Of all the foregone conclusions, universal health care isn’t something that we’re getting rid of (short of complete bankruptcy of the State forcing it). Should we even want to get rid of it though?

Consider: We need health care the most when we’re retired and when we’re sick. We’re never going to find another way for pensioners and people with chronic conditions to afford medical care without making making health insurance mandatory, spreading the cost of your life-time’s medical bills through your working life.

Then there’s people who, through no fault of their own, will never ever be able to afford to pay for the lifetime care they receive.

It was decided that this was intolerable and on the back of the war mobilisation the NHS was created.

Was this a good idea? Probably. It costs the person on the average wage £236 a month to pay for all this. The more you earn, the more you pay. Is it Marxist? Yes, of course it is – from each according to his ability, to each according to his need – it’s very Marxist. That doesn’t mean to say that it’s entirely irredeemably evil though.

The Government’s obvious role in all this is ensuring that medical care is paid for for everyone who needs it when they need it. No-one’s seriously challenging this in mainstream politics. People simply won’t accept the idea that people who haven’t paid for care should go without (as happens in America where health insurance is voluntary and many millions choose not to bother, in addition to those who can’t actually afford it).

The question: “Should families who can’t afford health care (for themselves, for their children and for their retired parents etc) go without health care?” Well, the answer’s been decided already – no. We’ve formed ourselves into an extended family – again, very Marxist – but the system works and it’s overwhelming popular as a means as paying for health care.

The real debate comes into the nitty gritty of who runs the hospitals and employs all the doctors and nurses. It’s here we’ve got room for manoeuvre to make the NHS better. For example, why does the state need to run all the hospitals? The answer is that it doesn’t. The chapter on health care in the Orange book made a very compelling case for an insurance model, where each individual treatment is paid for by medical insurance and the money goes to whomever the patient chooses to carry out the treatment for them – rewarding good efficient hospitals and seeing to it that the people running bad hospitals get fired.

You can have multiple insurance providers competing with each other – in fact that’s almost certainly essential. You can have private hospitals, too. All of them can be private, in fact. The difference is the state would only get involved to subsidise people’s insurance premiums when they can’t afford to pay them.

In other words, you can radically change the way medical treatment is provided without removing the basic ‘universal, free at the point of use’ element.

The rewards from such changes are obvious – the cost of medical care should come down and the quality of care should go up. If we look at the Singapore model and the Dutch Model we can see how these sorts of systems do deliver better outcomes.

The left wing blogosphere appears to be revelling in going out of the way to bully and castigate anyone who cares criticise the NHS – but this is, in my opinion, pure arse covering for their own failure – the truth is that the NHS is not perfect, and the only people who really want us to think it is are the people who’ve increased funding by 80% as their one single solution to the problem. The NHS has gladly absorbed this money without people feeling it’s 80% better. That ‘more money’ is the only tolerable answer is pure Labour dogma.

The question is are Labour more interested in preserving the status of nurses and NHS bureaucrats as employees of the state with cushy state pensions and conditions than they are in providing a human, better system for health care in the UK? 1.4 million people depending on the state for their employment make for a much more useful electoral block than employees of privately run hospitals. There’s not enough gratitude for simply funding healthcare. It’s less glamorous and exciting. It reduces politician’s ability to take personal credit for saving the lives of pensioners and children.

I hope that Lib Dems – and Conservatives in fact – can resist the temptation to be keep their opinions on how health care can be improved in this country to themselves for fear of being shouted down as extremists.