The FT, amongst many, reports that:
Non-EU citizens who come to the UK to work or study will have to pay a healthcare levy of at least £200 on top of visa costs before they are allowed to enter the country, under plans to be set out today.
I have to admit that my first reaction to this was to think that this was an advert for health tourism. If you have paid £200 and then have access to the NHS I think many will think that excellent value for money and will decide to take full advantage of it. Indeed, the payment may well encourage them to do so as much as possible.
Sometimes initiatives have perverse consequences. This one will, I predict achieve the exact opposite of what it intends and will both encourage 'health tourism' and demand for GP services from temporary residents.
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More ill thought out legislation a la bedroom tax – probably designed to cater for UKIP minded bigotry. As long as it makes the Government look ‘tough’ on Johnny Foreigner or the poor they might save the odd vote wending its way to UKIP.
If at the moment those coming here get NHS treatment for nothing and presumably are aware of that before coming here for extended periods of time [just as we are aware that unless wee make provision we don’t get healthcare free of charge if taken ill whilst on holiday abroad], then how would telling people they must in future pay a fee encourage them to come here just for treatment?
Because it will encourage them to get ‘value for money’ once here
OK. Perhaps I’m just rubbish at predicting behaviour but surely you’d be just as likely to get even better value for money if it were free? Would you suggest another method of ensuring some contribution to healthcare costs for foreign visitors. Compulsory medical insurance?
When you price something you make people think they should use
Temporary residents pay tax here
How about we give them the service free, as for other tax payers?
Richard , your question was probably rhetorical but ….
Whether it be house insurance , car insurance or national insurance , you pay in every year but hopefully only have to make a big claim once in a blue moon .
As per moral hazard , could we expect someone who is only in the country for a temporary visit to be more likely to require medical treatment during that time than someone who lives here permanently ?
Health usage is entirely different from those other insurances
I see no correlation at all
Since insurance has been mentioned in this thread .
Insurance underwriting is the only part of the City of London I can think of which as a nation we can feel any sense of pride about .
Two decades ago I did some I.T. work for Lloyd’s underwriting syndicates and although they came from a completely different background from me they appreciated innovators from the other side of the tracks .
It irks me and must really irk them to hear casino bankers and politicians using insurance terminology when talking about types of synthetic derivative products which have no social benefit eg synthetic credit default swaps .
For a start synthetic CDS fail the insurance principle of betterment and would be an open and shut case of insurance fraud .
There is a lot of this sort of deliberate abuse of terminology , for instance calling companies which make their money from proprietary trading investment banks rather than hedge funds .
Striebs, I don’t think there really is such a thing a synthetic CDS. You can have a synthetic CDO which comprises premiums from CDS’s, which are controversial, but the CDS market in general is useful in laying off risk. But each CDS should be limited to the size of the security it is providing insurance for.
See the philosopher Michael Sandel on the Israeli daycare cooperative that started fining parents for late collection. What happened is that the late pick-ups increased. Apprently, putting a monetary cost on it had made parents see it as something they were entitled to pay for: a fee, not a fine, in effect. (Details are in his book ‘What Money Can’t Buy’).
As John Lanchester says, in his review of the book for The Guardian:
“The fear of disapproval and of doing the wrong thing was based on non-monetary values, and was a stronger force than mere cash. The daycare centre went back to the old system, but parents kept turning up late, because the introduction of market values had killed the old ideas of collective responsibility. Once the old “norm” of turning up on time had been marketised, it was impossible to change back.”
There is a very amusing book called Freakonomics which examines the unexpected consequences of just this kind of “penalty”. Yes, if I had paid £200 for unlimited healthcare, I would look for value for money.
It’s simultaneously too much and not enough!
It’s also a rather poor book, if I am candid – but you’re right – they do highlight such things
You may be right Richard . The law of unintended consequences .
I don’t suppose many of us would contemplate travel without insurance which provided health-care cover , either in Europe with an EHIC (?) card or outside Europe .
Would it be practical to make travel-insurance a condition of entry into the country for both EU and non-EU visitors ?
For people who can only get travel insurance with exclusions there could be a visa process .
Make the carrier airline , ferry or tunnel operator responsible for validating the insurance and underwriting the cost if it subsequently turned out to be counterfeit .
Would it slow down movements of people too much ?
In the grand scheme of things how does the cost of health tourism compare to other costs associated with visitors or immigrants who have not spent a lifetime paying into the system ?
Why not just force people to have medical travel insurance before entering the country or getting a visa, just like some other countries require.
My understanding is that if someone is not registered with a GP practice they are charged as private patients. As for people turning up at A&E to get NHS inpatient treatment- its a lie- they would only be admitted if they were an emergency – something most people cannot plan.
Your understanding is wrong
The old NHS…
http://johnnyvoid.files.wordpress.com/2013/02/nhs-coffin.jpg?w=450&h=335
“the new NHS”
http://blacktrianglecampaign.org/2011/09/15/unums-game-plan/#comment-50310