In Australia, parents are allowed to take some of their share of the education budget, and spend it themselves to send their children to private schools. The reasoning is that otherwise parents who sent their children to private schools would be paying twice — once for the private school, and again in taxes for state education they don’t use — which is unfair.

However, introducing such a policy for the NHS would actually get some people to pay twice and like it. If we gave people the following option, they could take it up if they thought they’d be better off overall. If not, they simply wouldn’t take up the option. Things could only get better or stay the same — they couldn’t get worse.

So here’s a simple, subtle reform that could much improve the NHS: allow people to take some of the cost of their operation and go elsewhere. Say someone needs an operation, and they’re willing to pay some of the cost to have it done faster or better (like paying extra for tooth-coloured fillings instead of amalgam fillings). Let them. Let them take 80% of the cost of their operation, and have it done privately. They’d have to make it up to 100% with their own money, or more if it cost more than on the NHS tariff. (Unlike with education vouchers, there should be no argument against allowing patients to “top-up”.)

No one would be forced to quit the NHS if they didn’t want to. The NHS would have a bigger budget left over per person, so those who stayed would get better treatment. And those who left would also get better treatment (otherwise they wouldn’t leave). Everybody wins.

Those who went elsewhere would effectively be voluntarily paying more tax. They are paying that 20% twice. And what lefty could disapprove of rich people paying more tax?