Philip Hensher: Let's start counting the cost of health

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Since I was 14, I've used an inhaler for an ongoing but not generally serious medical condition. It gets renewed every month or two; I think nothing of it. Last week, for the first time, I just didn't have time to go to my NHS doctor to order a repeat prescription.

Another NHS doctor, approached on Wednesday, said they couldn't produce one before the following Tuesday. By then I would be in Germany, and you know what the German health service is like for form-filling.

I was stumped, until I thought of those shiny private clinics at every London railway terminal. I shelled out £25 for a quick consultation and a prescription. "You know that as this is a private prescription," the doctor said, "you will be charged the cost of the medicine?" I honestly hadn't thought of that. Who would? For me, my inhaler costs, like all other medicine, £7.20, which is what we all pay since April 2009.

Except that it doesn't cost that. "That will be £57, I'm afraid," the pharmacist said. I gulped; paid up and went my way with the medication I rely on. Now, I have no objection at all to being asked by a private service to pay for a consultation and the full cost of my medicine if I can't find the time to get to the NHS provider. What I wonder is this: why didn't I know how much my medicine actually costs the NHS?

On several occasions, I've forgotten a half-full inhaler while travelling somewhere, and blithely gone to another doctor for a replacement, thinking, "Oh well – it's only seven quid," confusing price with cost.

It is possible to find out the cost of medicine by searching the websites of commercial pharmacies, often operating from the US. But why should anyone do this if things are being supplied to us priced at such low levels?

Obviously, it is absolutely brilliant that the NHS supplies us, in almost every case, with the medication and treatment we need without asking the patient for payment which relates to their condition. But wouldn't it also be rather a good thing if, on every prescription where the medicine cost more than £7.20, the actual cost to the NHS was spelt out?

I know I feel very grateful indeed now that I've discovered this information, after 30 years of blissful ignorance. Anyone would, and would resolve to be more responsible in using and looking after the medication.

Transparency, in almost every case, is a very good thing. Since food manufacturers were obliged to inform us of the contents in fats, salts, sugars of their products, it has become much easier to make healthy eating decisions – or, if you prefer, to know exactly what lardy snack to head for on the shelves. Similarly, users of public services ought, I believe, to be informed of the value of the service, at the point when they use them, down to and including tickets on trains and on buses.

Of course it is possible to find out this information, but who, in practice, ever does so? It had never occurred to me to wonder how much my inhaler cost, despite using it on most days for the last 30 years. Transparency, and simplicity, should be the key.

Perhaps, too, on your monthly payslip, the information should routinely be printed that you have paid, out of every £1,000 of public contributions, £180 on health, £130 on education, £160 on welfare, £180 on pensions, and £350 on other no doubt worthy recipients. In the end, of course, the full cost has to be paid for by you and me. It is easy to avoid the knowledge of that cost, and we ought to be routinely informed of it.

Why coming out really isn't a criminal offence

You may have heard that the singer Ricky Martin, came out as gay last week. Or you may have heard a slightly different thing: you may have heard, from a number of quite surprisingly distinguished news outlets, that he "admitted" that he was gay, or that there had been an "admission" of the fact.

Even though Mr Martin had strenuously claimed to be exclusively heterosexual on previous occasions, I don't care for the language of "admission" here. No one would ever say that someone "admitted" to being Jewish or left-handed. It is the language of criminality, and if Martin denied it in the past, that may have been because of the inquisitorial tone of his interviewers. I "accuse" you of being gay: he "admitted" being gay. The one thing that is left in no doubt in such exchanges is that it is basically deplorable to be gay.

After the shadow Home Secretary suggested that the owners of B&Bs could inquire into their guests' sexuality before turning the gay ones away, we perhaps ought to be wary of this sort of thing. In Mr Martin's case, the language is still more inappropriate because he made it clear that he had been perfectly open with his social circle for years. Could we please consign "admissions" in this area to the dustbin? And, next, that hideous expression "openly gay", since, if the fact is stated in print, we can confidently assume that a person's sexual preference is indeed held openly.

How lucky they are, back in the old DDR

In Berlin for the weekend, we were seized with a sudden urge, not easily accounted for, to see the Bauhaus at Dessau. And very handsome it was too. On the way back, we succumbed to a similar urge to see Wittenberg, where in 1517 Martin Luther nailed his 95 Theses to the church door. It's still not a large city, but is a very pretty one.

Even in these historic and fascinating towns, the well-known population drain from the old East Germany was evident. Millions of East Germans went westwards after 1990, and those who stayed, it has been said, "stopped having children". Not many people went in the opposite direction.

But I must say, the idea of selling up a grossly overpriced London flat, leaving a terribly overcrowded metropolis and coming here to fill the population gap has its appeal: somewhere where you can buy a castle for a few hundred thousand, and a grand town house for less than that; where the services are first-rate and the historic towns not chock-a-block with coach parties. You could probably, and quite reasonably, settle in a place less than an hour from half a dozen world-class opera houses and orchestras. (On the other hand, a good pizza is, in my experience, quite a challenge to find.)

One of these days I might go all Junker, put a boar's bristle in my hat, and settle in a small Thuringian palace.

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