The answer is more investment in health and welfare-not more rationing of healthcare

Multi-national European studies have shown that investment policies in healthcare and other welfare services pay large positive fiscal dividends and promote economic growth (i.e., for every dollar put into health services governments get more dollars back, often referred to as fiscal multipliers).2 Even the International Monetary Fund, a bastion of neoliberalism, which initially disagreed with the results of these studies, has since conceded that such positive fiscal multipliers do result from investments in health and welfare.1 2. Undoubtedly, the situation has continued to deteriorate because not only has residual neoliberalism continued to eat away at healthcare funding, but it has also fuelled a widening of the gap between the "haves" and the "have nots".8'9 As a consequence, people in the lowest decile groups have suffered the double jeopardy of the worst predeterminants of health and the poorest access to healthcare services. If serious rationing of acute secondary services takes off rapidly here, as happened before with elective healthcare, we are likely to end up with a USA-type healthcare system, that is heavily privatised and inefficient, and where: the wealthiest 20% have some of the best healthcare in the world; middle-class Americans live in dread of having a major acute or chronic illness and thereby needing to declare bankruptcy; and a poor, uninsured 27.5 million people have almost no access to healthcare.10 It is easy to see how such a dystopian scenario is unlikely to motivate doctors like ourselves, who can afford to pay for private healthcare, but would be a persistent nightmare for many other people.