I think that this is to view things too much in terms of commodity
production.
The notion of things being 'paid' for is only relevant within
commodity relations, where, for each flow of goods or services there
must be an inverse flow of money. But this scheme could only be
applied consistently to a social formation in which capitalist
relations of production were the only social relations in existence.
Where there are not capitalist social relations as well, some labour
is performed directly for the benefit of the recipients without
there being any reflux in money.
Who pays for the labour of women/wives cooking for their families?
Nobody, because the labour product never assumes the form of a
commodity.
Similarly, the NHS and state schooling provide use values that
never take the form of commodities. What the commodity producing
sector of the economy values these services at is the flow of
commodities into the public sector. A certain amount of commodities
in the form of beds, medicines, consumer goods bought by the staff
etc has to be allocated by the capitalist economy to the public
sector. The labour embodied in these goods is, however, lower than
the labour expended in the public sector ( unless wages in the
public sector were so high that they were equivalent to the mean
weekly value product int he private sector ). The surplus labour
time expended in the public sector does not have to be 'paid for'
at all, since it never assumes the form of a commodity.
When constructing national labour budgets, which are not the
same thing as national monetary accounts, one has to be
careful that one does not unconsiously incorporate assumptions
from capitalist accounting practices. The operation of equivalent
exchange of commodities is the foundation of double entry book
keeping, where there must be a balance at the end of the day
between debits and credits, income and expenditure. This is
carried over to national accounts where income and expenditure
accounts should balance. But this is an artifact of capitalist
social relations.
If we abandon these pre-suppositions what we get is simply a
national labour budget which describes the allocation of societies
labour time into different activities. This specifies the
concrete labour into which societies abstract labour time
is actualised.
Quite distinct from this one may sub-divide some of the flows
of use values between the social classes and groups who benefit
from them. There is no reason to suppose that these streams of
use values, when valued in terms of the labour that produced them
will equal the total labour expended, since some of the labour
will be expended on non consumption activities, long term social
investments like the Channel Tunnel, waste - like previous attempts
to build a Channel Tunnel that were abandoned part way under
the sea - or social activities for which there is no clear
consumer - the labour of priests and monks for example.
> The value product of society reduces to c+v+s and it
> has to come out of one of them.
This premis is false and the whole subsequent argument based
on it falls.
> What society pays for is the *gross* output of the health
> provider.
No, what commodity producing society pays for is the *net* commodity
cost of maintaining the health care sector. This is only equal
to the gross output if the health care sector is private.
>In the private case, it functions just like any other commodity
> producer and its C comes out of the annual output of department I, its V
> comes out of the annual output of department IIa and its S 'comes out of'
> the output of department IIb. I put 'comes out of' in quotes because what
> actually happens is that they pay it to the shareholders who consume it
> as incontinent living.
I think that you are confusing value produced in a sector
with what the agents in that sector spend their income on.
It is only capitalist accounting convention that forces these
to be the same. If the relations of production are non-capitalist
the two are no longer equivalent.