Gordon Brown and David Cameron have been posing as champions of the National Health Service against the rabid outcry by US right-wingers.
What they gloss over is the fact that both Tories and New Labour have spent decades undermining the Health Service and pushing Britain in the direction of the USA’s market-governed health-care system.
Thatcher cut the NHS harshly and encouraged private health care. Blair and Brown have developed a “market” for care within the NHS and given massive handouts to the private sector to “encourage competition”.
New Labour’s NHS “reforms” have constantly worked to replace public regulation, by elected bodies, with the market. Both New Labour and Tory election manifestos are likely to proposes making the NHS an “independent” body with its own constitution, outside of government control.
Both parties have used the American model and employed consultants from the big American health care firms in developing their plans.
When Peter Mandelson and Health Secretary Andy Burnham attack the Tories for promoting the market system typical of the USA, it is pure opportunism. The NHS is safe is neither of their hands.
The marketisation has made the NHS less efficient. Administration costs have already more than doubled from the historic average of 6% of the total budget. But also, and more fundamentally, marketisation makes the whole basis of health care cruel and inhuman.
Michael Moore’s documentary Sicko exposed that cruelty of the market principle. In the USA, it denies health insurance to some 47 million people!
That documentary helped fuel the drive for the limited proposals that President Obama is trying to push through Congress for some social provision of health care in the USA.
Moore held up the British NHS as the alternative. As the world’s first universal health care service free at the point of delivery, the NHS has long been the inspiration of health care reformers internationally.
That is why lies and distortions about the NHS have been a staple for right wing Republicans and their Conservative Party allies in Britain. Ironically, New Labour Ministers have responded by speaking out for an “idealised” model of the NHS — the model which health-care unions and campaigners have been defending for years now against New Labour government attacks!
Obama’s reform package is very limited. He wants to bring in a limited level of universal health cover on the basis of a compulsory insurance scheme underwritten by the government. Under the weight of attack from the right and the vested interests of the health insurance companies and pharmaceutical industry, he has already retreated some distance.
Right-wingers in the USA have preyed on fears about “big government”, raised scares about rationing of care, and claimed that the fate of individuals, particularly the elderly, will lie in the hands of faceless bureaucrats sitting on “death panels”. As if it is fair and democratic that “rationing” should be by the well-off getting lavish treatment — in fact, in the USA, often more medical treatment than is good for them — and the poor getting only emergency-room care!
The USA spends far more on health care than any other country in the world — 16 per cent of national income, and the figure is projected to rise sharply — and delivers worse health, across the board, than any other rich country. It has mortality and morbidity rates much worse than the average for rich countries.
NHS spending has risen in recent years to 9% of British national income, but is still below the average for Europe as a whole.
The US leads the world in medical and pharmaceutical research. The rich can get good care there. But even if you can afford a basic insurance policy, or have a union and can get health cover negotiated as part of your work contract, exclusions imposed by employers and insurance companies deny you access to many treatments and services.
Five million more Americans have lost health care coverage in the last year, because of the recession. At the same time access is made more and more difficult by rising premiums. People suffering from chronic health problems such as diabetes or cancer are denied the ongoing care they need, and can fall back only on the emergency room, which is little use for conditions such as theirs.
Even if you have insurance, it can run out. Medical bills accounted for 62 per cent of all personal bankruptcies in 2007.
At the Labour Link conference of the big health service union Unison, in July, union leader Dave Prentis said he would rally other unions to demand a commitment against NHS privatisation in the Labour manifesto for the General Election.
Since then we have heard no more about Prentis’s efforts. Unison members should demand that he come good on his promises. Union members everywhere should demand their leaders fight to restore the NHS as a well-funded scheme of democratic social provision, and to reverse the push towards a US-style market system in Britain.
And,whatever the union leaders do, rank and file activists in every area should organise to defend our health service, through campaigns like “Keep Our NHS Public”.