https://www.gov.uk/national-insurance/overview

"You pay National Insurance contributions to build up your entitlement to certain state benefits, including the State Pension."

https://www.gov.uk/national-insuranc...surance-is-for

Nothing to do with the NHS!

The subject has been done to death, but people do not understand the essential ethos of the NHS. Unfortunately people today expect their eligibility and increasingly the quality of care to be linked to the amount of tax they pay. The NHS was set up to provide free at the point of service health care to UK residents irrespective of the taxes they pay or their ability to pay. It is funded from general taxation for the benefit or all UK residents. You should get the same treatment whether you are rich or poor, employed or unemployed etc etc. To " distinguish between those who have not contributed anything and those that have" is a fundamental misundertanding of the NHS. Many medical systems do run on such a "you get what you pay for" model, but they are the poorer for it IMHO. The essentially socialist and egalitarian nature of the treatment is designed to be subsidized by those with greater means through progressive taxation.

If you choose to become non-UK resident even if you continute to pay voluntary NI and have a UK source income and thus pay UK tax you are not eligible for the NHS becuase you are not resident. This seems entirely moral and appropriate to me. If you want the benefits of the NHS you can get them by moving back to the UK.

Thanks for this. If the subject has been done to death, then direct your comments to the OP who raised this subject. I gave my opinion, it differs from yours, but hey I'm entitled to it. I believe over 30 years of paying my taxes and NI gives me the right to voice it.

If you choose to become non-UK resident even if you continute to pay voluntary NI and have a UK source income and thus pay UK tax you are not eligible for the NHS becuase you are not resident. This seems entirely moral and appropriate to me. If you want the benefits of the NHS you can get them by moving back to the UK.[/QUOTE]

Anyone can just walk into the country claim residency and access vast amounts of expensive medical care. I happen to believe that is wrong.
However, the law and morals are two different things.

I agree that law and morals are not always coincident. However, the UK has immigration rules so that people can't become UK resident without meeting the legal criteria. Once they are resident they have as much right to the NHS as any resident. If a non-resident accesses the NHS for anything other than emergency care they should use their own insurance or cash to pay.

FYI if you are paying Medicare tax in the USA you'll be happy to know that there is no residency requirement for Medicare, you can fly back to the US and use the system. You will of course have to keep paying your Medicare premiums and have to pay substantial out of pocket costs if you don't have a Medigap policy

I agree, that someone can be excluded despite having contributed to the funding for many years, whereas others can wander in (from anywhere in the European Onion) and get "full coverage" immediately despite having contributed nothing, is ridiculous, but that is what the law says.

Free movement of labour across EU boarders requires reciprocity of health care. Anyone from the UK can simply waltz into another EU country and be part of their system too. That seems like a good thing to encourage an efficient market in labour.

There are two issues here; whether you welcome the reciprocity of health insurance across EU nations and whether you agree with the way the NHS is organized and funded.

I think that it's a good think, however for whatever reason and there are several, if not many, opening up freedom of labour movement has not led to people moving around in a balanced way (close to zero net movement), it has led to a tidal flow from south to north and east to west, with approximately 3 million net inflow to the UK. That is clearly not sustainable, and has put significant stress on housing, transportation, and healthcare infrastructure.

The UK is always going to draw a lot of people in from outside because most of them have an understanding of the English language. That has to be the biggest single factor for why most people go to the UK.

Most Brits on the other hand, can't be bothered to learn foreign languages or move out of their comfort zone. So even though they have the same EU freedoms as a Pole or a Latvian, they're less inclined to exercise those rights.

There are benefits to as well as costs from immigration:

http://blogs.telegraph.co.uk/news/ja...h-is-revealed/

Good point. Otoh, people don 't typically migrate to the UK for the weather, whereas plenty of Brits move to Spain etc for that precise reason. So although there's inward net migration its hardly one-way traffic. And as the OECD points out, migrants to Britain tend to be younger and make a net positive fiscal impact to the country.

People migrate to the UK to work. They become residents and eligible for the NHS and also pay taxes. This sounds perfectly reasonable to me. I've never understood why people would resent the delivery of services to tax paying residents.

So what's the bigger issue? That people who don't pay tax can get access to the NHS or that foreigners can come to the UK to find work, meet the immigration regulations, presumably pay tax, and get access to the NHS.

Anyone can just walk into the country claim residency and access vast amounts of expensive medical care. I happen to believe that is wrong.
However, the law and morals are two different things.[/QUOTE]

Have a read of this thread as well, it's a current thread in the USA forum.

http://britishexpats.com/forum/showthread.php?t=800109

shows different attitudes, as well as the 'I paid into it, so I'm going to use it' attitudes

A top British surgeon says that health tourism 'could even bankrupt the NHS':


http://www.dailymail.co.uk/news/arti...krupt-NHS.html

Perhaps NHS admin staff could/should check the latest electoral register and ask to see a recent utility bill to see proof of residency for adults to receive free NHS treatment (we had to provide proof when we registered our son to go to the local school in the US).

I will cross-post in the USA forum where there is a similar post.