I was hoping to engage in discussion with those who oppose the NHS, rather than in analysis of the differences found on either side of the Atlantic, however I think that the two may come together.

Contrary to what adoption of the American concept of freedom is doing to views of the NHS, one has to accept that any publicly-funded system must severely limit the opportunity for "choice". This makes it unable to be adopted as a serious principle, although the availability of some modest degree of selection between readily available alternatives is obviously worthwhile. One can never have the freedom in spending somebody else's money that one has in spending one's own. This is where the libertarian and the socialist clash over the concept of freedom. The former demands freedom to spend as one wishes, the latter seeks freedom from treatable illness for all.

Foundation of the NHS represented victory in principle for the latter view. Conflict has continued to rage, with the present emphasis on quality and choice suggesting that the tide may be turning, even though there is a reluctance to accept that the principles no longer hold true. Introduction of market principles as a way of improving efficiency and effectiveness has a certain logic, however one has to fear that the downsides introduced by the overheads and distortions of purpose that flow from a market may prevent any net gain.

Obama is repeating what Clinton tried to achieve but failed - a modest degree of intervention in a liberal market for health services. I do not believe that the US will ever be ready to adopt the socialist principle that the UK has (perhaps most oddly) accepted through a consensus that remains in place. I fear that dilution of the principle in the UK, to satisfy those who find anything associated with the "s" word unacceptable (notably those in New Labour), may ultimately lead to its saturation.

It is only those who hold firmly to the principle of "free at the point of need" who could object to the imposition of a relatively modest charge to fund additional telephone system features through use of a revenue sharing telephone number. I cannot think when this could ever become an issue in the US.

SilentCallsVictim wrote on Feb 15^th, 2010 at 2:15pm:


Perhaps, if as you see it everyone else's opinions as nonsnese, not only here but also on other threads, we had all better leave this forum as there seems little point in anyone having any opinions, as in your opinion, you are the only one that is right.

Dave wrote on Feb 15^th, 2010 at 3:00pm:



In answer to your first question Dave.......Yes

In answer to your second question, I have made no comment on that, all what I am saying is that SCV's is wrong in saying that the NHS is free.

sherbert wrote on Feb 15^th, 2010 at 2:53pm:

Each is entitled to believe in the ideas that they put forward. I hope to benefit from ideas put forward by others. None of us gain anything from simple statements of agreement or disagreement.

The suggestions that I described as nonsense were perhaps a reasoned conclusion from the very limited comments made in a previous posting - or perhaps not. If contributors wish to withdraw from discussion then we will never know for certain.

If brief comments are not properly expanded to address the point under discussion, then they may be open to misinterpretation. Have I understood the point correctly? - I understood an implied suggestion that the benefit derived from the NHS should be proportionate to the contribution made, but I may be totally wrong. If I am correct then this would seem to be an argument in favour of use of revenue sharing telephone numbers.

If I am wrong, then the relevance of the level of contributions to the funding of all public expenditure needs to be explained. The issue of whether receipt of NHS services was a contributory or non-contributory benefit was raised earlier in the discussion, but never concluded. I hope we all understand that hypothecation of taxation is a suggestion that is still being pressed by some against the strong will of the Treasury, even though some hint at it by the use of misleading phrases such as "death tax".