Going back to the short speech/talk I flagged.
This knowledgeable person (others have different and equally valuable knowledge) says that we do not generally pay less than others for health but that our wonderful NHS suffers from age-related issues.
It simply hasn't caught up with modern-day applications, and our increase in longevity has led to a weighting of spend on older people. The speaker pointed out that 10% of our NHS spend goes on the last year of life.
To deal with this, he suggests we need to unblock the bottlenecks. They are in both hospital and General Practice. He also suggested that the NHS must embrace joined-up information technology and the early-age use of AI.
From what he says about us generally being in step with other countries in what we pay, it seems we are in a place that is very similar to most businesses that are early adopters. The people who set up the first weaving shops to have mechanised looms were overtaken some years later by those buying bigger and better looms. Such companies may have still been paying for the very expensive early loom. This is where the NHS is.
His suggestion for upgrading the service is to take the emphasis off the hospitals and GPs and bring hospital services into the community. This would be possible with the amount we are paying if we ignore the fact that we have high costs from a very elderly and frail part of the population. We get no help from those on the extremes crying for only state-run or only private health services. We must learn from them both. It was always the case that the Private sector could learn from the Public sector and vice versa.
My bias would be to always be towards a mixed economy. This doesn't necessarily mean hiving off parts of the public service but just allowing private businesses to offer the best they can. We then have models we can look to, when it comes to improving public service.
It seems we can either, using our present system of raising money, have a service focused on caring for the old and vulnerable or a service using analytical methods to preempt illness and known conditions. We now have to understand how we can pay for both if we are to keep our NHS.
I would suggest that we move towards the community-based system many are in favour of. In fact, it is actually happening with peripatetic visits to community clinics by various consultants. This, and tracking possible conditions early, would/could be paid for out of the current budget.
Since the founding of the NHS, life expectancy has increased by around 13 years. More people are living with cancer or dementia, and other diseases due largely to increases in life expectancy and a fall in the rate of premature death.
Ceasing to pay for National Insurance post State Retirement age may have seemed fair in 1948, but now, with so much of the country's wealth in the hands of those who have retired, I can't see how it is. I believe it's time for this extended longevity and the comfort we have known financially to be balanced.
I would suggest the introduction of SNI or Seniors National Insurance to be paid by everyone, possibly at a lower rate than NI, from state pension age to death. The cost of "Care" at younger ages should then be paid from the current budget. The cost of elderly care should go down as the early intervention system takes away some of the frailty and complexity of conditions.
