There are a whole assortment of articles that discuss that in different
ways - e.g.

http://www.kingsfund.org.uk/media/the_nhs_will.html

http://www.bmj.com/cgi/content/full/320/7238/865

The significant points are what proportion of GDP is the government
managing (it's now up to around 40% of GDP); and what is the outcome in
healthcare.

The Wanless report
(http://www.kingsfund.org.uk/publications/kings_fund_publications/our_future.html)
makes for disappointing but unsurprising reading when the figures for
outcomes for key issues such as cancer survival are considered in
comparison with other countries.     This is despite massive increases
in NHS spending.

At the end of it all, the reality is that the UK is still not spending
as much as a percentage of GDP on healthcare (public and private
sector) as other countries, so none of this is surprising.

Unfortunately, the press creates much confusion in people's minds by
focusing on the wrong issues such as postcode lotteries.    Of course
there should be a variation in allocation of funds because healthcare
requirements do vary from area to area.    At the very least, attempts
to homogenise this nationally should be abandoned because it's not
useful.    Here's an article about that:

http://www.kingsfund.org.uk/publications/briefings/local_variations.html

Even this organisation admits that some variation is a reasonable thing.

The question is then who should be deciding on how funding is raised,
spent and services delivered.

Recognising that people will have different healthcare needs over their
lifetime and that there will be a variation in ability to pay, funding
seeks to even out those costs across time and a population.   In that
respect, the principle is one of insurance, whether that is done via
taxation and distribution or via insurance in the conventional sense.
The problems with doing this via taxation and distribution are a)  that
governments cannot be relied upon to spend on healthcare to the degree
wanted by the individual - e.g. profligate waste on defence spending
since WW2 - and b) that the public sector does not do a good job of
managing the money.      Therefore, I would much rather see an
arrangement where the government role in the managing of healthcare
funds is minimised, or at the very least, monies identifiably
segregated for healthcare.   In other words, I pay £X per month, and/or
a percentage of income in some combination, but it goes to a
competitive arrangement of insurance providers so that admin costs are
minimised.

The second point is how should delivery be determined?    The NHS has
been consistent in demonstrating that it is unable to manage and
allocate funding appropriate to the needs of geographical areas and
more importantly to individuals.   Policy decisions are made on a far
too broad brush basis and with little regard to individual need and
preference.     Theoretically, PCTs and their equivalent should have
improved local determination of how money is spent.   As we know, this
is not very effective either for a variety of reasons including opacity
and lack of accountability - another public sector disease.

At the end of the day, people are responsible for their own healthcare.
 To a significant extent, it is affected by factors that they can
control.  It therefore makes little sense to have the determinants for
treatment where needed remote from the individual and under the control
of faceless civil servants.    Far better would be for this to be
brought to an accountable local level where people can have a higher
degree of control.   Even better still would be for them to be able to
make their own healthcare decisions including treatments without the
interference of nebulous government policies.

None of your "tax" goes on the NHS supposedly.
It is funded through your National Insurance Contributions (NICS).
NICS are a health and welfare insurance policy you have to have by law and
which the Govt obligingly manages for you.

Obviously one would mandate coverage.

Therein lies a different question.     Should the state be nannying
people on decisions like that?   I think not.

Who said anything advocating a U.S. system?

I wouldn't be that naive.

If a job is unjustifiable it is unjustifiable.

In the end, it comes to a matter of administrative cost.

There is nothing wrong with executive stock options as part of
remuneration packages.    Trading in those by executives is a matter of
public record.

Indeed, but hardly the same.   The Enron scandal came about because of
fraud, but more importantly because of a lack of proper statutory
auditing procedure.

I am not making comparisons with the U.S. system, nor am I advocating
what is done in the U.S.

There are ways to address these issues.  Obviously where possible
detail of policy cover should be checked when buying.  Other approaches
involve mandating cover on certain areas.   Of course this will
increase premiums, but whichever way one looks at it, an increase in
healthcare need has to be matched by individuals being willing to pay
for it, whether via insurance or via taxation.

The PCTs are certainly a case in point.    The principle of local
determination is a good one.  The problem is lack of accountability.

Having universal healthcare is entirely reasonable.    Trying to
pretend that it can and should be the same for everybody is a nonsense
for a multitude of reasons.