THE best things in life are free, according to Luther Vandross. Instinctively that feels true. Everyone loves the free stuff. From the miniature pencils you can pick up in Ikea (very useful for the golf course) to the extra croissant from the hotel buffet (not so useful for the waistline).

However, surely without equivocation, the best free thing in life must be the NHS. Our NHS. Imagine having access to the undisputed best health service in the world, any time you need it, and not having to pay a penny!

Alas, though, these opening two paragraphs are a fantasy, not a reality. The Ikea pencil is not free – you pay for it in the profit margin the store makes on the other items you purchase when you shop there. The croissant is not free – the hotel has already accounted for it in your room charge.

And the NHS is neither the best in the world, nor free. Far from it, it is actually rather expensive. Let’s say that you, reader, are an average earner, making £25,000 a year. The government takes around one-third of that in the core taxes of income tax and national insurance – let’s say £8,000. And the government spends, conservatively, one quarter of its expenditure on the NHS. That means that you, directly, as an average earner, are spending something approaching £2,000 a year on the NHS. If you earn more than that, then do the maths.

It’s your health insurance premium. Your membership fee for living in a just society.

Now, you may not trust the veracity of my back-of-a-fag-packet calculation, and who would blame you, but the Organisation of Economic Cooperation and Development (OECD), perhaps the most trusted data collector in the world, comes to our rescue with an estimate that every man, woman and child pays something like $4,500 a year for the NHS, significantly above the average of $4,000, and more than than Denmark and Finland in northern Europe, more than Portugal and Spain in Southern Europe, and more than our far-away friends in Australia and New Zealand.

Despite all of this, the NHS is in trouble. It is in trouble as a concept, and as an operation. It is in trouble because the expectations of people about what the NHS can do for them are wildly unrealistic. And it is in trouble because the sense of entitlement amongst people about what the NHS should do for them is out of control.

The Coronavirus pandemic has opened this can of worms, and it is far from clear that it can ever again be closed.

Accessing primary care has become a headache and people are starting to ask why. Waiting times in emergency departments are all too often well outwith the target time, and people are uneasy with that. Waiting lists for elective surgery are becoming so long that the time from diagnosis to surgery is so long that people – ordinary people like you and me – are turning to private healthcare out of fear, anger and desperation.

We have to hit the reset button on our health service, now. If we don’t, we risk losing our faith in the concept.

There are two, practical steps the Scottish Government could take. They, in themselves, will not fix the problem, but they are the keys to the door to the room of ideas which could deliver the health service that the country is entitled to expect.

The first is to send each person an annual inventory detailing their use of the NHS; not dissimilar to the annual statement by HMRC which details, to the penny, what our taxes are spent on. This is rooted in transparency.

Those who use the service only a little will understand that, conceptually, they are making an invaluable contribution to society by funding those who need far more extensive treatment than their tax contribution would otherwise allow, and by funding those who need limited treatment but would not otherwise have an ability to pay.

Those who use the service a lot, perhaps because they have a chronic requirement or simply because they have had an unlucky year, can be reassured that they have a safety net.

This is the core of the concept of the NHS, which should never be altered, and which an annual statement would reinforce.

However, an annual inventory would also shine a light on the lack of personal responsibility which, as we all know even when we do not like to acknowledge it, is a significant and avoidable drag on the service. We all know people who overuse the service. Perhaps they would think twice if they saw it in black and white.

The objective of this first practical step is to clarify that the NHS is not free. The second practical step, arguably, even easier, and equally important, is designed to place the performance of the NHS in the context of health services in other countries.

This could be done at the same time as the annual inventory. It is the other side of the coin; you pay your money, and this is what you get for it. The document would contain the key, meaningful statistics which the OECD collects – government expenditure, number of doctors and nurses, number of beds and pieces of equipment, survival rates from cancer, heart attack and stroke, waiting times for the most common elective operations, and so on.

As a population, we do not understand enough about our NHS. We do not understand the relationship between taxation and service. We do not understand where the NHS ranks amongst peer countries.

We need to. We pay for our healthcare and we are entitled to expect a level and quality of service commensurate to our level of payment.

But the NHS is entitled to something from us too. It is entitled to expect that we will think before we use it, and help prioritise those in most need. That we will exercise some personal responsibility. And that we will lead a life that reduces the burden on the NHS and on all of us, the people who pay for it.

• Andy Maciver is Director of Message Matters and Zero Matters