A key issue in individual access to healthcare is who decides who shall get what, when and how. Which economic instruments and direct incentives can do most to deliver universal access, improved care and better outcomes?
How can we actually deliver the services which the National Health Service has promised but failed to provide? How, too, can the NHS catch up with the best in the world?
If we want to achieve the access, equity, improved performance and patient guaranteed care we need to make sure that each individual has the power of money by creating an individual health savings account for everyone. In a sentence, money talks and preference walks.
This is essential if there are to be direct incentives for purchasers and providers to do more and to do better, and for service users to look after themselves properly. It is also vital if patients are to define what quality means to them, and to be able to reliably secure this. It is critical if we are to stimulate incremental, evolutionary, imaginative and creative change.
It is not markets which have cheated the poor, the disabled, the disadvantaged, the unlucky and the elderly. It is their absence which has robbed the least fortunate amongst us. Instead of interfering with markets we should equip those who have done least well from the NHS to gain the fullest benefits from them.