If QE Was Withdrawn....

dktreesea

grizzly1911 wrote: »

The second half of the quation is also where the problem is we aren't generating enough income on which tax can be collected in sufficient volume..

If we were happily running on say a £10bn rounding shortfall would any of these conversations be taking place?

So with no debt at all, running at a small deficit for the year? Possibly not. But then, that would be a very different Britain. Presumably one with so many job opportunities, there was one for everyone who wanted one, and very few people claiming benefits.

dktreesea

grey_gym_sock wrote: »

so c. £2,000 per person per year.

it can't go on forever. it's affordable in the the short term, since the government's cost of borrowing is very low.

all the plausible ideas for how to reduce the deficit involve economic recovery as part of the solution.

charging millionaires for healthcare would make no impact at all on the deficit.

nor would charging more for prescriptions. the current system in england for prescription charges - with significant exemptions - raises only a few hundred million a year. (it's only because so little is raised by charges that scotland has been able to abolish them.) any big reduction in exemptions risks poorer and more ill ppl failing to take medicines, with both worse immediate outcomes for their health, and the likelihood of further costs for the NHS as a consequence.

I'm not advocating just charging millionaires for the health system. As Rollinghome alluded to, they probably barely use it. Every few hundred million counts. Because it's "only" a few hundred million doesn't support squandering it, does it? I want to charge everyone who can afford it. Anyone who is working, for starters. Even if it's only £3 per visit. What is wrong with a bit of user pays?

Forget the GPs - our local A & E, on any one night, is stuffed full of people who can't get in to see their GP, who can obtain the medicine they need from the nearest 24 hour supermarket, but instead have chosen to see a doctor, because they don't want to have to pay for the medicine. If there was a nominal charge to see a doctor, and for filling a prescription, maybe they would go and buy the medicine they need instead.

I take your point that not exempting the poor will likely mean that a significant number may just go without medicine that they need, with the resulting deterioration in the quality of their life. But exempting everybody? How much more tax are you prepared to pay, personally, to fund that across the board exemption?

And "the poor", if they play the game and have the children the government is so desperate to incentivise the less well off to have, are not as poor as you might think. A £20,000 a year subsidy, after tax, for a family with two children, privately rented home and a 24 hour a week NMW job for one of the parents doesn't sound too bad to me.

dktreesea

grey_gym_sock wrote: »

practical points aside, i see no moral problem at all with richer ppl getting something out of the system. if you're richer, you can expect to pay in more than you get out. but why should you get precisely nothing out?

it seems to have become a standard part of political rhetoric, from all the major parties, to suggest rich ppl should get nothing out. with of course no agreement on what counts as rich. but it's nonsense.

I would rather see lower rates of income tax across the board, and more user pays, even if it is heavily subsidised. And why shouldn't there be a lot more means testing of any kind of benefit? For example, no benefits if you have a family and more than £3,000 in liquid assets (currently £16,000).

There are very few genuinely rich people anyway, but why should those on a 40% tax bracket have to pay 40% of their income so that people on benefits get to conserve their rainy day cash/shares/bonds?

We've got a guy across the road from us. Quite an interesting person, but it does pain me a bit that he only works 24 hours a week and, his words "is delighted to accept the largesse of his fellow man" to supplement his income, because he feels life should have "space for plenty of thinking time" and he "doesn't want to miss out on his children growing up more than he absolutely has to".

I would feel somewhat mollified if the government required him to work full time in order to qualify for benefits, including community work if no paid work was available, required him to pay a small portion of his rent himself, (rather than subsidising him 100%) and cut the middle and top rates of income tax to 16% and 33% respectively. yes,....pigs might fly...:).

grey_gym_sock

£3 per GP visit would probably cost more to administer than it would raise. (and again, there would need to be some exemptions.) you need to apply some sense of proportion to possible money-raising schemes.

there may be a decent argument for keeping prescription charges roughly as they are. a few hundred million is something, and the charges may not do much harm. i'm suggesting there's very little room to raise more money there.

very few ppl go to A&E when they are perfectly capable of diagnosing themselves, and just need a specific medicine, and it's available without prescription, so they're only in A&E to avoid paying for it.

ppl going to A&E because it's easier to get seen there than by their GP can happen. which shows that neglecting 1 part of the NHS can have knock-on effects in other parts.

first you complain about how much "the rich" are getting; now about how much "the poor" are getting. do you resent everybody who doesn't have about the same as you?

JohnRo

dktreesea wrote: »

I would feel somewhat mollified if the government required him to work full time in order to qualify for benefits, including community work if no paid work was available, required him to pay a small portion of his rent himself, (rather than subsidising him 100%) and cut the middle and top rates of income tax to 16% and 33% respectively. yes,....pigs might fly...:).

You're going to help administer, operate and oversee the workfare scheme in your spare time presumably?

bigadaj

JohnRo wrote: »

You're going to help administer, operate and oversee the workfare scheme in your spare time presumably?

I'm in favour of some form of workfare (autospelling correction put this in as warfare originally which is a wholly different approach!) for people who have been claiming benefits for a significant length of time, even if there is a net cost. It would potentially have social and environmental benefits for the wider community but primarily would instill a connection between useful work and financial reward, this seems to be lost amongst a large proportion of benefit claimants. Won't be easy, and there's no way that you could get the full cost from minimum wage jobs of rental, council tax etc but one day a week, ie minimum wage equivalent for basic rate supplementary benefit might be good. May be surprising to see who didn't actually turn up when cash in hand is more lucrative.

sabretoothtigger

some form of workfare (autospelling correction put this in as warfare originally which is a wholly different approach!)

Conscription could be considered workfare. The problem is it tends to increase the budgeted cost hence why they are trying to privatise the idea and do zero pay job 'opportunities'

JohnRo

OK so your hatred of much maligned benefit claimants is sated, they're forced in to menial, soul destroying and by definition, pointless make work.

So how was that going to get the country's finances back on track again?

atypical

grey_gym_sock wrote: »

ppl going to A&E because it's easier to get seen there than by their GP can happen. which shows that neglecting 1 part of the NHS can have knock-on effects in other parts.

The out of hours GP contract change had little effect on A&E attendances. The probably we have now is more likely a result of naturally increasing demand (increasing population, more elderly etc) which hasn't been met by increased capacity. We've reached the point where there's little spare capacity left.

Reducing demand through co-pays etc. isn't a sustainable strategy and probably wouldn't save much. It also risks increasing costs through people delaying accessing care until it's much worse than it needs to be. The NHS is already very bad at prevention.

A real solution will come from better IT (currently archaic), joining up what is a fragmented NHS (including shared social & health care), rethinking how care should be delivered (we use hospitals too much) and the dirty word of competition.

dktreesea wrote: »

GPs are just as bad. Because they are salaried, they don't have to really care about the patients.

A large part of a GP practice's income comes from meeting health targets, so they do have to 'care'. GPs are really good at meeting these targets almost perfectly, more than was ever expected, hence the current GP contract is more generous than was anticipated.

The problem is, the targets set (like blood pressure targets, called surrogate markers) haven't translated into real-life benefits for patients (e.g. reduced mortality). That's the fault of the incentives, not GPs, and partly because it's difficult to target-ify such a broad concept as improved health.

dktreesea

grey_gym_sock wrote: »

first you complain about how much "the rich" are getting; now about how much "the poor" are getting. do you resent everybody who doesn't have about the same as you?

I'm not differentiating between the rich or the poor. I think income tax rates are too high, right across the board. If the NMW is too little to live on, i.e. being on it, even full time, entitles you to a whole raft of benefits, then levying income tax on it is ludicrous.

At the other end of the scale, why should anyone have to pay even 40% of their income over to the Chancellor of the Exchequer, let alone an even higher rate?

User pays, even if heavily subsidised, incentivises people, rich and poor, to properly use the services on offer, instead of exploiting the other taxpayers who are funding those services by using them to the max.