Showing posts with label Means testing. Show all posts
Showing posts with label Means testing. Show all posts

Wednesday, 26 March 2025

Avoiding the question

 

Pensions are a complicated business, and the UK State Pension is particularly so, given that the rules, amounts and eligibility criteria for the different rates keep changing. But in looking at the history of the triple lock, we need to go back to the Thatcher years. For some years prior to 1980, the uprating of pensions was based on a combination of average earnings and the Retail Price Index, but Thatcher’s legislation in 1980 ended the link with average earnings. Over the long term (even if it doesn’t always feel that way!), wages tend to rise faster than prices, which is why people generally feel better off over time and enjoy a rising standard of living. But an income linked only to prices will inevitably do no more than maintain a standard of living, and the extent to which it even does that will depend on which prices are included in the calculation and the extent to which the things purchased by an individual match that selected ‘basket’. Those on lower incomes (such as those dependent on the state pension) often find that their more personal rate of inflation is higher than the overall average, meaning that they slip backwards.

The triple lock was intended to reverse that decline and bring the state pension back to the effective relationship it had with earnings prior to 1980. On that basis, Steve Webb (the Minister who introduced the policy) was surely right when he said recently that "there will come a point when it's done its job". Whether merely ‘restoring’ that relationship to its pre-Thatcher level is the right target or not is a matter of opinion; there has been remarkably little debate about what the ‘right’ relationship between earnings and pensions should be. 30%? 50%? 80%? 100%? Parking that issue, the question in considering whether the triple lock has done its job or not should be an assessment of whether the percentage is or is not back to the 1980 level. At that point, and assuming some sort of agreement on the ‘right’ percentage of average earnings, a single lock (with average earnings) is all that is needed, and would also align the incomes of pensioners and employed people in the same relationship with price inflation. But making that assessment isn’t straightforward because of other changes to pensions (including the move from the old married couple pension to individual pensions, for example), but if any of those arguing for the abolition of the triple lock truly felt that they could make a good case for having restored the 1980 value of pensions, we can be certain that they’d be shouting it from the rooftops. The rooftops are looking and sounding conspicuously quiet.

They don’t, of course, put it in these terms, but anyone arguing for abolition of the triple lock (and Labour seems to have its share of them as well as the Tories) is effectively arguing for an arrangement which, at best, locks the rate of pensions at its existing relationship with average earnings. It’s easy enough to see why they avoid putting it that way – it’s not an argument that I’d want to make given the comparatively low level of the UK state pension. Those arguing that better off pensioners (those with savings and investments or good occupational or private pensions) don’t ‘need’ the full state pension and should be paid a lower amount are being disingenuous at best, and avoiding the real point at worst. Pensions, of necessity, require long term decision-making, and many people will have planned for their retirement on the basis of assuming that the ‘deal’ that they thought they were getting when they started work – paying NI in return for pensions in later life – would be honoured in due course. Had they known in advance that that particular income source would then be means-tested, they may well have taken different decisions, but they can’t go back and do something different. There is another way, though. Those on higher incomes – whether through pensions, interest payments, dividends, rents or wages – could be asked to pay more in tax. The source of that income ought to be irrelevant: the clue is in the name, it’s an income tax. The talk about reducing the state pension for some recipients is really about avoiding that issue. Labour, just like the Tories, is reluctant to tax more heavily those who can best afford to pay it. Talk of ‘need’ or ‘means tests’ is just a distraction from that reluctance to in any way reduce the disposable income of the group in society which they represent and serve - the most well-off.

Wednesday, 3 September 2008

Keep taking the tablets

The Lib Dems' Health spokesperson took a lot of space and words in the Western Mail on Monday to fulminate against the policy of Free Prescriptions, but she actually said very little. (The Tories' Assembly leader was making similar noises just a week or so ago as well.) Specifically, she once again totally failed to explain why Lib Dems and Tories believe prescriptions should be singled out for charging, whilst other aspects of the Health Service remain free.

Their main lines of argument seem to be:

• We should not have to refuse some treatments on cost grounds when there are other people who could pay for their prescriptions and don't;
• Providing free prescriptions diverts funds from other areas of the health service;
• People don't appreciate something (such as prescriptions) which they get for free.

But suppose we substitute 'appointments with the doctor', or 'minor surgery', or 'hospital accommodation' for prescriptions in those three points? The statements all remain just as 'true'. There is no particular rationale for picking on prescriptions other than the fact that people have been accustomed to paying for them; but the fact that something has been so for a period of years is never in itself an adequate justification for it to continue.

I suspect that the Tories and Lib Dems actually believe that a wide range of health services should be means-tested; with those who can afford to pay being charged for the services they receive. Prescriptions is just the tip of the iceberg for them. Just think of all the money that that would free up for other parts of the health service (or would it just go on tax cuts, I wonder?).

Actually, I welcome the way in which the Tories and Lib Dems won't let go on this one, because it helps to draw a clear distinction between those of us who believe in a free health service, and those who have simply never understood the underlying principle of 'free health care for all'.

Thursday, 21 August 2008

Pills and Potions

I'm not convinced that yesterday's story about numbers of items prescribed actually tells us anything meaningful about the effects of the introduction of free prescriptions in Wales. Without a good deal more background information on trends before and after the introduction of the policy, and a lot more detail on what is being prescribed to which categories of patients, I don't see how anyone can conclude that the policy is a "disaster" as some have been quick to claim.

That lack of precision has not prevented those who oppose the policy from jumping to conclusions, of course. It's the old politician's motto - why let mere facts get in the way of a good press release?

The basic case for free prescriptions – which I entirely support – has always been that medicines are an integral part of health care, and that health care should be free to users at the point of demand. The chief argument of opponents has always been that some people can afford to pay for their medicines and that would free up money for other purposes; but I've never understood why they apply that logic only to prescription medicines. Why single out just one aspect of health care for means testing, and why choose this particular aspect?

Some people can afford to pay for visiting the doctor; some can afford to pay for their operations, or their physiotherapy, or their nursing care. Why do some politicians argue that all of these should be free, but medicines should not? I've never heard any of them explain why medicines are so different from all other aspects of health care that they should be paid for whilst everything else should be free.

And since the objections to free prescriptions generally come from the political right, I wonder whether this isn't the thin end of the wedge for people who really believe, but don't admit it, that large swathes of our health services should be means tested rather than free, in order to give yet more tax cuts to the better-off.

That doesn't mean that the policy is entirely without its problems; some people do now visit the doctor unnecessarily to get a prescription for over-the-counter medicines. But some people also visit casualty departments unnecessarily for trivial injuries – isn't the effect the same? If there are cases where the system is being abused, I'd prefer that we attempted to deal with the abuse rather than re-introduce means-tested elements to the health service.