Health care - doing the sums

Managing health demands in the face of a widening gap between demand and supply, in an environment of massively rising costs, will inevitably mean that doctors and hospitals will increasingly have to triage patients to establish priorities of need among those patients.

Aiding that, good pricing signals could get across the message that there is no such thing as “free” health. A simple charging regime based on a principle that the less urgently medical care is needed, the more the patient would be charged if they pursued that care would reduce most emergency wards workload by 30 to 50 per cent. Conversely, investigating ways of economically rewarding people for self-management of their own health would also help to ensure that people who most needed care would get it.

There is no sensible economic reason why a two-income couple should get free non-emergency care in public hospitals rather than going to their GP and paying for the service. It is nonsense to say that they have already paid for the public system with their taxes. People pay taxes that are then spent on all sorts of public goods, most of which are not open to everyone. So we happily insist, for example, that welfare should be closely targeted without thinking about whether the same rules should apply for public health provision.

If we want to spend money on our notional two-income family, we’d all do far better to spend money teaching them about self-management of their own and their family’s health - how to conserve and foster their own health and how to make informed and sensible lifestyle decisions that maximise their healthy enjoyment of a long life.