Look back to 1941 for a coherent healthcare strategy
16 July 2009Sir, The government has finally recognised that elderly care cannot be purely taxpayer funded ("Options unveiled for elderly care reform", July 15). Sir William Beveridge, one-time director of the London School of Economics and Liberal politician, proposed in 1941 "an all in scheme of social insurance" allowing "no one to fall below a standard ... (leaving) everyone free to spend his income above that standard as he will".
The scheme was designed to preserve individual freedom and responsibility but ensure universal coverage. Those unable to pay their premiums would be government subsidised; those with the income and inclination to pay for a more elaborate model were able to do so. This was unique in combining social cohesion and equity with choice.
If implemented post-1945, it would have led to a mixed health and care funding economy - incentivising those on low incomes and not penalising those on middle incomes.
Politicians of all hues have shied away from social insurance with "top up"; the term is frequently misunderstood to be a variant of private, risk-based insurance.
Surely it is now time to consider the funding plans for health and social care designed by the leading thinkers of two generations ago, unencumbered by the political baggage of 60 years of a purely tax-funded welfare state?
Christoph Lees,
NHS Consultant in Obstetrics and Fetal-maternal Medicine,
Founding Member, Doctors for Reform,
London W14, UK
@reformthinktank
