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that's different from suggesting that healthcare is better provided privately (or I'm still missing the link
The link is that if you don't want National ID, you need to stop expecting the state to provide everything. Things which are the proper remit of national government are provided to everybody who is here, regardless of their status - things like defence, courts, environmental protection. As soon as you restrict a service to only certain classes of resident or visitor, you need to identify them.
I suppose - in my opinion - 'tightening up' on who is accessing the NHS is pretty irrelevant if you care about the cost of national healthcare.
The amount lost to what is popularly called healthcare tourism is, as you intimate, easily lost in the noise within the NHS budget. It's not necessarily the case that it would continue to be a financial irrelevance if you threw the doors wide open to all-comers, since there must be some deterrent effect provided by the limited checks we do now and the pursuit for payment of those caught defrauding the NHS. Even if the economics say healthcare tourism is irrelevant, the politics might say you have to do something about it if the small losses have a material effect on the willingness of taxpayers to keep funding socialised healthcare.
gbj_tester-
things like defence, courts, environmental protection.
I suppose I'm conditioned to think of healthcare as belonging with those things (environmental protection and defence are a bit all or nothing, but the courts is similarly applied to individuals), but I agree it's more complicated.
Even if the economics say healthcare tourism is irrelevant, the politics might say you have to do something about it if the small losses have a material effect on the willingness of taxpayers to keep funding socialised healthcare.
And that's one of the ongoing problems with politics - it doesn't matter what the reality is, if the voters think "health tourism" is a problem, then the politicians have to "do something about it". And why do they think it's a problem? Because it's an easy narrative that sells papers and gives politicians someone to blame.
Personally I think the NHS should be available to everyone who lives here, regardless of citizenship. "Tourism" suggests that someone can fly over and get on-the-spot treatment, which the system of being referred from local primary care to specialists, would seem to prevent. It does then mean that someone who anticipated needing expensive treatment could move here to live, but would that be a significant number? Perhaps it would be enough to cause a problem, I have no idea. I just don't see why someone who lives abroad and is a British citizen should be more eligible for free NHS care, than someone who has lived here most of their life but has no official status.
hoefla
Well, that's different from suggesting that healthcare is better provided privately (or I'm still missing the link, I am a bear of little brain).
Firstly, on what should the right to access the NHS depend - citizenship alone? Or should it also extend to those who have lived here for most of their lives, regardless of whether or not they've paid taxes.
Secondly, is the number of
significant? Reports of fraud in the NHS don't really mention that - they focus on patients falsely claiming exemptions, staff falsely claiming work done, and contractors being overpaid. Let alone PFI which is not fraud but is nonetheless a travesty. There seem to be much bigger fish to fry when it comes to paying the bills of the NHS.
I suppose - in my opinion - 'tightening up' on who is accessing the NHS is pretty irrelevant if you care about the cost of national healthcare.