Mike
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Post by Mike on Jan 4, 2019 16:03:32 GMT
Most private health providers allow you to see an NHS-registered Consultant, not something you're guaranteed under the NHS. Imo safety fears are groundless. The ability to see an NHS-registered consultant is great when things are going smoothly but it's not the same as having facilities & people on hand when you urgently need them because something has not gone to plan. It's when things go wrong that safety becomes an issue; to dismiss safety fears as groundless seems a little naïve - for example the HSJ certainly disagrees HSJ certainly disagrees and the linked CQC atricle also suggests the issue is likely widespread... Anyway. I suppose we all make our own choice in this regard -- but I would take care not to be too dismissive of what are not necessarily made-up risks
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IFISAcava
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Post by IFISAcava on Jan 4, 2019 16:03:50 GMT
An interesting thought; but I'm sure you don't need me telling you no children = end of civilisation as we know it so disincentivising (not a word but bear with me) having children may not be great news in the long run. PS I for one only had children to get that sweet sweet child benefit money  It is, of course, only a possible solution, in the "Think the unthinkable" category, a category which surely has to be very seriously considered if any kind of satisfactory result is to ever be obtained, IMHO. I'm obviously aware of your point, as you say. I don't however personally think it would be very much of a "disincentive" at all, The System already redistributes tax monies in varying amounts back to families. eg, last time I looked, over half of my Council Tax goes to Education. I don't begrudge that, but some benefits are surely set to be curtailed so they can be diverted to the NHS? The 64 thousand dollar Question of course, is "Which benefits?"!!! And there's another gnarly subject, I pay £2K pa for PMI (Private Medical Insurance) and rarely use the NHS. Yet another Double Whammy? (Commentators, please also don't remind me that for A & E and Long Term Care/Chronic Illness that you are still diverted to the NHS, that's not the point.) We're just having healthy debate here, it's a Forum guys & gals.  Most people's use of the NHS is heavily skewed towards the end of life so a) be thankful you don't use it much and b) don't think you can get out of funding the NHS by paying extra for private insurance! Private insurance is only as cheap as it is because it doesn't cover the really expensive stuff when you really need it.
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cb25
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Post by cb25 on Jan 4, 2019 16:08:05 GMT
Most private health providers allow you to see an NHS-registered Consultant, not something you're guaranteed under the NHS. Imo safety fears are groundless. The ability to see an NHS-registered consultant is great when things are going smoothly but it's not the same as having facilities & people on hand when you urgently need them because something has not gone to plan. It's when things go wrong that safety becomes an issue; to dismiss safety fears as groundless seems a little naïve - for example the HSJ certainly disagrees HSJ certainly disagrees and the linked CQC atricle also suggests the issue is likely widespread... Anyway. I suppose we all make our own choice in this regard -- but I would take care not to be too dismissive of what are not necessarily made-up risks Fair points. I was thinking about minor surgical procedures, not hospital stays, but your points are still valid obviously. NHS hospitals have also had their fair share of bad outcomes. Syringe pumps being one of the latest.
@ifisacava "b) don't think you can get out of funding the NHS by paying extra for private insurance" - of course not, those with PMI knowingly pay twice. Declaring my interest - I have PMI.
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Mike
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Post by Mike on Jan 4, 2019 16:13:29 GMT
Fair points, but NHS hospitals have also had their fair share of bad outcomes. Certainly; but not all bad - St Georges has a bar inside it if you know where to go :) I like to get a patient wristband and tell people I'm from hepatology dept.
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justme
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Post by justme on Jan 4, 2019 21:35:22 GMT
justme Do you have a solution? A lot of people say health services should be paid for by some form of insurance, but never go on to explain how the poor or unemployed would be treated when they couldn't afford the insurance. I think poor and unemployed should get the same - surely providing it for poor and unemployed only will be many times cheaper that to everybody and affordable as a result ?
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mjc
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Post by mjc on Jan 4, 2019 22:18:35 GMT
To see who is “poor” requires the “means testing” a lot of people, repugnant to many.
The other option is to give health care etc free to all, but set higher incremental, realistic, fair, tax rates for all. I’d rather pay higher rates of tax, get rid of NI by incorporating it into tax, and stop the iniquitous multiple higher rates of marginal taxation. It only encourages avoidance/evasion.
It is the likes of Gideon Osborn that did enormous harm to the standing of all politicians by hidden tax increases in such complex ways. Simplify tax and the tax take will increase, and the expensive avoidance schemes will not be so popular by the very well heeled.
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cb25
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Post by cb25 on Jan 4, 2019 22:43:06 GMT
To see who is “poor” requires the “means testing” a lot of people, repugnant to many. The other option is to give health care etc free to all, but set higher incremental, realistic, fair, tax rates for all. I’d rather pay higher rates of tax, get rid of NI by incorporating it into tax, and stop the iniquitous multiple higher rates of marginal taxation. It only encourages avoidance/evasion. It is the likes of Gideon Osborn that did enormous harm to the standing of all politicians by hidden tax increases in such complex ways. Simplify tax and the tax take will increase, and the expensive avoidance schemes will not be so popular by the very well heeled. Tax simplification is obviously desirable, but whether that alone leads to less avoidance (which is legal) depends very much on what 'realistic, fair' tax rates equate to. 40%? 60%? 80%?
I believe Gordon Brown was also responsible for a big increase in tax complexity. Governments seem to like tax complexity, possibly because they think it'll stop people making use of their allowances.
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scc
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Post by scc on Jan 5, 2019 4:26:14 GMT
My slightly more cynical view is that the tax code is so complex to allow only those with knowledge to locate the loopholes, and means to access them. When you add up all of the various allowances - some fairly obscure - you can enjoy a considerable amount of tax-free income, capital gains etc.
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Post by samford71 on Jan 5, 2019 10:32:29 GMT
My slightly more cynical view is that the tax code is so complex to allow only those with knowledge to locate the loopholes, and means to access them. When you add up all of the various allowances - some fairly obscure - you can enjoy a considerable amount of tax-free income, capital gains etc. The UK tax system is a complex mess. CGT is 28% and corporation tax is 20% when income tax is 47% (inc 2% NIC). Investment income is not subject to NIC but income from labour is. A retired married couple can generate £63.1k/annum from investments before paying any tax (2 x £11.85k personal allowance, 2x £5k savings allowance, 2x£1k PSA, 2x2k dividend allowance, 2x£11.7k CGT allowance). An equivalent working couple earning £31.55k each (total £63.1k) would pay a total of £13.43k in tax. We punish labour mobility through SDLT on property, rather than having an LVT. We have Entrepreneur's Relief of £10mm with a tax rate of just 10%. We provide high income earners with fiscal subsidies through pension tax credits plus further avenues such as VCTs/EIS/SEIS, whilst simultaneously cutting benefits to the poor via "austerity". I'd be the first to admit that I've utilized pretty much every one of the above allowances. I've taken ER at 10%, placed money in EIS, used my pension annual allowances etc. I don't feel bad about that since that is legal tax planning. I don't, however, feel the system is in anyway just or fair. It's incredibly poor at wealth redistribution, not progressive, and easily exploited for tax arbitrage. The UK tax system clearly favours "rentier capitalism", most especially through property ownership. It was constructed based on historical vested interests and is now justified via macroeconomic theory that is not just incorrect but often a blatant lie. The sad reality is the UK never really did shake off feudalism.
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mjc
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Post by mjc on Jan 5, 2019 10:53:58 GMT
What an insightful post, samford71. Grossly unfair, and if it was fairer I, and I suspect you would, (or would have) paid more. I wouldn’t mind paying more tax if it was fair, clear and allowances available to all. I can’t understand why ER is so generous, but I am getting annual tranches, so no complaints. Yet Probate ‘fee’ (tax) of £6k is unconscionable.
I see C2F is launching a £2m EIS bid, feel that might be useful for IH planning, but getting good information in an easily digestable form may not be so easy.
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scc
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Post by scc on Jan 5, 2019 12:02:39 GMT
Excellent outline, stamford71. Add to that domestic solar panel installation, renting a room, selling stuff on eBay - even income from a woodland if you have one. Self-employed? Plenty of allowances and breaks to take advantage of which the average PAYE won't consider accessing even if they are able to.
The list is enormous.
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aju
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Post by aju on Jan 5, 2019 13:26:15 GMT
My slightly more cynical view is that the tax code is so complex to allow only those with knowledge to locate the loopholes, and means to access them. When you add up all of the various allowances - some fairly obscure - you can enjoy a considerable amount of tax-free income, capital gains etc. The UK tax system is a complex mess. CGT is 28% and corporation tax is 20% when income tax is 47% (inc 2% NIC). Investment income is not subject to NIC but income from labour is. A retired married couple can generate £63.1k/annum from investments before paying any tax (2 x £11.85k personal allowance, 2x £5k savings allowance, 2x£1k PSA, 2x2k dividend allowance, 2x£11.7k CGT allowance). An equivalent working couple earning £31.55k each (total £63.1k) would pay a total of £13.43k in tax. We punish labour mobility through SDLT on property, rather than having an LVT. We have Entrepreneur's Relief of £10mm with a tax rate of just 10%. We provide high income earners with fiscal subsidies through pension tax credits plus further avenues such as VCTs/EIS/SEIS, whilst simultaneously cutting benefits to the poor via "austerity". I'd be the first to admit that I've utilized pretty much every one of the above allowances. I've taken ER at 10%, placed money in EIS, used my pension annual allowances etc. I don't feel bad about that since that is legal tax planning. I don't, however, feel the system is in anyway just or fair. It's incredibly poor at wealth redistribution, not progressive, and easily exploited for tax arbitrage. The UK tax system clearly favours "rentier capitalism", most especially through property ownership. It was constructed based on historical vested interests and is now justified via macroeconomic theory that is not just incorrect but often a blatant lie. The sad reality is the UK never really did shake off feudalism. Very interesting, i didn't understand some of the abbreviations but I looked up ER ( Employers National Insurance) so then I understood a bit more, although having a friend who has a business and paying the 10% bit I should have known better I guess. I'm working my way towards the retired couples cash generation pou mention, have not sold any shares stuff since day one. The divi's are quite lucrative so recently shared some with Mrs Aju to mitigate the 2k drop from 5k may sell if the 0% levels come in but gradually so as to not pay CGT. The stamp Duty Land (SDLT) Tax did hit us quite hard when we downsized 4 years ago as just as our purchase was going through they moved the goal posts and cost us quite dearly. Sadly we could not get round that one either as the chain was international and wouyld have lost more than we would have gained. I am always torn when it comes voting time as from a wealth perspective we probably would do better under the Blues but realistically I am a Reds labour person at heart (still in my comms union even though I am retired for the last 11 years or so) . Mummy came from Hebburn just up the road from Jarrow upon Tyne so you can get a feel for my roots although I was born in Cambridge that wonderous seat of learning where I mostly read "Newspapers and Magazines".
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locutus
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Post by locutus on Jan 5, 2019 14:03:24 GMT
Very interesting, i didn't understand some of the abbreviations but I looked up ER ( Employers National Insurance) so then I understood a bit more, although having a friend who has a business and paying the 10% bit I should have known better I guess. ER is Entrepreneurs' Relief. www.gov.uk/entrepreneurs-relief
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cb25
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Post by cb25 on Jan 5, 2019 14:27:10 GMT
I near always smile when I hear/read people complaining about tax being 'unfair'. Nearly always comes down to "we want government to take more money off somebody other than me". If people feel they're under taxed, they can always give the shortfall to charity and forego giftaid.
Very often when the government tries to make the tax system fairer, it gives more incentive to somebody to avoid tax. E.g. tax allowance gets raised, with the (good) intention of taking the low paid out of income tax. Side effect is that people higher up the income scale get to pay more, thereby giving them more incentive to look for legal ways to avoid tax. If they don't already use a tax accountant, it gives them a nudge in that direction. Another side effect is that if you don't pay income tax, you're very likely to be in favour of continually raising tax on the 'rich' as you think it'll never affect you.
Imo it will never be the case that everybody agrees tax is fair.
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michaelc
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Post by michaelc on Jan 5, 2019 16:35:29 GMT
Given the level of responsibility, stress and skill required for some jobs in the medical field a salary of 150k+ is probably very reasonable. The government should do something ASAP if the tax system is discouraging people from working. There aren't that many on £150K plus salaries, that's rare - basic NHS consultant salary only reaches £100K after 20 years as a consultant (and that's after 6 years medical school and at least 8 years speciality training, usually more). To get over £100K you need to do extra hours or get clinical excellence awards for doing extra duties above and beyond the normal. And it's the pensions distorted taxation that gives these 70% plus marginal rates (and sometimes over 100%) that mean it is not worth working extra and often is better to work less. Government knows but either doesn't care or has that little B word slightly more on its mind at the moment. Isn't part of the problem that we train too few doctors?
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