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The NHS debate in this election is being conducted at achildish level, with Labour saying & #39;the NHS is not for sale& #39;, implying that the Tories would sell it. As proof they wave sheafs of redacted documents (and now minutes of discussions) about possible increases in medicine
prices if US companies are allowed to enter. The Tories respond by saying & #39;nonsense, the NHS will never be up for sale& #39;. I have put this thread together to bring some sense and perspective into the debate, and to help understand what & #39;selling the NHS& #39; means.
There is no such thing as an overnight sale of the NHS to anyone. The decisions that lead to a process of erosion are mostly ideological, and the actions that result in either an eventual & #39;sale& #39; of the NHS happen in slices, one slice at a time, spread over years.
To understand this, we need to:
1. Understand the cost of healthcare is not just the cost of medicines, but the entire expenditure on healthcare, which includes spends on insurance, in running hospitals, providing services.
2.Look at the history of healthcare costs in the U.S.
1. Understand the cost of healthcare is not just the cost of medicines, but the entire expenditure on healthcare, which includes spends on insurance, in running hospitals, providing services.
2.Look at the history of healthcare costs in the U.S.
The UK in 2018 spent only 9.8% of GDP on healthcare.
In the U.S. the history is summarised below:
1980 : 8.9%
1990 : 12.1%
2000 : 13.3%
2010 : 17.4%
2018 : 17.8%
(all data from Statista)
Why did this happen?
In the U.S. the history is summarised below:
1980 : 8.9%
1990 : 12.1%
2000 : 13.3%
2010 : 17.4%
2018 : 17.8%
(all data from Statista)
Why did this happen?
It coincides with the rise, growth and concentration of health insurers, and the fact that anti-trust laws (preventing monopolies) have rarely been applied rigorously to the health care sector (versus what happens in retail or industrial sectors).
As insurers became more powerful and acquisitions and mergers meant fewer and fewer of them controlled the market, they squeezed hospitals and pharma companies to lower costs, and they squeezed customers (you and me) to increase prices (premiums on policies).
Only in the last decade has the rapid increase tapered off, but it& #39;s already huge. For comparison, it& #39;s neighbour, Canada spent 10.7% of GDP in 2018.
These high costs have made health insurance unaffordable for many. In 2018, 27 million Americans had NO insurance cover,
These high costs have made health insurance unaffordable for many. In 2018, 27 million Americans had NO insurance cover,
i.e. they can only rely on A&E type of treatment!
Is this what we want eventually in the UK?
It will happen, slice by slice, as the US extracts the price of trade deals. Stage 1 is getting longer patent life (and therefore higher prices) for drugs from US companies.
Is this what we want eventually in the UK?
It will happen, slice by slice, as the US extracts the price of trade deals. Stage 1 is getting longer patent life (and therefore higher prices) for drugs from US companies.
Now compare UK with our European neighbours who have good national health services. The % of GDP spent on healthcare in 2018:
UK : 9.8%
France : 11%
Germany : 11.2%
Sweden : 11%.
UK : 9.8%
France : 11%
Germany : 11.2%
Sweden : 11%.
This difference, approximately 1.2-1.4% of GDP, or roughly £30 billion per year is perhaps what the NHS is crying out for, possibly with a clear plan to improve efficiencies as well.
Why can& #39;t politicians explain this in simple language to the voters? Why are they screaming generalities?
As I mentioned at the start, decisions that allow a US type scenario to develop are basically ideological. For my money, the Tories are far more likely to push us there.
As I mentioned at the start, decisions that allow a US type scenario to develop are basically ideological. For my money, the Tories are far more likely to push us there.
