10. Most controversially of all, the only way we are going to spend more on health without bankrupting the state is to encourage the public to pay more itself, as already happens in almost every other country. We need a European-style, insurance-based universal health system, with co-payments by those who can afford it and much greater private provision. Everybody should have access to high quality health care, regardless of ability to pay, but it will no longer be possible to provide it all through the NHS.