#009 A Design For Life

Universal Healthcare & Universal Basic Income

Progressive Primers
6 min readNov 21, 2014

The National Health Service is one of Britain’s most successful ideas. In a world dominated by market capitalism, a social system underpinned by exploitation and competition, here in Britain, in the middle of the twentieth century, we collectively decided to pursue and implement a universal health care system, built upon an extremely powerful idea. The idea was beautifully simple, to pool money from everybody in the country, via taxation, in order to fund a health care service, free for everyone to use when in need, regardless of individual contribution. The NHS very quickly became the most succinct manifestation of ‘communal spirit’ ever devised and since its introduction in July 1948, it has remained a huge success; to the point of being declared the best heath care system in the world by a panel of international experts in 2014.(http://www.theguardian.com/society/2014/jun/17/nhs-health)

Pooling wealth collectively to provide everyone in the country with a universal service has also extended to other areas, such as education, where everyone growing up in Britain has access to free, full time education from roughly the age of five through to age eighteen, and to food sources, where ‘public money’ subsidises some of the costs involved in production and distribution, thereby helping to provide everyone with food at a cheaper cost. As with healthcare the idea remains to simply provide everyone with the basic necessities of life regardless of individual factors, such as social background, personal wealth and contribution, and most rational people recognise the value this idea brings to society on many levels. In a world of markets and tit-for-tat trade agreements, this idea helps to make our country a more socially cohesive place than it would be otherwise.

Now despite the vast majority of people passionately believing in the principle and central idea behind the NHS, as it stands most necessities of life are excluded from this principle. This is partly because the idea of sharing (or ‘socialism’) is often negatively promoted as a dangerous thing, which can only lead to state tyranny and injustice, but more importantly because many existential necessities of life, such as food or water, are fundamentally different from education and healthcare. Unrestricted, universal free access to some types of goods and services are simply more open to abuse or supply problems than others, free education at the point of use is technically easier and less problematic to provide and sustain than say free clothing for everyone — both constitute basic necessities of life but each brings significantly different challenges to deliver free at the point of use, in practice.

Some goods and services, essential for a decent living, such as dentistry, (life long) education of varying types, childcare and funeral costs, could be treated like healthcare and funded socially in a similar way to education and healthcare, however other essential goods & services, such as food, water, transport, housing, clothing, energy and internet access, although equally important, may struggle under this communal concept.

In both these cases generally we are in need of a better solution than capitalism’s markets, in order to progress toward a more fair, reasonable and universal-access society, symbolised by the institution that is the NHS, and away from a more individualistic, privatised and less equal society, symbolised by private education, private healthcare and so on.

Rather than laboriously means testing people as individuals, to try and target help on the basis of need, which is prone to abuse, errors, high administration costs and often adds to division and resentment within society, and rather than subsidising various industries, often having the effect of primarily helping companies financially rather than those directly in need, one idea worth examining, one that is quickly gaining traction across Europe and beyond, is Universal (Basic) Income.

The Universal Income idea is really nothing original, the same simple idea underpinning universal basic income, underpins the NHS. We all collectively put in to a system we can all then benefit from directly, free of spurious notions of deserving and underserving poor and similar.

The Universal Basic income or UBI goes further however in that it is designed to allow each individual greater freedom in meeting all of their existential needs, via money, rather than meeting only one need at a time, at the discretion of the state. This means it must be totally up to the individual to decide what to spend their basic income on, promoting individual responsibility and financial autonomy, which takes into account every individual’s widely differing circumstances and priorities. For instance one person may utilise their income to help meet their rent and childcare costs and avoid debt, allowing them to use their salary on purchasing higher quality food for themselves and their children, another may choose to use their basic income primarily to pursue part-time education, enriching their lives and their future job prospects, a third person may decide to save up their income and start a business which could vastly benefit their local community or a fourth person may use their basic income to fund quickly rising energy and transport costs.

If everyone received a universal base level income high enough to significantly contribute to meeting an individual’s basic needs alongside work, to which everyone should aspire on one level or another, then potentially we can significantly increase liberty, decrease inequality, decrease poverty and increase social justice for everyone on an equal basis and also potentially replace many problematic social welfare programmes with a far more effective alternative.

Interestingly this idea has been trialled across the globe via small-scale experiments, here are the details of one example from India,

Conversely, Universal Income is not without problems, firstly it is simply not a revolutionary policy, it is merely a reform/concession within market capitalism. It does not constitute a revolutionary direction, as worker or community self-organisation does, but at best merely helps subvert the central concept of earning a living, which could be both positive and negative.

Secondly universal income, like universal healthcare, carries relatively high costs which must be raised across society, and unlike universal healthcare, carries the risk of both triggering high inflation (although this is arguable — https://medium.com/basic-income/wouldnt-unconditional-basic-income-just-cause-massive-inflation-fe71d69f15e7 & https://medium.com/basic-income/supply-and-demand-variables-d8d15cf85368), leading to significant price increases, devaluing both our earned and basic incomes in practice, and even being all out socially dangerous where power is given to politicians to set the basic income level, for political reasons.

These issues have fairly simple solutions however when explored further, firstly reforms and revolutionary moves are not mutually exclusive, it is reasonable to both try and improve our conditions in the short term whilst simultaneously working toward longer term solutions and the two don’t necessarily undermine or work against each other. So it is reasonable to push for measures now that can improve the quality of life for most people, whilst also working towards a truly just social, post-capitalist society.

Second there are many ways of raising money collectively and in a progressive way, in order to fund a universal basic income, things like financial transaction taxes, removing personal tax allowances, replacing benefit programmes, land and luxury taxes and increasing income taxes on earned income higher up the scale could all be explored for this purpose.

Third we already have mechanisms for dealing with inflation, should it occur, such as altering interest rates from the central bank, and we could easily set up an independent organisation to recommend and set the level a universal basic income should be, with average prices in mind and rising with inflation. This happens already with institutions like the ‘Living Wage Foundation’, which determines the living wage levels in and outside of London. (http://www.livingwage.org.uk)

In conclusion then, providing Universal Income was set at the right level, set independently, funded progressively and regarded, not as a replacement for post-capitalistic revolutionary activity, but as a significant twenty first century concession to be fought for at a time marked by globalisation, rising inequality and technological unemployment, the idea has real potential to build upon the National Health Service and extend the profoundly social, collaborative and communal idea which helps to fundamentally bind society together.

The Universal Income has the potential to liberate us all from poverty and the anxiety and stress that comes with the ‘tyranny of wage slavery’ (Frances Fox Piven), just as the NHS idea liberated us from disease and squalor in 20th Century Britain, and the abolition of slavery eventually liberated African-American people in 19th and 20th Century America.

Universal Income, as a practical policy, seems worthy of serious consideration.

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Progressive Primers

Exploring and arguing for radical, green & progressive ideas. https://twitter.com/ProgressiveJimi