I've had the opportunity to live in both the UK and US. In a previous life I spent a career in healthcare. Consequently, I have always kept an eye on this subject as I'm interested in it, and have watched England’s steady march to Privatisation for a decade and more.
The first issue is; why privatise?
No, really, why bother?
The universal government line is that it is:
2) ‘Reduces costs’
3) ‘Fosters competition’.
The first two are obviously hokum; the last is probably undesirable in a health care scenario, unless folk just get the opportunity to go elsewhere, which could be satisfied by simply electing to go to another health board. It would be easy to make a statute to cover a right to change health boards. The cost would be no more than some legislation.
Let’s look at the first two for a minute, the hokum claims.
Well, I would deal with ‘Necessary’ first, except I've come up against an immediate issue; nobody is telling me Why it’s necessary, unless it circles around points two or three, in which case it’s irrelevant fluff; and fluff we should also be able to agree is hokum.
So, if reason one for privatisation is self evident ‘padding’ of hokum, and reason three can be fixed by statute that leaves reason two.
Reason two says it ‘reduces costs’, which is smoke and mirrors. Let’s say the State, and we’ll make it the entire UK as well as use easy numbers, has a hundred billion for health care. We’ll make it simple by abbreviating scenarios and not adjusting for inflation.
In 1973 the nation had a hundred billion to spend on health care. We were taxed a hundred billion to support it, we spent a hundred billion on it. We got what we paid for, more or less directly returned.
Now, fast forward forty years. At this point about a third, twenty to fifty percent depending on how you work the numbers, of that service is effectively privatised, from PPI to PFI contracts to farming out of services and people.
So, now we've got a hundred billion of our money going in and about sixty five billion returned directly in ‘services’
What has happened to the other thirty five billion? Well, ‘The City’ and ‘Wall Street’ like to see profits of thirty to forty percent; we’ll call it a third on average. Executive salaries in the private sector are generally higher, hourly wages generally lower, but about ten percent of company revenue is usually kept to repay banks and shareholders as well.
Of that thirty five billion, we’ll be generous; about twenty billion might come back in services which have been included as part of PFI/PPI agreements, e.g. laundry, security, some aspects of direct care services, building maintenance etc.
So, in 2013, we still put in a hundred billion, but we lost fifteen of it to the ‘privateers’ padding their treasure chests. Now you know how a lot of those new yachts I see every day get paid for. Luxury lifestyles being financed while your children or your grandparents go on waiting lists. In fact, at the time of writing, our £19,000 floating home is next to a $7,000,000 yacht – financed by the insurance side of the US health care industry. And let’s be clear, it is an Industry.
So, what inspired this blog, and why now?
The NHS has just announced it expects a thirty billion funding gap by 2020.
To meet that, Lady Williams is advocating charging for visits to doctor’s surgeries. They’re also proposing having pensioners pay. So-called “wealthier” pensioners, just because they might have worked all their lives and saved like crazy and have a pension other than the State’s, now get to buy that executive or banker’s new yacht. Yet, had those elderly squandered their money instead of saving, they’d be off the hook for the time being - until the financial threshold is eliminated.
Of interest are the comments made by NHS England’s information director, Tim Kelsey.
Here is the gist of what Mr. Kelsey said:
"We are about to run out of cash in a very serious fashion."
Followed by a revealing statement:
‘... the UK and US governments were currently working on a common standard of certification for health companies to make it easier for them to access both markets”.
As the Guardian article pointed out, critics of the government's health reforms say they were conceived as a "necessary prelude" to a trade agreement with the US.
He further stated:
"one of the things that we agreed with the US government which will be hopefully signing at the G8 meeting in November is that we want to make it as easy as possible for small businesses to get access to both the US and the UK market places” .
“To do that we want to have some common standards. We will be working on a standard of certification so that you can be in the digital hospital marketplace or the apps marketplace and you only need to sign up to one certification scheme."
Based upon his statement and those of others, US healthcare companies, in return for their millions poured into US election campaigns, want a return on those millions. They need fresh markets and fresh profits. The government and those who manage the NHS appear to be on the brink of devising a system which would enable the simple, painless integration of NHS services into private US health care systems. This is a very accomplished system that charges ever-increasing amounts of money in the form of monthly insurance payments from its users i.e. Patients.
The fundamental interpretation here is that these US companies have lobbied their ‘bought’ representatives to make access to the UK market a prerequisite of any future trade deal. Very quietly, the US is telling Westminster, ‘Privatise Your Healthcare’, and Westminster, London, like the subservient poodle it is, is agreeing.
The only way they (health care companies based in North America) can get that access, and therefore additional opportunities for profit, is through increased privatisation of the NHS. If that privatisation doesn't happen, then they’re only fighting for a bit of that existing thirty percent. They will then undercut each other, services will suffer, bankruptcies will follow, and our people will get hurt by both poorer care and unpaid bills.
Remember just because Blue Cross UK goes belly-up and leaves a medical wasteland in its wake, it doesn't mean Blue Cross USA has to pay. That’s the “beauty” of independent subsidiary companies.
Therefore, feel free to vote “NO” in 2014. Just be aware there is every likelihood one of the many things you’ll be voting “NO” to is the NHS. You have to remember, reduced public spending in England will result in a claw-back of our meagre pocket money under the Barnett Formula. The outcome of which can only mean reduced spending in Scotland.
The current cost of a quality ‘family healthcare plan, i.e. the kind of health care we currently take for granted, in the USA is creeping towards a thousand pounds per month. Can you afford that?
Furthermore, from personal experience, I know that even “comprehensive” cover doesn't truly ensure care in every eventuality that may become a health imperative in your life. Like many in the US, we were forced to sell everything we owned - from our home to my guitars - to pay for brain-scans and tests following a serious industrial accident.
As the UK will be copying the US health care model over the next several years, with both Labour and Conservative members pledging to ‘continue these reforms’, what you’re looking at is a return to the nineteen thirties. If you have any doubts about this, just check the list of Registered Members Interest in both Houses and see how many are intertwined with private healthcare companies. We need only look as far as Ms. Cherie Blair to find one very well-known example.
Then again if you do vote no, perhaps next time I break down on the ocean, maybe one of these new multi-million pound yachts will stop and help me. If it does, I’ll thank you for that ‘No’ vote. In reality, I’d expect it to do what the last one did when emergency struck. I’d expect it to ignore us, to keep on sailing, and pretend it didn't see the distress flare’s being let off or it didn't hear our anxious calls on the emergency radio channels.
You see, like us, if you don’t have health insurance in several years time, you’ll be able to expect that hospital ship to just maintain its current course and keep sailing on by.