Small tweet on this strange section of UK Twitter talking about NHS and making direct or indirect references to the German system. Just don't, if you don't know your point of comparison - and chance is you don't have a f*cking clue about it or its context - just don't do it. /1

For one, just because you have an insurance based healthcare system doesn't mean you "sell out" NHS. Lots of system are insurance based, for example the German system. Healthcare insurance is mandatory and if you are unemployed the state has to pay for you. /2

The outcome - in other words - is similar: health care is "for free". You don't need to pay for a surgery, yes, was a very small surcharge in the past but that's it. Your NHS isn't that unique in terms of creating good quality health care free at the point of entry. /3

The obsession (especially by the Labour left) is very odd. However, what Conservative commenters who reference the German system as a counter point often miss, is the context. /4

1) You can chose the insurance company but their offers are regulated heavily. The difference in their offers is minuscule and, more importantly, they definitely cover more than the NHS (e.g. dental care). /5

2) You pay a significant fee (~14% of your income), again de facto no difference between the insurers. And if you are unemployed, the state HAS to pay (that's not negotiable either). /6

3) There are constitutional safeguards UK simply can't offer. Germany is a social state by constitution and can't be changed on a whim of an artificially inflated majority in a de facto one chamber system. Let me explain. /7

Germany has two chambers an constitutional matters require 2/3 majorities in both chambers. One chamber is packed with representative of the 16 federal state governments, the other is a parliament voted in with PR system. Good luck with finding your 2/3s. /8

And even if you find them (it's probably more likely that a nuclear strike destroy Europe), in this particular case it wouldn't be enough since there's an extra protection: Art 79 (3) provides an indefinite guarantee to the five principal pillars (social state is one of them). /9

You'd need to introduce a new constitution: Again good luck w/ that one. Coming back to UK, I doubt you can give those iron cast guarantees towards any future health care system. Since you can't maybe your answer why the defence against any NHS reform attempt's so vicious. /10

Consider the last years & ask yourself: Would you trust that guarantees won't be followed by a u-turn (I didn't see people dying in ditches lately) or very inclusive towards people who are most dependent from NHS (or how did it work w/ teachers and grading/school openings?). /11

Long story in short: Without real guarantees that the outcome of the healthcare system remains the same and as long as UK's political system isn't inclusive (but inflates maj artificially & has no other de facto veto players), I would suggest to defend NHS viciously too. 12/12

PS: One last comment. Journalists and artists (who work as freelancers) pay less (I'm not sure Tories would be thrilled by that either).