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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-
I have no data to speak to on the health tourism side of things, just wondering about our own health tourists in Spain who are largely retirees, all of whom are presumably counting on the UK to pick up the bill for their infirmities in coming years.
IIRC Spain isn't claiming that back from the UK but I imagine it may do post Brexit.
Dammit
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.
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.