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Helen Rainbow: A new model of healthcare

Rainbowhelen Helen Rainbow is a Senior Researcher at Reform.  The report 'Making the NHS' the best insurance policy in the world is available at

Competing successfully on a global stage is essential for any modern economy.  The ability to do this is a result of a number of key factors, one of which is undoubtedly maintaining a healthy population.  At present, the signs in this area are not good, we are at the bottom of the international league table in comparison with other leading economies in terms of health outcomes. 

Analysis in a new report by Reform suggests that the best performing health services have two key characteristics – universal cover and the use of insurance incentives.  Insurance incentives are responsible for achieving greater value and a focus on prevention.  Most importantly, as a result of defining individual entitlements, they are capable of empowering service users by giving them real control over their healthcare.

The report proposes a new model of healthcare, a National Health Protection System, which draws on the successful elements of international systems while retaining the key strength of our current system, universality.  The new system would see every individual spend a tax-funded premium of £2,000 per year (the amount the Government currently spends per head a year on the NHS) on a Health Protection Provider of their choice. Individuals would be able to choose who was responsible for looking after their health.   

The model will lead to de-politicisation of the health service, with the role of government being transformed from a provider of services to a regulator.  This fits in with the Conservative ideas around the need for an independent NHS board.  Other essential elements would be access to high quality information on health conditions and outcomes, and the development of a supplementary insurance market to cover rare drugs and luxury items.

In a recent speech to Reform, Andrew Lansley reiterated his commitment to improving public health.  This new model, would achieve this by re-orientating the service towards it’s customers, focusing on individual outcomes.  As HPPs would be responsible for the costs of poor health, they would have an incentive to keep customers healthy. This could lead to encouraging good health through measures such as annual health checks and gym memberships as well as rebates for healthy living.   

The overall conclusion of our report, is that for same price you can receive a much higher level of health care abroad.  People in France and the Netherlands spend a similar amount on their health insurance and receive high quality comprehensive health services.  If we are not able to do the same, we are forgoing a major competitive advantage. 

In his speech to us last week Andrew Lansley, said “Reform and I don't always see eye-to-eye on the future funding of healthcare”. Nevertheless I hope he and his counterparts, Norman Lamb and Alan Johnson, will pay this report close attention as the ideas we present are a way of achieving the goal all governments seek to achieve, high quality, universal, healthcare.


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