Advances in medical technology have added many expensive possibilities for improving the physical quality of life of people with previously untreatable conditions. There are limitless possibitities for further developments. Unfortunately the skills to develop and use these techniques are not limitless. It is often impossible to get the best treatment to all patients at the time which would make it most effective and at a time which is convenient to them. Some patients have to wait and for some the delay may mean that treatment is too late to be effective. No one likes this situation but no one can change it. However much funding is available there is likely to be more that could be done for many patients if more funding could be devoted to them. Difficult decisions have to be made. These decisions often involve comparing the relative value of an increment in the quality of life of one individual with a different kind of improvement in the quality of life of another individual.

The REAL Party believes that where difficult decisions have to be made, especially where they involve judgements of relative values, the decisions should be made in a way which allows the values of all individuals and cultural groups to be taken into account. The best way for the values of all people to be taken into account is for them to bid for services in a free market in which they all put the same value on the money. Unfortunately in our present system we do not all put the same value on the money. Those who have less money are likely to value money more highly: they are not likely to be willing to pay as much as those who have more money for something which is of equal value to them. In a situation in which incomes are very unequal a government which considers that its primary role is to protect the rights of the weak and powerless must be very cautious about a market health system or user pays. The alternative methods of determining the values of the population are time consuming and therefore costly and are highly inaccurate and subject to unintentional bias. The decision between these decision making processes is not simple.

The REAL Party believes that with the Resources Taxes and Natural Dividend incomes will be much closer to equality. When this happens individuals will value money equally and will be prepared to pay the same amount for services they value equally. In this environment the REAL Party believes a genuine market health system, in which individuals really have choice about what kind of treatment they want and how it is delivered, will improve the mental, physical and spiritual health of the people. Instead of the government spending the people's money for them on highly paid medical specialists and complex technology, people will be able to choose to spend their money on things they believe will keep them healthy. More food, warmth and shelter may keep some healthier than any number of visits to the doctor. Things which make lives less stressful or more satisfying could prevent more sickness than we imagine. People will be able to afford private health insurance if they want it. People will have a secure income to borrow against if they require medical attention which they have failed to budget for. Unpredictable, very costly, medical expenses are currently often met by public donation. This mechanism could continue to be used and developed, as it has been in some cases, so that surplus from appeals goes into a permanent fund for similar cases. The REAL Party would investigate the possibilities of taxation schemes which would make those, whose choices increase the risks for others, pay towards the health care of those who suffer as a consequence, for example taxing smokers to pay for health care for conditions caused by passive smoking or taxing drivers to pay for the health care of those injured in road accidents.

The recent moves towards user pays in the health system have made some people pay twice without really giving them any more choice. The REAL Party does not believe that there is anything inherently wrong in the new structures which have been set up. Recent failures to deliver acceptable levels of health care are probably due more to people being unfamiliar with new procedures than to the structures themselves. A REAL Government would not make any more significant changes to the Health System in the immediate future. We would monitor standards of health care and make ad hoc adjustments if necessary. Generally the REAL Party believes it is better to protect the underpriveleged by increasing their incomes rather than by providing services. Providing services inevitably gives money and decision-making power to professionals who are already comfortably off and do not necessarily know what is best for those less fortunate.

When incomes became almost equal a REAL government would increase the user pays element in the Health System and reduce wage and salary taxes.