We still use QALYS. The problem is you don’t get to choose how much a given level of health care costs, and I think 1% of GDP is woefully inadequate. You spend

We still use QALYS. The problem is you don’t get to choose how much a given level of health care costs, and I think 1% of GDP is woefully inadequate. You spend about 4% of GDP just on Medicare alone. As a US tax payer you pay about as much for Medicare, Medicaid and CHIP as tax payers in most developed countries do on health care in total. But then to actually get health care yourself you have to pay about the same again fir private health insurance. I get private health care here in the UK through my employer. I pay for the NHS through taxes, and that’s actually how I and my family get most of our health care in practice. The private cover is basically a top up. If I use it I can get treatment more quickly, but at no cost to the NHS. I think this is the best of both worlds. As a nation we get health care comparable to the US at half the cost, it’s truly universal so millions of people don’t fall out of the system. So I fully support the NHS, as a beneficiary of private health care I still think I and my family have got excellent value for money from it throughout my life. Private health care expands health care capacity, and reduces demand in NHS services, so everyone benefits. It may not see, ideal, but in practice I think it works very well, and frankly it’s how well it works that actually matters. Currently the NHS is in rough shape, but this is mostly down to the flat economy since the financial crisis and the pandemic. Spending levels at the peak of the boom in 2008 were unsustainable whoever was in power.