In this report, the SMF's Health Commission reviews the main attractions of social insurance schemes, including greater consumer responsiveness, choice and transparency.
The Commission points out that there are respectable arguments for and against social insurance, just as there are for tax funded systems. The suitability of either system depends fundamentally on the country’s starting point, traditions and institutional structures.
The view of the Commission is that the UK lacks the social institutions to support a social insurance scheme. The key benefits of these schemes can and ought to be sought within the existing NHS framework. The NHS is increasingly well funded, and it would be perverse to embark on costly restructuring work to secure benefits that could be secured within the existing framework.