Reform want to basically do away with the NHS
Reform want to basically do away with the NHS as we have come to know it. But it'll be fine, because what they propose works in Europe. And they *love* Europe. Someone commented today on their experience with the French Healthcare system. What they described is completely normal for a Bismarck-style healthcare system. It is excellent care, often faster, often very humane, but it is not free at the point of use in the way people in the UK instinctively understand that phrase. It is paid for through a mix of compulsory social contributions and what is, in practice, near-mandatory top-up insurance. If you don’t pay into both layers, you are exposed. End of story.
The killer detail here isn’t “France is better than the NHS” (often true), it’s the personal price tag. Nearly €900 a month in health-related costs, on a decent pension. And this is not some exotic edge case.. it’s the structural reality. Crucially, the private “mutuelle” isn’t optional in any meaningful sense. It exists precisely because the state system deliberately doesn’t cover everything. That’s the design.
This is where Reform UK Ltd's assurances to their voters becomes dishonest.
A lot of people hear “French system” and imagine NHS care plus nicer waiting rooms and better cheese. What they don’t imagine is writing a four-figure cheque every month in retirement, regardless of how often they get sick, just to stand still. They especially don’t imagine that cost being flat-rated for insurance, not income-linked, so it hits ordinary retirees far harder than the wealthy.
And that’s before you even touch dentistry, optics, excess specialist fees, or the postcode lottery for GPs that somehow never gets mentioned in the Reform manifesto.
Sure, you absolutely can have a system like France. It delivers many things the NHS currently struggles to. But it requires a population that accepts higher, visible, personal healthcare costs as normal. Britain has never consented to that.. quite the opposite. The NHS was built precisely to remove that anxiety.
Which is why people like Nigel Farage leaning on “they do it in Europe” is so slippery. He gets to imply continental outcomes without ever admitting continental contributions. The bill is always left offstage, like a magician palming the coin.
So yes, my contributer's account is eye-opening, and frankly invaluable. Not because it says “France bad” or “NHS good”, but because it punctures the fantasy that you can quietly slide into a mixed insurance model without the public noticing the cost. People would notice. Very quickly. And many, especially Reform voters I suspect, would not be able to afford it.
Also, and importantly, The National Health Service consistently runs with freakishly low administrative costs of roughly 1.5–2 percent of total health spending. That figure includes commissioning, billing, management, HR, procurement, the lot. It’s low because the NHS is a single-payer, tax-funded system. No billing departments arguing with insurers, no parallel claims bureaucracy, no marketing and no profit extraction. One big pipe, money in, care out.
Depending on how narrowly you count it, France’s pure public insurance admin sits around 5-7 percent. But that’s only half the picture because when you include the mandatory private complementary insurers, claims processing, billing overhead in clinics, and the bureaucracy required to make all those moving parts talk to each other, most serious health-economics analyses put total administrative overhead in the 8–12 percent range. (Many put it higher.)
That still makes France more efficient than the US, which is a bureaucratic bonfire north of 25 percent. But it is nowhere near NHS efficiency.
The UK made the opposite historical trade-off. The NHS squeezes admin to the bone so money goes to care, not paperwork. That’s why it delivers universal coverage at lower per-capita cost than almost any comparable country. It’s also why it collapses so dramatically when underfunded.. there’s no slack. No insurance buffer, no spare bureaucracy to hide behind. And let's be clear, the reason the French Health service may be better in some areas that the UK, is that the NHS has been cronically underfunded for decades.
If we’re going to talk about reform (small R), it has to start with telling the truth about trade-offs, not selling imported dreams with the receipt hidden in the lining.
Reform UK manifestos shift tone and detail depending on audience and electoral pressure. The consistent pattern though is that explicit commitments get fuzzier the closer you look. That’s not an accident. It allows supporters to reassure themselves that “nothing radical is planned” while keeping the ideological door wide open. However, I have always been an advocate of "follow the money". Several prominent donors and backers associated with Reform have backgrounds in private healthcare, insurance or outsourcing. That does not require a conspiracy. It’s just incentives doing what incentives always do. People that bankroll movements tend to want something in return.
And Nigel Farage himself has been remarkably consistent over the years about this one thing, even when his party branding mutates like a fruit fly. He has repeatedly argued that the National Health Service model is “unsustainable” and that the UK should move toward an insurance-based or mixed funding system “like France” or “like Germany.” He often frames this as “free at the point of use,” but that phrase becomes extremely elastic once you introduce compulsory insurance, co-payments, and top-ups. Technically free, in the same way a car is free if you ignore the purchase price, fuel, insurance, MOT, and repairs.
But, let's be honest, even if Reform UK Ltd. ended up in government, the NHS would not vanish overnight. What would happen, based on Farage’s own long-standing comments and the “continental model” dog-whistle, is a gradual shift: more charging, more insurance, more “choice”, more things quietly pushed outside the core state offer. Think erosion, not explosion.
So I would advise anyone planning to vote Reform to also start planning to put an increasingly sizeable chunk of cash aside each month to cover their health costs.
I would advise everyone else to fight for what we have with every breath in your body to keep Farage away from our National Health Service. Vote for whoever is most likely to keep a Reform UK Ltd. candidate from getting a seat. Once the NHS is gone, it is NEVER coming back.
The killer detail here isn’t “France is better than the NHS” (often true), it’s the personal price tag. Nearly €900 a month in health-related costs, on a decent pension. And this is not some exotic edge case.. it’s the structural reality. Crucially, the private “mutuelle” isn’t optional in any meaningful sense. It exists precisely because the state system deliberately doesn’t cover everything. That’s the design.
This is where Reform UK Ltd's assurances to their voters becomes dishonest.
A lot of people hear “French system” and imagine NHS care plus nicer waiting rooms and better cheese. What they don’t imagine is writing a four-figure cheque every month in retirement, regardless of how often they get sick, just to stand still. They especially don’t imagine that cost being flat-rated for insurance, not income-linked, so it hits ordinary retirees far harder than the wealthy.
And that’s before you even touch dentistry, optics, excess specialist fees, or the postcode lottery for GPs that somehow never gets mentioned in the Reform manifesto.
Sure, you absolutely can have a system like France. It delivers many things the NHS currently struggles to. But it requires a population that accepts higher, visible, personal healthcare costs as normal. Britain has never consented to that.. quite the opposite. The NHS was built precisely to remove that anxiety.
Which is why people like Nigel Farage leaning on “they do it in Europe” is so slippery. He gets to imply continental outcomes without ever admitting continental contributions. The bill is always left offstage, like a magician palming the coin.
So yes, my contributer's account is eye-opening, and frankly invaluable. Not because it says “France bad” or “NHS good”, but because it punctures the fantasy that you can quietly slide into a mixed insurance model without the public noticing the cost. People would notice. Very quickly. And many, especially Reform voters I suspect, would not be able to afford it.
Also, and importantly, The National Health Service consistently runs with freakishly low administrative costs of roughly 1.5–2 percent of total health spending. That figure includes commissioning, billing, management, HR, procurement, the lot. It’s low because the NHS is a single-payer, tax-funded system. No billing departments arguing with insurers, no parallel claims bureaucracy, no marketing and no profit extraction. One big pipe, money in, care out.
Depending on how narrowly you count it, France’s pure public insurance admin sits around 5-7 percent. But that’s only half the picture because when you include the mandatory private complementary insurers, claims processing, billing overhead in clinics, and the bureaucracy required to make all those moving parts talk to each other, most serious health-economics analyses put total administrative overhead in the 8–12 percent range. (Many put it higher.)
That still makes France more efficient than the US, which is a bureaucratic bonfire north of 25 percent. But it is nowhere near NHS efficiency.
The UK made the opposite historical trade-off. The NHS squeezes admin to the bone so money goes to care, not paperwork. That’s why it delivers universal coverage at lower per-capita cost than almost any comparable country. It’s also why it collapses so dramatically when underfunded.. there’s no slack. No insurance buffer, no spare bureaucracy to hide behind. And let's be clear, the reason the French Health service may be better in some areas that the UK, is that the NHS has been cronically underfunded for decades.
If we’re going to talk about reform (small R), it has to start with telling the truth about trade-offs, not selling imported dreams with the receipt hidden in the lining.
Reform UK manifestos shift tone and detail depending on audience and electoral pressure. The consistent pattern though is that explicit commitments get fuzzier the closer you look. That’s not an accident. It allows supporters to reassure themselves that “nothing radical is planned” while keeping the ideological door wide open. However, I have always been an advocate of "follow the money". Several prominent donors and backers associated with Reform have backgrounds in private healthcare, insurance or outsourcing. That does not require a conspiracy. It’s just incentives doing what incentives always do. People that bankroll movements tend to want something in return.
And Nigel Farage himself has been remarkably consistent over the years about this one thing, even when his party branding mutates like a fruit fly. He has repeatedly argued that the National Health Service model is “unsustainable” and that the UK should move toward an insurance-based or mixed funding system “like France” or “like Germany.” He often frames this as “free at the point of use,” but that phrase becomes extremely elastic once you introduce compulsory insurance, co-payments, and top-ups. Technically free, in the same way a car is free if you ignore the purchase price, fuel, insurance, MOT, and repairs.
But, let's be honest, even if Reform UK Ltd. ended up in government, the NHS would not vanish overnight. What would happen, based on Farage’s own long-standing comments and the “continental model” dog-whistle, is a gradual shift: more charging, more insurance, more “choice”, more things quietly pushed outside the core state offer. Think erosion, not explosion.
So I would advise anyone planning to vote Reform to also start planning to put an increasingly sizeable chunk of cash aside each month to cover their health costs.
I would advise everyone else to fight for what we have with every breath in your body to keep Farage away from our National Health Service. Vote for whoever is most likely to keep a Reform UK Ltd. candidate from getting a seat. Once the NHS is gone, it is NEVER coming back.
