In real terms the amount the UK spends on healthcare has risen from £500 in 1970 to £3,000 per person today. That’s a massive increase, but the payback has been that we are living 10 years longer. Ask people if they would be prepared to spend 10% of their income to live ten years longer, most would say yes. Yet we have a real problem in having the government spending more on healthcare.

As always, it gets back to the question of where is the money coming from? A government provided healthcare system is funded with government created money. A privatised system is vying for a share of your pay packet, using money that is already in circulation.

Phil and Steve discuss how our approach to healthcare is based on the standard question of, ‘where does the money come from?’, rather than ‘what can we be doing to make everyone’s life that much better?’

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There was an article in The Economist last week, shared widely in press around the globe, about the apparent fixation with manufacturing. Aussie economist Saul Eslake calls it Manufacturing Fetishism, with government support focused more on that sector than anything else. President Trump wants to bring home everything from steelmaking to drug production and is putting up tariff barriers to do so. Britain is considering subsidising manufacturers’ energy bills; Narendra Modi, India’s prime minister, is offering incentives for electric-vehicle-makers. But of everyone subsidises the same products, does anyone come out ahead? And isn’t the manufacturing focus based on the simple notion that they are better paying jobs than hospitality and retail?

Steve thinks manufacturing is important for a while variety of reasons, including building the skillset to make economies more self-sufficient. That requires well-funded education, which is not one of the central pillars for Trump’s strategy of bringing jobs back home. Perhaps he hasn’t thought it through enough.

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There’s an irony that the UK Chancellor Rachel Reeves has imposed an inheritance tax on farmers, whilst a trade agreement with the US could see Britain selling-the-farm on a farm grander scale.

Phil argues that some sort of tax on the inheritance of farms makes sense kif its only used as a tax dodge. Jeremy Clarkson bought his farm (reportedly for £6 million) and had a farm manager run it for 10 years before he started making his TV series. If we he died before the new tax rules the £6 million would have been passed on exempt from the rules of inheritance tax. A nice little tax dodge. So, surely, the government was right to close a loophole.

The broader question, though, is what the government does about farm productivity more generally. As Steve points out, 40 percent of UK food is imported. Just over the channel France is 80% self-sufficient. Rather than talking about buying stuff from over the Atlantic shouldn’t the UK be working out how to be more reliant on its own food sources, in the same way it is pushing to be more self-reliance on energy and defence?

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Bill Gates has predicted that within 10 years we’ll be working a two-day week, thanks to advances in AI. He says it’ll mean a vast rethinking of the workplace. It’s not too dissimilar to Keynes's prediction in the 1930s that wed al be working 15-hour weeks, with more time to enjoy the good things in life.

Of course, Keynes was wrong. We are working longer hours with loads more stress. Tools to aid productivity have freed up time for us to take new jobs and add to the economic output. Steve says a lot of this extra income has been used to increase the price of assets, particularly housing.

This time, though, who is to say the replacement jobs will exist. AI and robots could replace us in almost every job. So then what do we do? A universal basic income, perhaps, which Phil says will not be too dissimilar to unemployment benefit. But that’s going to take more government money. If we ignore the MMT arguments about governments’ ability to create money the only way to pay for the unemployed is through higher taxes on those businesses doing the work. But the focus today is on less regulation, so these companies can complete their cycle of job destruction unhindered. As a society have we really thought this through?

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There are challenges that the insurance industry faces, even though it can look like a licence to print money, Since the Big Bang of the nineties, when deregulation allowed the industry to flourish, insurance now accounts for 2.5% of UK GDP. Not bad money for an industry that is a cost to society, rather than a benefit.

Until now the business model has been simple; charge a premium based on the risk profile of the customer, avoid high risk customers altogether and invest the payments you receive in the markets to make even more money. And, unfortunately, payout when someone makes a claim, but keep the legal profession gainfully employed to ensure that doesn’t happen too often.

If you find claims are rising, imply put up th premiums next year. Which is why we’ve had several years were premiums have grown significantly faster than inflation. The consequence of that is people from lower- and middle-income households simply can’t afford the insurance, so they avoid it altogether or under-insure.

Phil and Steve discuss the merits of government-run insurance. We already have it in health, of course. The problem with having it applied more broadly is that it won’t alert us to the impact of climate change. As insurance moves from covering us for episodic events, to systematic change, the business model folds. Steve’s hope is that, as this happens, the industry starts to squeal and wakes us all up to the profound impact of climate change. It acts as the canary in the coal mine and becomes the first industry to lobby for us to take it seriously. Although, with them still enjoying healthy profit margins, it’s not happening yet.

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The pandemic killed 200 thousand people in the UK. Are we ready for the next time? Experts reckon will be even less prepared should we see another pandemic in the near future. Prof Tom Koch from the University of British Columbia reckons we don’t have long to wait - the next one could strike in the next five to eight years.

If you were a virus with an understanding of how economics is taught, this is exactly how you would have planned it. Yet governments to spend a fortune on the first blow, knowing they would spend the intervening years trying to pay back the debt, rather than spending new money on the preventative measures to dampen the impact of the second blow.

If we had a clearer understanding of how fiat currencies function, maybe we would be better prepared. Meanwhile Steve has a mask he can sell you.

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