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Insuring the nation

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There is a peculiar and worrying state of political dissonance in our county at the moment when it comes to ethnic diversity. On the one hand no politician would condone racist abuse in any shape or form, no matter what the legal or social status of the victim of such abuse - while at the same time our political leaders are queuing up to be seen to be tough on immigration, and even tougher on the migrants themselves. How is it that we can defend an individual unreservedly when they are subjected to a verbal racist chant and yet at the same time see it as virtuous that we deny that same person access to healthcare, or benefits, when they are at their most vulnerable?

Hot on the heels of the decision to refuse access to the NHS for non-EU migrants, our leaders are engaged in a bidding war over how long to deny all immigrants the right to access to welfare. The Coalition started the process by suggesting 3 months, with the Mayor of London and UKIP arguing that justice will only be served for the British people by imposing 2 and 5 years respectively. The justification for such measures is often on the basis that you should only get out if you pay in, and have paid in for long enough. The welfare state is funded, after all, by National Insurance contributions, and we are used to the concept that insurance pay-outs depend upon whose names appear on the policy document. The economic climate is used as an excuse to impose these measures, and the argument is made that ‘something must be done’, and yet this remains primarily a question of ethics and political ideology, not economics.

The key question is what we believe to be the purpose of National Insurance. If receipt of its benefits were to be entirely dependent upon the level of contribution, then we would be left with nothing more than a state-run insurance bundle comprising essentially private health insurance, income protection and a pension. One would wonder why bother having the state involved at all - the whole thing could simply be handed over to the private sector. We see things rather differently, however, if we see National Insurance not in an individualistic way, but as the insurance of the nation as a whole.

The nation needs to be insured, as we should place a high value on the provision of a safety net for all, to catch all those who fall into difficulty and prevent them from the damaging effects of poverty. There are two reasons why this is so important, and why we should robustly defend this ideology – this true spirit of nationhood that arose from the ashes of the Second World War. The first is that the degree of civilisation that a society has achieved should be judged not by its economic prosperity, or the size its army, or even the function of its democracy, but by the way it cares for its most vulnerable and disadvantaged. If British society treats its visitors, or its unemployed, or its disabled, more kindly than any other then, far from protesting that a few might take advantage of our generosity, we should be proud of the example we set, and encourage other nations to follow our lead. 

The second reason is less idealistic and more pragmatic – for a society to function well it simply must look after the disadvantaged; it is good for us all if we care for each other. There is an old Hebrew proverb where the writer asks his God to ‘Give me neither poverty nor riches’ for he fears that if he were too rich he might get full of himself and forget his God, but if he became too poor he might become desperate and steal in order to survive – made desperate enough, few of us would be immune to the temptation to survive through such measures; criminality is closely linked to poverty, which means that poverty is bad for us all. It may win political points to deny immigrants the right to receive benefits, but will this help them to integrate into British society, or encourage the formation of ghettos? What happens when a visitor, legitimately living in the UK and trying to make a life for themselves falls into difficulty and is unable to work? With no support from the Government what will stop a spiral of poverty, debt and desperation? Deny people healthcare on top and they will be less likely to be able to work and more likely to spiral into debt, not to mention the risks to public health with infectious disease.

National Insurance has its limitations; it is a safety net to avoid poverty and provide an acceptable standard of healthcare for all, not a ticket to a lavish lifestyle for free, but a society needs to choose how to protect itself from the ravages of poverty. It can choose to keep everyone included in the concept of nationhood, whatever their background, means or ability to contribute, or it can be selective and turn a blind eye to poverty, making judgements about who deserves to be looked after and who does not. If it chooses the latter then those who have will need to get used to the idea of building bigger and bigger walls to protect themselves from those who have not – and you only have to look around the world to see what that looks like.

 

Readers' comments (3)

  • If your neighbour has his house flooded, or burgled, but has no insurance, I assume that you would be happy for him to claim from your insurance company and for this to be reflected in higher premiums for you, on the basis that we wouldn't want him to face hardship. I disagree with your assertion that this is an ethical argument rather than an economical one.

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  • Anon@9.16 - if my neighbours flooded house resulted in damage to my own house I might appreciate some sort of national insurance scheme to kick in if the neighbour couldn't manage to fix the damage.

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  • "What happens when a visitor, legitimately living in the UK and trying to make a life for themselves falls into difficulty and is unable to work? ", May I politely point out that a visitor to the UK does not have any legitimate "right" to live in the UK or to seek work here. They are just that - visitors - and by dint of this they have no permission to work (paid or unpaid). It is these very "visitors" who are taking advantage, often of the NHS, when they arrive with pre-existing conditions which may require costly and ongoing treatment.. There is a route for "visitors" to access the NHS, and that is by obtaining a "Medical Treatment" visa which involves private care not NHS treatment. Migrants who have permission to work/study etc are not in the same category as visitors, and have a different route to access NHS care, yet the two categories are often blurred in the minds of many.
    Dr Brunet's views are laudable, and if we had a bottomless pit of money, they would be a good idea. The reality is that the pace of immigration has been too fast for proper assimilation to occur in an orderly and manageable fashion, and thus pressure on all the services is being strained to the limit..
    I yet again urge Dr Brunet to visit the Overseas Visitors Office at his own local hospital in Guildford for an informed view of the issues involved.

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