How to Pay for Health Care: Public and Private Alternatives (Choice in Welfare)

In this collection of essays the authors investigate different ways in which health care could be funded. Judith Allsop argues for the continuation of a centrally-planned service 'free at the point of use', on the grounds both of economic efficiency and social solidarity. Michael Goldsmith looks at the possibility of introducing additional charges - for example, 'hotel charges' for hospitals - but concludes that the amounts raised would be insignificant as a proportion of the NHS budget. Chris Ham describes the Singaporean system which involves compulsory savings in Medisave accounts, an open acknowledgement of rationing, and the choice of different classes of hospitals. David Green argues that health care should be returned to the institutions of civil society: health authorities should become independent mutual organisations, and hospitals should become non-profit charitable trusts. Social solidarity could thus be achieved without having a state monopoly.