Should Contractors pay their fair share of tax?

[DodgyAgent]

If you happen to have care which is regarded as cost-effective (oddly enough this isn't substantially different from the NHS, just that the motive is ensuring greater profits rather than limiting costs) and you can afford your policy. But hey, don't take my word for it, I'm just an American expat who lived with the system for most of my life.

Universal coverage in the private sector is unlikely to provide better coverage or be cheaper. In most privatisation exercises, the people who benefit most are unlikely to be service users - you have your pick in the UK if you want an example. Of course I suspect the people who push for it the most are in the "I've got mine" camp.

@fullyautomatix I've been wondering the same thing. Unless I'm getting shafted by an umbrella I really can't see the value-add of an LLC outside of tax-dodging...

The point is the debate should be about implementing the best possible solution to healthcare for everyone - whether private or public or a combination of the two. I happen to agree that running the NHS in a profit motivated environment would be a disaster just as operating it as public service would also be a disaster. The problem is that people like you and the left in general are polarised "out of principle" in how you think the health service should be run.
The dynamics that make institutions run efficiently should be introduced where they are appropriate. Dynamics that create negative outcomes for patients - restrictive practices, profit motivated processes should be weaned out. For example nurses, paramedics and other clinical skills are in short supply. Pay for these jobs is less than £30 k per year yet hospitals are constrained by National pay scales that prevent trusts from paying market rates to workers. What happens? these people leave the NHS and work as locums/banks earning more than twice as much and costing even more (thanks to huge agency margins ) thus creating a vicious spiral of escalating costs. if any trust tried to break free and pay more for clinical staff the wailing Unions and left would start crying "not fair" "everyone should get the same"

[NigelJK]

well-being of patients as the first priority

That's what the Hippocratic oath is for isn't it?

[seanraaron]

The problem is that people like you and the left in general are polarised "out of principle" in how you think the health service should be run.

Of course. That's because most of the time basic services aren't in and of themselves money-making enterprises so you end up with either having the state subsidising private companies (public transport) or allowing prices to spiral in the pursuit of profit without any enhanced services (utilities). Ultimately the only thing the lawmakers get out of it is not having to take any responsibility for problems in those formerly public-owned industries.

Looking at the NHS a lot of the problems are down to poor managment at the trust level: failure to plan long-term and relying upon too few staff to provision service. Emphasis on lower costs versus quality of care and work environment probably doesn't help either.

I think the private sector can help pick up the slack, but given the past record of privatisation which ended up having the primary effect of enriching a few businesspeople without enhancing services, I'm sure you can understand why there would be a strong resistance to anything that smacks of privatising the NHS.

[seanraaron]

That's what the Hippocratic oath is for isn't it?

You'd think so, but given the privately run hospitals in the States that charge outrageous fees for the most basic services and have a history of denying care to poor people are administered by doctors, it doesn't seem to be enough.

That's assuming you weren't being snarky of course ;-)