Adam Smith Institute

Reforming the state healthcare monopoly

Despite the billions poured into Britain’s state-run healthcare system, people still face long waits and complain of unresponsive service. But that is no surprise in such a centralized tax-funded monopoly. Its sheer size makes it impossible to manage, while its politicization makes it impossible to reform.

Instead, we should follow the lead of almost every other country, and shift the balance of healthcare spending away from tax and more to the individual. There are many examples of social-insurance systems, tax credits, and direct payment plans that give healthcare users real customer power over the providers, while still ensuring that everyone has full access to the care they need.

At the same time, we need to transform today’s state monopoly providers into independent, competitive ones – giving them the incentive to drive improvement and ensure that users are fully satisfied with the service they receive.