>>*Who* does object to means testing?
OK I’ll bite.
Firstly, for all Zero’s dismissive comments I suspect it could quite quickly lead to a ‘two tier’ service. Might there be a temptation to cut corners on things like food for those not paying? I don’t mean starvation just restriction to a minimalist menu. I think in time the same ‘economy’ would creep into treatments. The likelihood is that those paying would develop a mentality that they were subsidising those who got free stuff and demand a say. We’ve seen that on here where people demand rights over how ‘their’ taxes are spent.
If you want to see two tier provision look at NHS Glasses on sixties/seventies.
It’s undoubtedly true that some people will run a mile from a means test either from pride or because they can’t manage the questions never mind computerised application process required the 'digital by default' mantra.
Their health will suffer as will that of those who miss the means test but genuinely cannot afford the cost.
Will the means test take account of travel to work costs, real housing costs, child maintenance and all the other stuff that applies in real life? You’ve got a big bill coming up; repair the car so you can get to work or get your mole looked at?
How do you set charges? A fixed fee for a GP appointment is at least easy to work out but where do you set it? Even if it’s ‘only’£10 that’ll be a real burden for those with just a bit too much or who are on a run of bad luck. And frankly £10 goes nowhere near covering the cost. I doubt it would even cover the cost of administering testing never mind recovery of charges due but unpaid.
What about a hospital stay? Do you just levy a ‘hotel’ charge for bed and food? Or will cost depend on treatment so cancer cost lots more a hernia? Rationing of treatments and a second class service for those who cannot pay? - bet.
Debt recovery would be a massive big issue – see problems recovering charges from foreigners treated here. And don’t even consider suggestion of pay in advance. Windrush victims have suffered in pain and probably died because of that policy.
And then devise a means test to separate the free sheep from the paying goats? Is it just those on income based benefits who get in free or would others do so as well?
We means test ‘free’ prescriptions and things like dentistry and eye tests/spectacles; and that’s a mess. If you get Universal Credit (UC) as a Job Seeker or for sickness you get free prescriptions etc. But there’s no space on the form for that you have to pretend you’re on JSA or ESA. Get it wrong and a fine will result – I’ve seen this with my own eyes. If you’re on UC to top up low earnings free prescriptions depend on how much you earned in the last ‘assessment period’. So you get them free in July and September but not August or October.
Is there a policy unit or 'think tank' that come up with a serious/workable model for means testing health care.
It’s simply not a practical proposition.
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