Top up National Insurance contributions for guaranteed free health and social care

In the UK we seem to be piggy in the middle between an almost fully marketized health and social care system like the one in the US and the truly social democratic approach seen in Scandinavia. This doesn’t work out well for a lot of people, who have paid National Insurance contributions throughout their lives but are then forced to liquidate their assets in later life or the onset of serious illness.

It’s time to explore a new approach — give people the option of topping up their NI contributions for guaranteed free health and social care services when they are in need. For this to work there would need to be a minimum entitlement in terms of years of contributions, but this could potentially be topped up by transferring a pension lump sum. This approach would give individuals the option of opting for a more ‘social democratic’ approach to health and social care, without undermining the current system.