I'm still waiting for someone to answer my question about how much tax rates would have to go up by to properly fund the NHS. Until we have that information, all talk of the NHS as we know it being unaffordable is just right-wing propaganda as far as I'm concerned.
The answer actually depends on some factors almost no-one mentions or realises could be taken into account. People have realised that using private companies to 'outsource', etc, generally ends up degrading the performance/cost over time. The last decade or two now makes that pretty clear. But they overlook factors which are treated as 'external'.
For me the big 'invisible elephant' in the room is the behaviour of the drugs companies. Again, people now know from the writings of Ben Goldacre how they game and manipulate regulation. What isn't so well known or widely understood is the gross inefficiency in the way they do research and development.
Consider for example the way they say r-and-d is expensive because they have to test thousands of possible compounds. In itself true enough. But then notice that they keep confidential all the 'fail' results for 'commercial' reasons and think about that.
Yes, from the POV of a company it makes commercial sense to ensure that any potential competitor has to *also* spend a similar amount trudging through much the same large library of 'possibly useful' compounds in order to dismiss almost all of them.
But from our POV it means paying the same costs over and over again when we buy their successful finds, subsidising in that price the same monkey-motion 'fail' tests being done over and over and over and over...
Contrarywise, if all results *had* to be published, every company could benefit from the work the others had done, and the costs to us would actually fall. The whole process of finding new treatments and drugs would be faster and cheaper *for the NHS*.
Note that in general when the companies employ academics they limit what they can publish. Which is contrary to the usual presumption that we have universities for the public benefit and academics succeed on the basis of publishing their work.
Yet the UK Government has often trumpted what a great 'success' it is to have large drugs companies based in the UK. Go figger...