Brexit and the NHS

Let’s briefly show how the UK and US healthcare systems work.

UK – medical care is provided to anyone on the basis of medical need. No charge is made at the time and place at which the care is provided. Anyone, however poor, however chronically sick, receives the medical care they need.  The costs are met from taxation. The UK spends less than 10% of its annual income (known as GDP) on healthcare.

US – medical care is provided by private healthcare providers and paid for by claims on insurance policies. These policies are very expensive for individuals, prohibitively so for those with chronic conditions. There are state schemes for the elderly (Medicare) and some categories of the poor (Medicaid), but about 10% of the US population – that’s 30 million people – effectively have no cover. The US spends more than 15% of its GDP on this non-universal healthcare.

How does Brexit affect this? In two interlinked ways:

Firstly by cutting ourselves off from the shared European systems and from the simplicity of recruiting nurses and doctors from fellow members of the EU. You can read detailed explanations of this in these:
From the British Medical Association
From the Lancet

Secondly by opening the UK up to US healthcare providers and insurers as part of a trade deal with the US which will be urgently required, especially in the case of a ‘No Deal’ Brexit.

The NHS reforms enacted by the Conservative governments since 2010 already  make this much easier. You can read an excellent analysis of what has happened and how that could develop here

Although the government  currently deny it their think tanks and supporters are itching to get at the NHS. See this article from Conservative Home to see the kind of thinking going on. The paragraph relating to the NHS reads:

The Government needs to face up to the fact that the NHS cannot be wholly funded from general taxation. There are several areas where it makes sense to render charges. Some, such as visits to the GP, could be a modest charge, e.g. no more than £20, and so can be universal. Others, which could be significantly larger, should be levied on a means-tested basis – for example the cost of board and lodging in hospital.”

 So the problems of the NHS initially caused by a combination of idealogically driven changes and the associated underfunding will be immeasureably worsened by Brexit and especially by the ‘No Deal’ Brexit  desired by many of those in government and their outriders. The crisis will then be used to justify abandoning the current system and replacing it with some sort of payment on contact.  In a ‘no deal’ situation the UK’s inevitably very weak position in negotiating a trade deal with the US this could mean a US style insurance based scheme.

See also:

US Ambassador says NHS on table in any trade deal

As does Donald Trump

A doctor explains it all