Most of us can spend a tenner quite easily.

It might be 20 cigarettes (circa £9.60), or a decent bottle of wine. Perhaps we'll buy a cinema ticket (£8), or a couple of pints, ditto; or maybe indulge in fish and chips and take a taxi home if it's pouring with rain.

Some of us may have a newish car, depreciating silently at more than a tenner a day. Two pay-as-you-go gym sessions, or a few lottery tickets, or a phone top-up, will cost much the same every week.

We spend according to our needs, means and circumstances. The point is that various different commodities carry prices which people accept and are happily prepared to pay. They know the value of what it is they need. The market sustains what it can sustain.

But ask those same people to pay that same tenner to their GP for the cost of a consultation which might just save their life, and see what happens. A fair few will be shocked and outraged. Deeply affronted, in fact, as if you had insulted their religion, or kicked their dog, or reprimanded their child.

Because the notion of free health care in Britain is seen as a moral right. We have no sense that we must pay for our health. And therefore we don't think about what it's worth and we have absolutely no sense of its value.

Of course, in real terms, a GP's time, expertise and training makes her or him far more valuable than, say, a lawyer, whose time, depending on experience, tends to start at £100 an hour. It's just that we're not programmed to think like that.

But I think it's high time we were.

This is the season for hot air about health, before the election. Every political party "weaponises" the NHS; every politician wants to pretend that they'll give it more money, look after it better, rebadge it more efficiently, shorten waiting lists. And over all of them, this time, blithely ignored, hangs the doomy warning from the impartial accountants at Audit Scotland: "The NHS will not be able to continue to provide services in the way it currently does. Fundamental changes and new ways to deliver healthcare in Scotland are required now."

Instead, watch out for more vote-winning political flourishes which simply impoverish the service. Take the last one by the SNP, the removal of prescription charges -- and the resulting madness that people who can well afford to buy their own medicine are now getting it free. Because everyone who needed free medicine -- the elderly, the infirm, children and people on benefits -- were already getting them for free. All that the free prescription charge did was give money away to the economically active and the middle classes.

But doomsday is coming and we simply have to start thinking differently. The NHS saved my life and I am forever grateful to it. But it's in a desperate state: a massive, flawed, dysfunctional, revered, anachronistic, socially-binding but bankrupt, life-saving institution. It's also a cult, a sacred cow, and we have all been brain-washed into thinking that free care, as constituted, is untouchable. And we don't have a clue what our health costs and what it is worth.

I know a bit about hospitals. In 2010 I broke my neck and became tetraplegic. I was an inpatient for a year, latterly with weekends home for good behaviour. Subsequently I have had been in hospital for three more operations, in various emergency, high dependency and acute wards, meaning another month or so inside. Now, paralysed in a wheelchair, I rely on my community health service to keep me functioning.

What I've seen is a service which is under terrible pressure, only just coping and no longer sustainable. Simply increasing its budget every year, pretending this is the answer, is deceitful. The basic structure no longer fits modern health needs. There are not enough beds, surgeons, nurses, ambulances. Besides, it is now evident that any government which put tax up, say, 5p in the pound, to pump into the NHS, would be voted out of office. Even though the public say the NHS is always their top priority.

It's doubtful whether even that extra money, spent within the existing system, would meet the massive demands posed by a) people living longer, with more chronic conditions; b) the speed (and expense) of technological advances in medicine; c) the expectation of patients that the latest advances and drugs will be available to them; and d) events such as failure of all antibiotics, or unforeseen disasters like ebola.

We have to start thinking more realistically and we have to start taking more responsibility for our own health. This means growing up and stopping being sentimental about something which no longer exists, if it ever did. The NHS is not some big kindly substitute parent who will look after us all our lives, cuddle us, kiss away our tears and make it better. It doesn't run on love and warm words. It needs to be funded in a realistic way, and that means special ring-fenced, or hypothecated taxation, propped up by contributions from state and private-backed insurance policies. With the poorest in society always, but always, protected.

Forget the cinema tickets or the bottle of wine. I would happily pay a tenner as a token of value every time I see my GP or my district nurse. I'd like to see on my payslip that a percentage of the tax being taken off me is dedicated to health care. I would take out insurance to pay for any larger, more expensive hospital stuff I might need. I'm in work; I can afford it. I appreciate the enormous skills of NHS staff and the expense of the facilities. And I believe there are many working people like me who can and would do the same, if we could be certain that we had access to choice, the best treatment and that free-at-point-of-use continues for those who cannot afford to pay.

I would like us to move to a situation similar to that in France or Germany, which have civilised, sophisticated public/private health care systems which cater successfully for the disadvantaged -- and yet out-perform the NHS by miles.

France, according to the World Health Organisation, has one of the best healthcare systems in the world, and the fewest preventable deaths. The French system is paid for by a social insurance scheme, managed almost entirely by the state and publicly financed through employee and employer payroll contributions, and earmarked taxes. The rest is via cover with mutual insurers. This means the country has much more money to spend and far greater choice. France has more doctors; more MRI scanners ; a shorter wait for elective surgery; better life expectancy; and lower infant mortality. The French government has the prime responsibility for the health and social protection of its citizens and regulates safety.

The sticking point, for us Brits, is that for most people it involves payment up front, even though that money is immediately reimbursed into people's accounts from the social insurance. Those on welfare or with chronic conditions do not have to pay up front.

The French are completely free to use any doctor or hospital they wish. They may go directly to a specialist either outside or inside hospital. As a rule, appointments with GPs are between 15 and 30 minutes long. There is a real sense that the customer is purchasing a service. In the NHS consultations typically take 5-7 minutes.

Take, for instance, a French mother I know, working part time, with two children under ten. She has a private insurance policy costing €18 a month. It used to cost €50 but since January 2016 her employer pays most of it.

A child has earache and she takes him to see the GP she has registered with, and pays €23 for the visit. This is already a subsidised price; it is not the true cost of the service, but even so, the full €23 will be refunded to her by the government within a month. So will the cost of the prescription she gets at the chemist. If she chooses to take her child to another doctor, the money is still refunded, but minus one €1.

The same woman goes to see her regular local gynaecologist. She does n ot need to be referred; she can go straight to a specialist. This visit will cost €28, which again she pays up front, but, again, the money is reimbursed in full by the government and her mutual insurers.

Similar contributions in Britain would restore the NHS; they would also be a fundamental step towards encouraging the public to accept more responsibility for their health. What is a visit to your GP worth to you? I would argue that only by paying something will we ever get a sense of worth, and start to value our bodies, and our doctors, more.

One example -- look how many missed appointments there are. In France and Germany citizens and their employers take some responsibility for their healthcare, rather than leaving power almost exclusively in the hands of the state. They look after desperately poor people in society better than the NHS does. And there is anecdotal evidence that co-payment acts as a brake on consumption among people who don't really need to see a doctor at all.

In Germany, under another kind of contributory system, most patients do not pay doctors' bills and care remains almost free at the point of delivery. The majority of the population who pay their national insurance contributions accept that they must also pay for the poor. The Germans focus on ensuring that the standard of care available to the poorest people is acceptably high.

If we could only change our attitude towards paying for health, imagine how good the future could be. I would love to see a reformed, enriched NHS create specialist hospitals for chronic illness, like dementia and obesity and cancer and mental illness, enterprises to be run jointly by charities and the private sector, with minimum standards of care set and policed by the state. These specialist centres would, as much as possible, be satellites around the emergency and acute hubs on the sites of big public hospitals.

These places would raise the quality of life for chronic suffers exponentially. Imagine how consumer-friendly and high-achieving a multi-disciplinary centre could be for, say a diabetic, treating their complex mix of physical, emotional, social and financial issues. It is worth stressing how care of patients is transformed by centres of excellence. Treatment is educated, resourced, tailor-made and sympathetic. Ill people whose lives are miserable, who feel they are a permanent nuisance, may for the first time get a sense of being among people who understand.

That's surely worth a tenner or two.

Comment by Melanie Reid. Melanie's Spinal Column appears in The Times Saturday magazine. She recently contributed to The Health of the Nation: Averting the demise of universal healthcare (ed Edmund Stubbs; published by Civitas).