Col. Jessop: “You want answers?”

Lt. Kaffee: “I think I’m entitled to them.”

Col. Jessop: “You want answers?!”

Lt. Kaffee: “I want the truth!”

Col. Jessop: “You can’t handle the truth!”

Here we are, deep into another General Election, with everyone, it seems, in search of the elusive truth, just as Lieutenant Kaffee was when questioning Colonel Jessop in A Few Good Men.

This search for truth in politics is viable only in part. There are no facts, and there is no truth, about what the future holds. We, the people, simply have to rank the credibility of the assertions put before us. That’s politics.

But there is truth, and there are facts, in the present, and in the past. That goes for Brexit, which was supposed to be the single issue of this campaign. But it also goes for the issue which, as night follows day, inevitably emerges: the NHS.

Not for the first time, it is the debate on the NHS that has provoked peak hysteria on all sides. It is, once again, the “last chance to save the NHS”.

READ MORE: We must strive to redress the balance in the NHS between primary and secondary care 

And once again, we are to save it from privatisation, this time Donald Trump’s variety. Truth in this debate is hard to find. Opinion poll after opinion poll after opinion poll tells us the NHS is Britain’s national religion, so politicians have free rein to employ hyperbole liberally. Biggest scare story wins.

But the NHS has its truths, and if we were able to handle them we might create a decent national discourse. The central truth that would unlock the debate is that the NHS is not free. Our national conversation is conducted on

a bizarre premise that we are so lucky in this country to have a “free” NHS. We’ve all seen the ubiquitous gush on our Facebook feed: “Last night I fell and hurt my arm and I went to A&E and they X-rayed me and it was broken and they put a plaster on and now I’m home having a cup of tea. I love our NHS.”

But what is missing from this narrative is the fact that the ostensibly lucky ducky sitting at home sipping a cup of tea with their good arm has paid for that privilege. Scotland’s average salary is roughly £25,000, with the income tax payable being around £2,500 per year. The NHS receives, very conservatively, about one-third of Scottish Government spending, so an average earner spends over £1,500 of their personal earnings on the NHS every year. And, of course, that does not include any of the other taxes they contribute to the Government’s pot.

This is called health insurance. For that is what the NHS is – a national health insurance system. It is akin to all insurance systems, whereby we collectively pool our risk. There are differences, to be sure. Firstly, our health insurance has a compulsory provider. Secondly, we guarantee nobody is uninsured. And finally, instead of premiums based on risk, premiums are based on income – if you earn £50,000, you’ll pay well over £3,000 a year in health insurance – with the quid pro quo that claims do not affect your premium.

READ MORE: Herald view: NHS needs accountability 

The person sipping the tea with their arm in a plaster need be no more grateful to the NHS than they would be to Direct Line after a burglary, or to the AA after a breakdown. They got what they paid for.

By acknowledging our personal financial investment in the service, we might change the way we think about modernising it. Instead of simply being grateful we have “free” healthcare, we might interrogate what we put in, and what we get out, and critically we might compare that with other countries.

We are spectacularly reticent to invite international comparison of the NHS. We much prefer to operate in our morally superior bubble, wishing to believe that all across the world there are people with broken bones, begging for money to hand over to a man in a suit before he lets them in for an X-ray.

We want to believe the only alternative to the NHS is the US system, with hundreds of millions of people uninsured. The truth – there’s that word again – is that the UK system and the US system are the two poles, with most of the rest of the rich world, including the EU, lying in between and, critically, also receiving care for what we call “free”.

The truth is the NHS is average, or slightly below. There are many indicators of outcomes, but if we look at those for the most common cancers, heart attacks and stroke, the NHS usually ranks in the twenties, according to data from the Organisation for Economic Co-operation and Development (OECD). This is not a financial issue; the funding to the NHS is around the OECD average, and so we actually get slightly less than average bang for our buck.

The NHS is not the envy of the world, as its apologists say, and when we trip over ourselves to claim it is without any supporting evidence, we debase ourselves. We limit our ability to be rational.

Nowhere is this more evident than in the debate about “privatisation”. Our collective hysteria creates a wilful misunderstanding of the difference between privatisation, and private sector provision for profit.

There is private provision everywhere in the NHS, the most obvious (but seldom discussed) being in primary care. Almost every GP in the country runs, or works for, a company. The patient gets treated, the GP bills the NHS, and turns a profit.

Less hidden is the alleviation of waiting lists by using private hospital suppliers to perform elective operations. This is often called privatisation, but it simply constitutes the use of a profit-making non-NHS facility to perform a procedure, paid for by tax, on behalf of taxpayers.

This private sector supply continues right down to a micro operational level, so that Siemens makes a profit when it sells the

NHS MRI scanners, Dell makes a profit when it sells the NHS portable computers and Bic makes a profit when it sells the NHS pens.

None of this is privatisation, because privatisation means the denial of a service without a payment, in the way that, post-privatisation of telecoms, you are denied a telephone line without paying for it. This does not happen anywhere in the NHS and I am not aware of a political party whose policy is to make it so.

Many of those who claim to be in search of the truth in politics are complicit in the NHS whopper. Let’s handle the truth. It’s ours, we pay for it, and it isn’t good enough. So let’s have a grown-up discussion about how to make it better.

Andy Maciver is Director of Message Matters.