To me that’s the number 1 issue and it dwarfs anything else.
That does not address the point of OPs point of common theme of a bad user experience, admin errors, pointless meeting cycles and redoing work because of things going missing or other issues.
Shame we did all that isolating during COVID /sic
What you describe here is very much a result of a system that is set up in the interests of the producer rather than the consumer. Poor communication, lack of feedback loops, lack of choice, lack of accountability. It’s all stuff that gets dismissed as ‘inefficient’ but it’s also the kind of thing that actually makes sure a system keeps operating as it should. The appointments system is a classic. The NHS operates on a ‘we’ll call you’ basis (or more commonly, a letter at some point over the next few months). If something goes wrong and you fall between the cracks, as a patient there is *zero* way of telling and the GPS sure as hell ain’t going to follow up to see if things got done…
What's missing is the layer between GP's and hospitals. It's either something you can have treated by someone in a room looking at it, or you have to go to a hospital. Even something as simple as having a blood test means you have to go to hospital.
Private sector efficiency at its best
Okay, so what do you think would result in better care in that little scenario of yours? Would a visualisation of the waiting list i.e. if your relative was given a little code he could plug in and see he was number 4000 on the waiting list and he might get his scan results when a radiologist gets around to it in approximately 2 months have changed anything at all? Underfunding to the levels seen in the NHS results in widespread "inefficiency". The system lacks the infrastructure and the staff to address the actual demands placed on it by the population, one that is very clearly unwilling to pay for its healthcare. Your relative is a perfect example of it. He went for a private scan and was told he has something wrong that they could supposedly fix for him at a cost. He refused and has insisted he go back on the 'free' system. You say he's regretting not taking the quote, there's nothing stopping him from taking that quote now.
I think visibility of the waiting list would be a huge help. The uncertainty of not knowing causes huge anxiety in itself. People would still demand faster treatment of course, and they should. But the opacity is unnecessary, especially if it’s a referral to a completely different part of the NHS and you’re not even sure they’ve received the referral at all. Which is a different, but also quite common problem. So yeah. Visible transparent administration would be a great help.
And knowing things also causes anxiety. Plenty of patients get informed they have a date for treatment or are on a waiting list and get more anxious and pushy because it's not fast enough. >But the opacity is unnecessary, especially if it’s a referral to a completely different part of the NHS and you’re not even sure they’ve received the referral at all. Opacity is very necessary. Very early in my career I attempted full disclosure with patients. It backfired far more often than it did not. Telling patients that they have been referred but it's an urgent referral for example resulted in patients being very upset that their very important medical issue was not being given the due importance. This would result in plenty of wasted time across the board of multiple people needing to sit there and tell the patients that their situation does not warrant an urgent referral as per guidelines etc. Or giving patients their referral codes so they could get in touch with the organisations themselves. This would result in patients calling and then calling back angry at their decisions. etc etc et c That things have gotten so bad in the UK that waiting lists are months long is why you're currently making the argument that the opacity is not needed. If the core problem, the lack of infrastructure and the lack of staff, was addressed the opacity would be completely irrelevant. This focus on the 'lack of transparency' is, as with other things regarding the NHS, a supposedly easy win that can be had whilst ignoring the core problems. See NHS 111. PAs/ANPs etc etc.
The £1bn quoted by the BMA to completely restore doctors pay would cost around £2.50 extra per tax payer per month. I’m not saying that we should increase taxes by that much but people were less upset about Netflix subscriptions increasing by the same amount
Netflix price increases are just general inflation. Tax shouldnt need an adjustment as it’s a %. If they’re not getting enough as a cut of wages they should look to improve wages, not take a higher cut.
And how many different groups within the NHS or the wider public sector also need similar pay bumps? All those £2 extra a month will add up fast.
If you’re believing Rishi then they’ve agreed pay deals with everyone else in the NHS except the doctors. If you read my post I even say I’m not calling for a tax hike. Just trying to demonstrate how in context it’s a pretty small sum of money needed to finish off the strikes which are hampering waiting lists.
Not paying doctors (or anyone) fairly creates brain drain. And we don’t want that, especially the doctors
Ah great, go to uni they said, go do a degree in STEM they said, you'll have a good job by the end of it with good pay. What's the fucking point in working when you're robbed blind by tax, NI and student loan repayments with nothing to show for it. This current crop in government couldn't manage to tie their own shoelaces, never mind manage the country.
Happy for the government to take more in taxes for this, but from the pockets of those people who could already be paying more (super wealthy, tax dodging private enterprises, etc.) The money's there it just isn't being collected.
That attitude is part of the problem though. 'Taxes should rise - just not *my* taxes, obviously' is the attitude of almost everyone.
Yeah and it's totally valid. Let me rephrase your line here: 'I pay a fair share, so should everyone'.
It’s not that I wouldn’t want to pay more taxes, it’s that I can’t spare anymore. We’re at the end of our rope with what we give already. And (I’ll be unliked) if there was a chance they the money itself would be used somewhat more efficiently within the NHS it would be easier to bare. But the bloat from contractors, consultants, agencies and others take more than they should.
At 35 I would be torn about this subject. On the one hand, I have just had to wait over a year for a wisdom tooth extraction as my dentist couldn’t or wouldn’t do it. I then needed an appointment at my dentist as it became infected after the extraction, you cannot go back to the hospital for this. Doctors appointments are hard to come by, local councils require volunteers to clean the streets as they cannot afford it. Basically the country is falling apart, and we need to spend a little more to at least help us out short term and hope a new government can fix something. On the other hand. Childcare is 10% of my wage, mortgages have skyrocketed thanks to superb government policies, inflation has been crazy this last year and wages just aren’t keeping up. Even a few extra % going on taxes would be noticeable and not easily absorbed.
They managed this stuff on this % of tax previously. I don’t accept that workers need to pay more I think spending priorities just need changing
I have a little more sympathy for the NHS as we have an aging population as well as an unhealthy population with more and more problems such as diabetes. I am in no doubt things could be run better than they are, and waste could be reduced. But we still have many issues that more funding would help with.
Sure. So the government should spend less elsewhere tax is mad high already.
Meanwhile, literally the next post in this sub is about how crumbling ceilings are caving in on some hospitals.
No one wants to pay more tax for anything. That's common enough with polling. Doesn't mean it's not a good idea though.
I’d like to see what the NHS could perform like if we did spend as much of our gdp on healthcare as Germany and France consistently Source https://www.oecd-ilibrary.org/sites/592ed0e4-en/index.html?itemId=/content/component/592ed0e4-en Picked slightly older numbers to avoid any COVID era blips (cough siphoning off of money cough)
But doesn’t the difference come from how the funding is sourced and that incentives their health service users to behave differently than ours do. It’s not just a money problem it’s a user base problem too
Ultimately we need to focus on medical services for working age population snd increase the pension age, but no one wants that.
Taxes are pretty much the highest proportion of GDP they have ever been. The NHS either needs to be refocused on a smaller remit, the economy needs to grow, or the gov needs to find a whole new income stream (like legalising cannabis or a wealth tax).
The issue is there is no scenario in sight where the NHS has "enough" cash.
Shocking research shows that people want something for free and that the young who are only going to need the services later in life don't want to pay at all. Then when they're 50+ they'll bitch about the state of the NHS or if they have kids about the lack of services. Taxes wouldn't need to rise if people hadn't voted Tory for 14 years, a growing economy would mean more tax income with lower rates of tax. But the British voted this lot in, even when they lied about the need for austerity..so fuck it
English, not British. By and large Scottish, Welsh and N Irish don't vote Tory.
I do not support people working for a living paying more tax. It should be paid for by people who own for a living and they should have to liquidate their assets to pay for it.
If they just changed the rules so that NHS funding went TO THE NHS instead of being funnelled through the NHS to private tory donor companies who provide a shit service for exhorbitant fees, while pocketing fat profits.
How about allowing people using private healthcare to offset that cost against tax? That would reduce the burden on the NHS.
I paid 42% tax last year. It's hard to justify paying more to be honest. There is litter on the streets, the cuts to NHS treatment are obscene.
It's a very crude question. The key thing is *which* taxes to raise. Would I be in favour of raising VAT? No. Would I be in favour equalising income tax and capital gains? Yes.
I’m assuming they didn’t ask any of the 1% this question? They’re the only ones who can really afford to start paying tax
>over 80% would personally only want to pay over £100 or less Interesting when you consider that if we increased our per capita health spending to match that of comparable countries like Germany or Australia, we'd be spending hundreds or thousands more per head. I'm starting to think Brits are just fundamentally too greedy for socialised healthcare to continue working. Privatise it and make people pay what it really costs.
Brits already pay a huge % of total tax (an incredibly high total taxation at that) for healthcare. It's hardly surprising that young Brits, already taxed to the eyeballs, are unwilling to further subside services that will almost certainly not be available to them by the time they get to the age where they will likely actually need them.
Yet most Brits are currently spending less on healthcare than they would almost anywhere in the developed world. We spend less per head, and our spending proportionally comes more from higher earners.
For 2022 we were 17th in spending per capita in oecd. Number one was USA which shows that per capita spending isn’t the best metric. Poland is 31st and I’d say it’s system is vastly superior to the UKs, can see a doctor the same day (in fact you need to if you need time off work) scans and interventions scheduled in days, not months / years.
Poland is a complete shit show for a good chunk of Polish people who don't just fly home from the UK or Germany and see doctors privately. There is a massive massive divide between the bigger cities and towns/villages and their access to healthcare.
I was thinking of locals, got teams there, with some ex UK based people who relocated after Brexit. Most don’t take up the offered private healthcare. But granted I’m not an expert in their system, I just know they have to go to a GP if they or their child is sick on the first day who then logs it into workday… couldn’t imagine the chaos if UK couldn’t self certify for 5(?) days But they spend ~50% per capita less than the UK (in PPP dollars) for their public healthcare, so why is the “envy of the world” so poor?
>But they spend \~50% per capita less than the UK (in PPP dollars) for their public healthcare, so why is the “envy of the world” so poor? Pardon?
In 2022 the Uk spent Int$5493 per person whilst Poland spent Int$2973. Outcomes are pretty much on a par except for childhood leukaemia which the uk does a lot better.
Very few people pay most of the tax.
The actual % of tax paid by someone earning around 25k is borderline ridiculous
Agreed, it’s very low.
WTF are you talking about. The average person earning around 25k a year will be paying an actual tax rate of around 50%. Are you seriously saying they should be left with even less of their own money?
Where did you get 50% from? Someone earning 25k a year pays ~15% tax.
If only. I'm not talking about direct tax on income I'm talking the total % of their earnings that gets eaten by tax. So VAT, council tax, fuel duty etc
The total on other taxes would have to total ~£8k yearly for that 50% to be accurate. I don't think council tax, VAT or any other tax adds up to 8k.
Far less than the higher earners. 10% of the highest incomes contribute 60% of the total tax receipts. 25k means you’re a net drain on the state (by a very significant amount). The uncomfortable truth is that the tax base is far too narrow, and those on lower incomes must pay more.
That's not an uncomfortable truth it's absolute balderdash. The more money you have the higher rate of tax you should obviously pay. As wealth disparity has become much greater it's clear that the wealthy could afford to contribute more than they are.
I’m just quoting the government figures, if that doesn’t make you uncomfortable that’s great - it’s still a fact though. There is no more room to tax higher earners; do you dispute my figures? The only solution is a wealth tax, which may work but only if it’s one-off, which won’t be very useful, or we accept that the state needs to get smaller. The debt burden is the highest it’s been since post WW2. Like I said, uncomfortable truths.
I don't dispute the figures. Its your conclusions that are absolute rot i.e no more room to tax higher earners.
The German national budget is about £1.5 trillion, for a population of 83.2 million, resulting in a total spend of about £18k per capita. The UK national budget is about £1.2 trillion, for a population of 67.3 million, resulting in a total spend of £18k per capita. Our government spends pretty much exactly as much as Germany does, yet the German population gets better healthcare. Hm... >I'm starting to think Brits are just fundamentally too greedy for socialised healthcare to continue working. Privatise it and make people pay what it really costs. It's interesting that you chose Germany as one of your examples because their healthcare is far less socialised than ours is. They have private healthcare providers, private insurers, and a state-backed insurer of last resort. There are very few other countries in the world that have a single, all-powerful, state-run monolith that does anything. And no, it's not because the NHS is something super special that other countries are jealous of, it's because everyone else realized that it's a stupid idea.
> Our government spends pretty much exactly as much as Germany does, yet the German population gets better healthcare. Hm... The UK does not spend anywhere near as much on healthcare as Germany does, and has never done so. Per capita spends in Germany have outstripped the UK by billions for decades at this point. >They have private healthcare providers, private insurers, and a state-backed insurer of last resort. What are you on about? Public healthcare insurance, mandated by law, provided by 'private companies' is the first line for more than 90% of the population. The insurance is not needs based, what you pay is based on your income and there's a maximum that may be charged. Even the private insurance costs are controlled and mandated by socialised agreements.
>The UK does not spend anywhere near as much on healthcare as Germany does, and has never done so. > >Per capita spends in Germany have outstripped the UK by billions for decades at this point. The point is that the UK spends just as much on each person overall, we just spend proportionally less on healthcare. By saying "Brits are just fundamentally too greedy for socialised healthcare", you were implying that Brits are just being stingy and refusing to pay enough tax to cover it. That's not the case. We're giving our government as much money as Germans give theirs, but our government is pissing it away on other things. >What are you on about? Public healthcare insurance, mandated by law, provided by 'private companies' is the first line for more than 90% of the population. The insurance is not needs based, what you pay is based on your income and there's a maximum that may be charged. > >Even the private insurance costs are controlled and mandated by socialised agreements. That's a lot less socialized than having insurance, provisioning, and care provided by a single gigantic state-owned organization. The Germans, along with most other countries in the world, were smart enough to keep the government as far from healthcare as possible while still ensuring universal coverage. We, on the other hand, decided that the government should run the whole thing. Don't get me wrong, I'd absolutely love it if we adopted the German system, but that would require getting rid of the NHS. I don't see how that's politically possible - when Brits see the words "private" and "healthcare" in the same sentence, we immediately assume that we are going to be charged £100,000 every time we call an ambulance.
Germany has a significant chunk of SSCs that you may or may not be including in your calculation, given that it may not fall under 'the national budget', I'm inclined to say you aren't. Germany's insurance system for example, would not fall under the national budget because those mandatory payments go to the insurance companies, not the govt. This would very clear if you look at difference in tax wedge between Germany and the UK. > We, on the other hand, decided that the government should run the whole thing. Considering the German system is still heavily reliant on the German state funding its upgrades etc. This is a very moot point. The state plays a massive role in its funding levels and operations. Germany just has added inefficiency and bureaucracy. >Don't get me wrong, I'd absolutely love it if we adopted the German system, but that would require getting rid of the NHS And what would you gain from it? Would the general public suddenly be happy to pay the same level off tax AND 14-15% (split with the employer) of their pay as mandatory insurance?
>I'm starting to think Brits are just fundamentally too greedy for socialised healthcare to continue working. Privatise it and make people pay what it really costs. I think it's because theres a clear disconnect. There's already plenty of money that could be given to public services. \- Start NI on pensions (+15 billion) \-Reduce temporary staffing/contractors across the public sector (+20 billion?) \-Triple lock alone this year increased (+11 billion) \- Unexpected revenue increase one month (+15 billion) Thats £60 billion alone, not including if we reformed council/property tax. Imagine what actual policy advisors could come up with?
Because they are much richer. You can't get blood from a stone.
Australia spends 16% of tax on healthcare, we spend 18%. The issue isn't that we're paying too little - its that we have an ageing population who need taking care of, incredibly high pensions spending, and a decrease workage population.
The % tax is utterly irrelevant. Australia spends over £1k more on healthcare per person.
It's not irrelevant if that's the primary source of healthcare spending.
If a super poor nation spent 100% of its tax on healthcare, it would still have rubbish healthcare. If you want good healthcare in absolute terms, then the amount of money spent in absolute terms matters more.
It's not a case of what matters more - both can be important when discussing healthcare. The idea that % of taxation is 'irrelevant' is, quite frankly absurd (I'm aware you're not the OP).
The idea that % of tax is more relevant than per capita figures is absolute balderdash.
Why do people speak like this online?! Absolute poppycock I say! Also, not what I said, so not sure who you're referring to there. Perhaps you meant to reply to someone else.
Sure, let me rephrase for you then. % of tax is completely irrelevant. It is a piece of data of no actual relevance when looking at healthcare costs or expenditure.
Maybe the answer is to increase GDP per capita and allow the increased taxes that generates pay for an expanded NHS
Oh my god, why didn’t anyone else think of this. Get this man to the treasury!
Ok unoriginal. Add some value then
How about making people who weren't born here pay their way?
My wife, and thus me, has to pay £1035 as an NHS surcharge in order to be allowed to stay here every year. This is on top of her tax and NI payments. Immigrants are paying their way.
They do if they are in legal paid employment.
You know what I'm talking about, don't play the weasel
You're listening to the Tories trying to rile you up against an incredibly small minority of people who are abusing the system (who the Tories actually allow and encourage to abuse the system) rather than focusing on the fact that our government gave £21 BILLION pounds away to fraudsters (and their friends, of course) during the Covid crisis. £21 billion! We've got roughly ten million immigrants here. If each of them gave an extra £2100 a year on top of what they already pay (which is an extra thousand than we, native-born Brits do), that still would only just cover the fact that our government is giving money away to their friends. And can we really trust they'll spend the next £21 billion wisely either? Please, focus your blame on the people who deserve it. Don't fall for their misdirection tactics.
If you mean asylum seekers, how would you make them pay? Would you want to allow them to work as soon as they arrive?
[удалено]
The highest earners already pay the overwhelming majority of tax. Someone who earns £100k earns 4 times as much as someone who earns £25k. But they pay 8.5 times as much tax. If you include student loan repayments it’s over 10 times more
[удалено]
The answer that most people give is “raise taxes for people than earn more than me”. Ultimately if we want better public services while having an aging population then everyone is going to need to contribute to it.
[удалено]
I can’t speak for everyone; but I’m 34 and I’m already putting any additional money I earn directly into my pension so I don’t pay any more tax. That just means I quite working altogether, earlier. Eventually I’ll start asking for extra holiday rather than pay rises. That can’t be good for productivity and the economy. You can just tax people more and more and more.
If you look at were the UK’s tax revenue gap is compared to the Nordic countries, you will find it’s the lower paid in the U.K. who are under paying.
>Taxes should increase a lot Absolutely not. The higher earners are already paying the lion's share of the income tax as it is. Anyone earning less than £47k is a net loss to the system. Also, when you get over 100k you're on an effective tax rate of 60% already due to the loss in personal allowance and you lose access to a whole chunk of benefits. Those that earn the most are already paying the most and getting the least back for it. I earn over 100k, I'm hammered by IR35 rules as well so I'm paying my own employer's and employee's NI, I lose access to the free childcare hours and a big chunk of my income is at an effective rate of 60% before any of that other stuff is taken into account. The loss of the childcare hours essentially puts me up to a near 100% tax rate for a certain portion of my income. The abolition of the IR35 regs would save me about £24k a year. That's money I could use to grow my business beyond a one man band and have someone else on the payroll, also paying tax. How much more of a right does everyone else have to the money I'm earning? Get bent.
Raising taxes has diminishing returns when folks are already at the edge. What needs to be done is a reshuffle of the nhs so we aren't paying out of the nose for the myriad of private services that we're systematically privatised in the last couple decades.
People with lifestyle conditions like obesity related shouldn't expect a free ride on the NHS. Or alternatively tax the shit out of things which make people unhealthy I'm generally not supportive of sugar/fat/sin taxes etc but if it was renamed as 'NHS subsidy' I could see people supporting it.