Mark Steel: Shall we let rich people decide who gets treated in our hospitals?

Patients could just lie there screaming, hoping a banker rescues them

However the dispute about tax and charity donations ends up, the one thing we must all agree on is how inspiringly generous these philanthropists are, selflessly donating chunks of money that, by coincidence, are the amount they would have had to pay in tax anyway. Even the Good Samaritan would have said: "That's TOO philanthropic, you're being a fool to yourself."

Instead of punishing this kindness, we should extend it, so rather than funding the NHS through compulsory taxation, we get millionaires to wander round a ward and give a few pounds if they see a patient they think deserves curing.

Instead of paying for kidney machines out of tax, patients will be free to scream away in the hope a banker pays for a "Fred Goodwin Centre of Dialysis", or keeps it for himself, depending on the mood he's in. Then we could stop the cruelty of forcing high earners to pay in other areas. Wages, for example, could be scrapped, and replaced by voluntary donations. So if the employer is in a giving frame of mind they might pay their staff, but if they don't feel like it, or forget, or would rather fund a solid-gold zebra crossing, they can. They will be free to choose.

The only thing unfair about the current debate is this system should apply to everyone, not just the rich. To start with, there could be a trial for a few items such as pork pies. When you buy a packet, you should have the choice of paying for them, or giving the money to a charity of your choice instead. Then, when the pork pie companies complain that this leaves them short of funds, everyone can go berserk and say, "Rob the charities would you, you heartless bastards."

The legal system could play a part, so convicted gang members could opt to pay their fines into a charity, which would then hold a dinner in their honour. There'd be a toast to "Firearms Dave", and a plaque would be unveiled saying "This Cancer Research project warmly thanks the Stab Everyone u Meet Crew".

Whenever someone in a pub puts a pound in the box for the local hospice, a pound should come off their tax, and if you give 20p to the woman sat under the cashpoint machine, that comes off your national insurance. If you put a fiver in the guide dog fund you should have your photo published in a glossy newsletter saying you're amazingly gorgeously unimaginably generous and be exempt from VAT for a month, and if the Government disagrees, everyone writes to the Daily Telegraph until they back down.

Some people might object that as charitable donations from businessmen have been allowed to replace their tax payments, those donations are actually our money. So when the plaques go up in schools and hospitals to thank the donors, they should really be thanking the rest of us. But that's because the rest of us are selfish pigs compared to the philanthropists.