INTRODUCTION
The NHS is overfunded, receiving more than a generous share of government funds, and yet also finds itself overwhelmed, understaffed and underperforming. There are long waiting queues and an overall sense of disillusionment within the British public.
Demographics is one of the biggest factors affecting the performance of the NHS. When the NHS was created, the British population was half of what it currently is. The population in Britain grew too fast over the last half a century, while the NHS didn’t grow fast enough. The NHS can’t keep up with the increasing demand. The patient/GP and patient/nurse ratio have reached alarmingly disproportionate levels. In order to save the NHS, dramatic changes must be adopted.
The NHS belongs to the British People, which is why British people should, in all areas, receive priority over everyone else.
This means:
a) Local v Foreigner
To tackle the long waiting queues, a distinction between nationals and immigrants must be created.
A hybrid NHS system is hereby adopted for the NHS, being, from now on, both a public and private institution. Public for British citizens, while at the same time Private for those without British citizenship, as well as citizens convicted of grave offence, or serving a sentence superior to five years of prison service.
- British nationals shall continue enjoying NHS public and free at point of delivery; while foreigners, immigrants and convicts who received sentences equal or superior to five years, as well as any grave offence, in order to access NHS services, shall be subject to a form of the American-style healthcare system, with the purchase of a health insurance plan, and where ambulance rides, admission to hospitals, pills, medicine, treatments, and all other services provided by the NHS, shall be billed and paid for by the patient or his insurer, in this case, either a private provider or the NHS itself, and, should the insurance plan not cover the service provided, forms of joint payment, such as co-pays and other out-of-pocket payments, shall be enforced.
For this effort, we hereby introduce:
- The NHS Insurance, which is health insurance for non-British nationals and convicts, in order to have access to services provided by the NHS. Co-pays will be based on the range of services the insurance plan covers, and all immigrants are liable to acquire such insurance during their visa application.
The insurance does not override the payment of National Insurance or other takes, including the NHS surcharge.
A British/Other category at every NHS operation shall be introduced, in which the British will always receive priority when it comes to scheduling consults, surgeries, appointments, and other services.
OTHER serves for Foreigners, Immigrants and convicts. British citizens engaged in the consumption, distribution, production, sale, or purchapse of recreational drugs are also under the Other category, thus ineligible for free access to the NHS, liable to acquire NHS Insurance. The same applies to smokers and obese/overweight citizens, who are prone to tobacco and obesity-related diseases.
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ID cards shall be introduced, and individuals must have to provide their ID number while setting up an appointment and filling forms, or show the card during in-person appointments or visits.
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Those who visit or make appointments to the NHS without an ID card shall be automatically put in the back of the queue, with priority given to those with ID cards.
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Immigrants (Others) become eligible to apply for an ID card after completing two consecutive years in the UK as a naturalised citizen. Those ineligible for an ID card can apply to receive an NHS Insurance Card, which is an ID card containing important information about the holder (name, date of birth, picture, type of insurance plan, insurance number, etc.
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Convicts (Others) become eligible to apply for an ID card after completing five consecutive years abiding the law, that is, without committing new offences. During this period they must apply to receive an NHS Insurance Card, as well as a Convict ID card, which is a standard ID card containing additional information about the conviction, such as date of release, duration of parole, offence commited and years served in prison of prison term given. Individuals convicted for Sexual Crimes, Terrorism and treason are ineligible for public NHS in perpetuity, as well as ineligible for normal ID cards, using the Convict ID card in perpetuity. The Convict ID card is issued automatically upon release. Convict ID cards must be renewed every five years, just like the standard ID card.
(Others) engaged in the consumption, distribution, production, sale or purchase of recreational drugs, or overweight/obese and pet owners become eligible to free NHS upon evidence of cessation of any engagement with recreational drugs, smoking, or once they achieve healthy BMI.
b) The Urgie Fee
In cases where urgent assistance is required, those designated as Others, can pay an “Urgent Fee” to jump the queue and get priority service, treatment, visit, appointment, surgery or consultation. This applies to surgeries, treatments, consults, visits, and appointments. Emergency care such as ambulance services and first responders will be available for all with no prejudice, although Others are subject to billing after the service has been provided, while citizens remain to enjoy free access to services at pointof delivery. For example, in America, an ambulance ride can cost up to £1,000 or more. In the UK, emergency services would be provided regardless of the priority hierarchy. However, Britons would continue to pay no cost while Others would, as soon as possible, be billed the £1,000 as well as any other services received while under care, with their insurance covering or not the costs.
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The Urgent Fee will not be at a fixed rate. Instead, it will be calculated based on the overall cost of the service required. In other words, an urgie for a simple GP appointment will be far cheaper, compared to the fee for surgery, which can reach the house of thousands of £s. The minimum fee is £100.
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British sacred queuing culture shall also be put into consideration. The urgie fee will not only be calculated based on the overall cost of the service required, but also by adding £50 for every Briton ahead of you in the queue. This means, for example, if the service costs £100 and there’s three British citizens ahead of you in the queue, your urgie fee will be of £250, of which £150 will be given to the three Britons ahead of you, £50 each. If the cost of a surgery is £500 and there are two Britons also waiting to receive the surgery, the urgie would be of £600. Paying the urgie does not nullify the cost of the service, that is, for example, if the urgie is £600 you would pay the urgie plus the cost of £500 totaling £1,100 unless your insurance covers.
c) Immigration
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Although asylum seekers and refugees are exempt from NHS Insurance, they do not qualify for priority access to NHS services and are liable to pay the urgie if they wish to skip queue.
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NHS patients who can’t understand English and require interpreters, shall be charged for such services, with their insurance plan covering or not such costs, and out-of-pocket payments for interpreters billed on the patient, citizen or other.
The cost of Health Tourism Visas shall be increased by 500%.
NHS INSURANCE
The NHS Insurance is a health insurance foreigners and immigrants are liable to pay in order to access services (treatments, appointments, surgeries, etc.) and products (prescriptions, materials, etc.) provided by the NHS. The insurance shall be charged and paid through the PAYE system, and unlike income tax, it won’t be progressive, however, it may be updated every fiscal year in tune to how much the government spends on the NHS per capita, which currently sits at about £3,000 per annum (£250 per month). This is the basic plan which would cover basic access to NHS services.
An immigrant family of 4 would be liable to pay £1,000 a month towards NHS Insurance, on top of income taxes, rent/mortgage, NI and council tax, which beyond improving the NHS could also dissuade future immigrants, thus lowering net migration over time.
Immigrants must prove capability to support oneself and his dependants, liable to visa refusal or revocation should they be unable to support themselves. For example, an immigrant with two children and a wife should be able to pay at least £12,000 in NHS insurance if they wish to enter the UK. Their income, thus, either combined (if both are employed) or not, should be enough to cover at least £12,000 in NHS Insurance after taxes. And should their situation change during their stay, that is, are no longer able to afford such payments, the visas will be revoked.
Payment of the NHS Insurance does not cover the payments of other taxes, insurances, fees or charges, such as Urgies, the NHS tax, co-pays and premiums. The NHS Insurance is thus, an insurance scheme copied slightly after the American Model, where the costs of a given service, procedure or treatment are charged in full, at cost or at marginal profit, adjusted for inflation, and depending on how much the service costs and how much the individual has paid in insurance, co-pays and other fees and charges may apply, based on the range of services the insurance plan covers. Any profit from NHS Insurance will be used to improve the NHS and provide better services. If profits are significant then they can be used to cut the NHS budget. For example a £1bn profit would allow the government to cut the NHS budget by £1bn. The government could then increase defence budget by £1bn.
Individuals can opt to pay a higher rate than the basic plan, in other words, just like health insurance of other nations, the higher rates cover more services provided by the NHS than the standard rate.
An individual who pays about £3,000 in NHS Insurance every year only has a coverage of services that cost below £3,000. If he requires a treatment or procedure that costs above the amount, or if in a given year he or his dependants have exceeded their plan yet need further care, co-pays and other forms of payment shall apply. For example, if a patient needs a £4,000 treatment and he pays a yearly £3,000 insurance, the co-pay is £1,000. If a patient gets sick three times in a given year, with the first time, the treatment costing £1,500 and the second time, the treatment costs £500, with the third time the costing £3,000, the co-pay is £2,000.
All immigrants are liable to select an NHS insurance plan during their visa application, except those with scholarships or sponsored; the sponsor is liable to cover the insurance costs. The NHS Insurance is to be charged every month. Individuals with medical debt and their dependants are not eligible for citizenship until they meet the debt payments in full.
The NHS Insurance does not offer deductibles.
A difference between immigrants with right to work and those with work visas sponsored should be made. Those with right to work must cover their own insurance while it is the duty of the sponsor (employer) to cover the insurance of an immigrant with work Visa, and his dependants.
Employers employing immigrants, by sponsoring their work visas, are too liable to cover the NHS Insurance of their non-British employees and respective dependants. This would further dissuade and deter employers from hiring foreigners, making British workforce more competitive and lowering net migration.
