Socialized Health care

Health care in Britain has, until recently, been provided almost exclusively by the National Health Service that was formed in the aftermath of WWII after the Labour government defeated Churchill in a landslide.

It is a government-owned and administered service that provides care to everyone. The health minister responsible for the NHS, Aneurin Bevan, noted it would provide “freedom from fear” of getting sick. (I find it ironic that the “don’t tread on me” crowd claims it is also freedom they are worried about—freedom not to have government involved in health care.)

Overall, the NHS has been popular and a great success, and any politician who has tried to mess with it has been met with a lot of opposition. At least that seemed to be the case until the last 10 years of conservative government.

Underfunded

Now, “the NHS has experienced a decade of underfunding” with inadequate annual budget increases to keep up with needed medical advancements, according to the NHS Support Federation.

The claim is 17,000 hospitals have been closed, and shadow health secretary, Wes Streeting, complained there are “record waiting lists, 100,000 NHS staff shortfall and 112,000 vacancies in social care.”

At a dinner party I was invited to, the hostess, who is a consultant pulmonologist at a large London hospital, corroborated this deterioration of the NHS. She noted things have been particularly bad in the last couple of years due to defunding, COVID and Brexit—Brexit having forced an exodus of health care workers.

Brexit has also likely added to the defunding of the NHS as Britain has had “the largest contraction of GDP among the G7 countries during the pandemic.”

An article in the BMJ—the flagship publication of the conservative British Medical Association—notes the government appears to have tried to hide behind COVID. “The pandemic has, undeniably, provided a cover for the most significant dismantling of state that the country has experienced in years,” notes the article.

Private Medicine Moves In

Unhappy with the shortcomings of the NHS, many people I spoke to told me how they had taken out private health insurance. My brother-in-law Olly paid some 22,000 pounds out of pocket to get a heart ablation for his recurrent atrial fibrillation, as it would have been a six-month wait to get it under the NHS.

The unhealthy consequence, to my mind, is that this move to private health care has attracted vendors from across the Atlantic—the most prominent symbol of which is the 1 billion-pound, 184-bed hospital built by the Cleveland Clinic in Grosvenor Place—“where patients enjoy views of Buckingham Palace.”

HCA Healthcare (which owns Spotsylvania Regional Medical Center, and which made what was—at the time—the largest health care fraud settlement in the U.S. in 2002) owns 30 hospitals in the U.K.

And a subsidiary of the U.S. Insurance company, Centene Corporation, recently bought out a group of 58 primary care practices, covering half a million patients, that was previously owned by a group of British doctors.

A Saleable Commodity?

You might argue it’s OK for people who have money to spend it on faster or more convenient health care (though not better—Olly’s ablation would have been done by the same cardiologist under the NHS if he had waited).

But the director of the thinktank Centre for Health and the Public Interest, David Rowland, says that his “worry is the two-tier health system”—a phenomenon I see here in the U.S., where you can get the best health care in the world if you have the money. Then there’s the chronically sick and underserved “have-nots” I see at the Moss Clinic.

“An estimated 1B-pound investment in a single hospital is a sign of how strongly foreign investors are betting against the NHS being able to meet the future health needs of the population,” says Rowland. “And the government seems entirely relaxed about this shift.”

An article in The Guardian echoes this, saying, “it is clear that an increased role for the private sector is the government plan.” It goes on to raise the alarm at the idea of exchanging the NHS for private health care.

I would note, the avarice of U.S. health care vendors that have pushed health care costs in the U.S. to nearly three times that in the U.K. ($12,530 versus $3,271 for 2020) is not encouraging. The Guardian seems to feel the same, noting, “the public sees clearly how much worse people fare under for-profit health care systems such as in the U.S.”