Saturday, May 06, 2017

Vote Tory, vote to pay for healthcare in the UK

Back in April, Twitter had a busy hashtag, #publicduty, used by professionals to warn against the perils of voting Conservative.

Here is my contribution:

As a retired NHS GP & psychiatrist it is my #publicduty to tell you that if you vote in Tory Government you will lose free health care.

That got 80 retweets and 52 likes, which is not bad. 

Then a friend questioned whether it was true.

It is beyond doubt that the provision of healthcare in the UK is in the process of being privatised. 

The whole thrust of successive reforms by governments, both Tory and Labour, ever since the purchaser-provider split was introduced in the NHS in the 1990s, has been to make it easier and easier for private health corporations to provide care. This despite the manifest inefficiencies of privatisation.

The Tory argument is that GPs have always been private contractors within the NHS, and so there is no problem - the Government is just continuing that tradition. The core argument is that so long as the patient gets treated, it matters not who provides the service.

Now there is a sub-plot. Over the past couple of decades, pundits frequently report on solemn discussions about how to fund health care. The old model, of funding it out of general taxation, is clearly old fashioned and therefore wrong, say these experts. The method of funding needs to be modernised. Long, involved discussions follow, and the conclusion is that we need some kind of insurance system.

Well, of course, we do already have an insurance system. It's called National Insurance. Everyone pays taxes, and everyone gets healthcare. Simple. But to the modernisers, this is no good, because it is nationalised, which means public, and Public is Bad, whereas Private is Good. Therefore we need some form of private insurance.

Can you see what it is yet? We are being moved towards the system they have in the USA. The system that costs twice as much as the NHS, and does not provide health cover for uninsured people. The system that Clinton and Obama have been trying to replace in the teeth of bitter and enduring opposition from Republicans.

Why do we have to go in the US direction, when it is so blatantly less efficient and humane? The reason is very simple. Corporations must grow. US health corporations are coming up against the buffers of growth in the USA. Therefore they need to spread to other markets. The UK is a natural target market, because we speak (roughly) the same language, and we are not already saturated with health corporations.

Therefore the pressure is on for the NHS to be replaced with private corporations operating in a health insurance matrix. 

Now the thing about private health insurance is that you can choose to belong, or not to belong. To pay for it or not to pay for it. Therefore the poorer among us, being unable to afford private insurance, will fall out of the system. So also will insured people who are sufficiently unwise as to contract an expensive and ongoing illness that is not covered in the small print of their insurance policy. 

These people will have three options
1) suffer in silence
2) die, or
3) to pay. 

Quod erat demonstrandum

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