This is our truth, tell us yours
My understanding of the NHS became a little more real in 2013, and now, in 2014, with the vultures circling the NHS, it’s good to reflect on what I know now with a clarity that I didn’t have in 2012.
It started with a phone call from one of my siblings. They’d been diagnosed with a congenital disorder that probably killed one of my grandfathers, and possibly, by coincidence killed the other (they weren’t related – this isn’t one of those stories). Without surgery my sibling would have a better than 50% chance of dying of this disorder within the next ten years, and a better than 90% chance of it being the primary cause of death before they were due. Surgery was the outcome – life saving, life changing surgery.
Ihad to be tested for the same disorder. There is a measurable coincidence of more than one family member having this disorder if one of them has it, and the general risk is much greater that men will have this disorder as compared to women. I am a lucky man – the test came back negative, and I don’t need the surgery.
I am lucky in one hundred ways too tedious to list, and several too personal to put on show, but today, knowing my sibling has returned to full health, I thank Beveridge, Bevan and Attlee and all the other stars of the socialist firmament for my grandfathers and grandmothers, working men and women who campaigned and organized for a national health service, so that never again should their children, like them, have to wonder if that ache or pain was worth the price of a visit to the doctors over the cost of food for clothes or books for the kids.
I am, irretrievably, a lucky man who lives in a time when conditions that slaughtered our grandparents before their time can now be detected, diagnosed and treated, with no thought on my part for the expense. The risk that I also have the condition is low, but I do not have to make that calculation – the NHS will care for me.
I am such a lucky man; in this case, where the worst that could happen within the bounds of probability was some inconvenient surgery, this has never been truer, and the fact that Jem and all the others who matter to me will share the conviction that the NHS is the greatest gift our forefathers gave to us is another blessing.
So when Lord Warner comes along and suggests we should all pay a £10 fee for being members of the NHS I ask myself some hard questions. Do I believe the NHS needs more funding? Yes. Do I object to paying extra taxes for the NHS? Ah, well…. Here’s the rub. Why is Lord Warner proposing a membership fee and not a tax rise? You might think it’s all just a slippery use of language to hide a tax rise from the general public. I understand that, but I think it’s slightly more complicated.
There are two reasons why politicians opt for taxes that aren’t taxes – the poll tax of the 1990s was originally called the community charge, for instance. The first is that they’re ashamed of introducing a new tax. That’s obvious, and clear. The second, more complex, is that they want to use pseudo-hypothecation to hide the regressive nature of the tax they are proposing.
Pseudo-hypothecation is the lie that the tax you pay funds a specific service. National Insurance for instance. National Insurance is a regressive tax introduced allegedly to fund pensions and benefits on a contributory basis, but which now makes sure that the poor and in work pay more in tax, as a proportion of their earnings, than the rich and feckless. Council tax? Leaving aside that the vast majority of council funding comes via the ruthlessly gerrymandered formula grant from central government, what does get paid in council tax bites hardest on the poor and in world, not the wealthy.
So it is with Lord Warner’s membership fee. First it would be introduced, then exemptions would be offered if you could prove you had private health insurance, or a private GP. Soon, only the poor and unlucky would pay it. Do you doubt me? Take a long hard look at the rise of contracting schemes and bonus schemes that enable the middle classes to minimize their national insurance contributions. Those tax dodges are available because government makes them possible, and winks at them.
I grew up in the lucky generation, for whom the health of the nation was a national priority, funded, if necessary, from taxation. The current government, dedicated as it is to letting the wealthy keep more of their wealth, doesn’t want to admit that if they keep shrinking the tax take, they will have to shrink the services that made us the lucky generation. Useful idiots like Lord Warner aid them in that mission, of making the poor pay so the rich can consume and accumulate without hindrance.