27

The Neoliberal Disaster of US Healthcare

Simon Hodges

Imagine if a political party in the UK included in its manifesto a pledge to increase public spending on the NHS by 55%! Such a pledge would be derided by Neoliberals as being delusional accompanied by the TINA claim that the only way forward is privatizing the NHS in order to improve its efficiency.

Comparative studies between health care costs between the US and the UK show that it is the Neoliberal assumptions that are actually delusional and that private sector health care is astonishingly bad value for money.

In 2018 the UK spent 18% (£145.8 billion) of the total government budget in order to provide free universal health care.

By contrast, in 2018 the US spent 28% ($1.5 trillion) of the total government budget in order to apparently subsidise a woefully inefficient private health care sector.

The US government spends 55% more than the UK government on health care: yet somehow fails to be able to offer free universal health care for all its citizens.

It would appear that in relying upon private sector health care provision the US taxpayer is getting spectacularly bad value for their tax dollars.

Indeed anyone looking at this spending difference would assume that the country spending 28% of its budget was the one providing free health care and the country spending 18% was more likely using the private sector model.

Of course, it gets a lot worse for US citizens when one also includes their exorbitant private health care costs on top of their tax contributions.

OECD health data from 2013 showed that including public and private spending on health care the US citizen is forking out nearly 3 times as much as a UK citizen ($9,086 per year, as opposed to the UK spend of $3,364). The average US citizen privately spends an additional $4,516 on top of the $1.5 trillion national budget.

One would suppose this massive extra spend would lead to a big difference in health care outcomes but nothing could be further from the truth. Life expectancy in the US was 78.8 years compared to the UK’s 81.1 and infant mortality rates were almost double at 6.1 per thousand compared with the UK’s 3.8 per thousand.

This is made even more curious by the facts that the UK had a 20% population of daily smokers compared to the US rate of 13.7% and that the UK had a population of 17.1% aged 65 and over compared with the US level of 14.1%. These factors make the US performance even worse.

From a US perspective, it should be a matter of general concern that of the 65+ population demographic that 68% of them suffer from two or more chronic conditions compared to 33% in the UK.

Of course, we cannot assess these issues purely in financial terms but should also consider additional costs or factors. The exorbitant cost of health care in the US is in itself detrimental in that it leads to highly increased insecurity, depression and anxiety which in themselves have a negative impact on health.

This was made manifest in a US survey by Gallop published in April 2019.

Given the nature of the crisis in the US health care system then it is risible for Donald Trump or indeed anyone to suggest that the UK should open its health service provision to corporates operating in the failed US system.

Neoliberal Blairite privatization, PPPs and PFIs etc have been a disaster for taxpayers as Liam Halligan shows in the expose for Dispatches on Channel 4.

The private sector Neoliberal approach in the US strongly suggests that rather than the UK following the US route and privatizing its health care system it is clear that it should be the US which should be following the UK and European models.

Given that they are already spending 55% more than the UK in terms of public spending, then $1.5 trillion should be more than enough to give them an excellent free universal health care system: indeed it should be vastly superior to the UK system.

These figures clearly expose the economic fallacies and deceit of Neoliberal capitalism and its corrupted practices of private sector outsourcing. Across Europe, the public sector health care model is superior by orders of magnitude and it would be utter lunacy to abandon it in favour of the failing and ludicrously expensive US Neoliberal model.

Far from there being no alternative to Neoliberalism it transpires that the public sector alternative we already have in the UK is vastly superior. This is undoubtedly the rule and not the exception.

SUPPORT OFFGUARDIAN

If you enjoy OffG's content, please help us make our monthly fund-raising goal and keep the site alive.

For other ways to donate, including direct-transfer bank details click HERE.

Subscribe
Notify of
guest

27 Comments
newest
oldest most voted
Inline Feedbacks
View all comments
Harry Stotle
Harry Stotle
Jun 8, 2019 7:22 PM

The US health care system proves how easy it is to manipulate the public.

Given the gargantuan sums poured into US health care (literally twice that spent by the NHS if we take % of GDP as a measure) it should at least be a beacon of excellence, albeit one that comes with a mouth-watering price tag – but it isn’t.

Perhaps the central reason for its abject failure is the high bureaucractic cost allied to corporate profit margins.

To distract attention from the lousy deal tax-payers receive a never-ending propaganda campaign is required to warn the public against the dangers of ‘socialised medicine’.

This is where ideologues like Ben Shapiro come into their own – despite a mountain of objective evidence illustrating manifest failings the public are led to be fear worse if power were to be transfered from CEOs or BigPharma to those trying to a set up a model capable of delivering universal and comprehensive health care that was free at the point of delivery.

The bizarre thing is that some of the strongest advocates of the current iniquitous system are those most damaged by it – even so they would rather pull their own teeth out without an anaesthetic rather than allow Commies to infiltrate the land of the free.

mark
mark
Jun 11, 2019 1:36 PM
Reply to  Harry Stotle

Apparently there is no alternative to this system. If anybody tries to change it, there will be “Death Panels” and “concentration camps.”

Deschutes
Deschutes
Jun 8, 2019 5:40 PM

Yes, corporate healthcare in USA sucks massively.

Wilmers31
Wilmers31
Jun 9, 2019 2:43 AM
Reply to  Deschutes

Corporate healthcare is not fit for purpose.

mark
mark
Jun 7, 2019 7:52 PM

As is pointed out here, the US spends 3 x as much on health care as the UK. In GDP terms it is about 18% v. 6% By rights, if you so much as sneeze in America half a dozen doctors should jump on you.

But you have to look at where all the money goes. Health and drug CEOs on $80 million a year. Every ambulance journey billed at $5,000. A single pill that costs a few cents to produce charged at $750. Monopoly pricing and extortionate price gouging at every twist and turn. Bought and paid for politicians in the pockets of the insurance and drug monopolies have constructed the health system as a giveaway to those interests. The patient has to pay whatever they choose to demand. No negotiation is allowed on drug pricing or anything else. This is just rent seeking at its worst, all the worst elements of monopoly crapitalism.

Health care is now simply unaffordable for most Americans. I know of one case where a man in his 40s, married with 2 teenage daughters, found out that he had a brain tumour. He was a metalworking machinist. The cost of treatment would bankrupt the family. They would be homeless, with no money for the education of their daughters. So he telephoned the local police station. Said, – I’m going to kill myself. I’d be grateful if you could come round and sort things out. I don’t want the family to find my body. Then he shot himself in the head.

Yep, that’s the Land Of The Free and The Home Of The Brave.

Brian harry
Brian harry
Jun 8, 2019 12:24 AM
Reply to  mark

The silly thing about it is, most American people seem to sneer at the “Socialism” that makes National Health Care systems in the UK Canada, Australia etc so popular. The American system is like…. “Turkeys Voting for Christmas”………

mark
mark
Jun 8, 2019 4:00 AM
Reply to  Brian harry

If a Canadian falls sick in America, the Canadian NHS flies him home for treatment in an air ambulance. It costs a fortune, but it’s far, far cheaper than the cost of US treatment. Any Americans who can get their health and dental treatment abroad – Mexico, even India.

Wilmers31
Wilmers31
Jun 8, 2019 12:59 PM
Reply to  mark

For Australian travellers they say ‘if you cannot afford insurance, you cannot afford to go’ and the only reason we take it is for the air ambulance. A woman got caught in the US, when her pregnancy started to go wrong. She had no insurance and was in for millions. I do not know how it ended but travelling to the US while pregnant is is daft idea.

And wouldn’t you know it, Trump said in London two days or so ago, re trade negotiations after Brexit, that all would have to be on the table including NHS – but a day later he had to retract.

Be warned, they know and have the experience how to fleece people with health. Don’t let the Americans touch it.

Wilmers31
Wilmers31
Jun 9, 2019 2:45 AM
Reply to  Brian harry

And they do not even understand that every insurance is socialism. Insurances need to be outlawed (!!!) because everybody pays in but only those who have a case get something.

DunGroanin
DunGroanin
Jun 7, 2019 3:09 PM

It needs repeating daily.

Also the further and fuller ‘privatisation’ of the NHS is not related to the outcome of the Brexit referendum. Attempts to toe the two are aimed squarely at dislodging the Corbynites.
That plan like all others FAILED as shown in Peterborough yesterday.
So much so that the gobbshite irrelevances of the putrid Blairite remenants in the PLP – instead of celbrating their party success rolled out the AS slur!!! Shameless wankers, why will they not go do they insist on defenestration? There’s a queue to help them out…

It has been accelerating over the last 3 decades – From the great sow Thatchers’, birth of neoliberal bs in the UK, to the wolves in sheepskin Thatcher babies Blairite NuLabourInc, and the great Etonian restoration of Cameron/Gove and the numbskulling LibDems Clegg/Campbell treason of their voters in accelerating it further (Student fees/ PR and daylight robbery of retiring women were amongst the many crimes of the LibDems).

There is only one party that can stop and reverse the neolib bastard children of Maggie, the Corbynite Labout party, they should call themselves the NHS party for absolute clarity! They started it because the great grandparents who lived through war and austerity of the 30’s and 40’s voted for it.

A link i came across somewhere yesterday, apologise if it was here.
‘What’s wrong with the idea of opening the NHS to US traders? Plenty.’
http://blog.spicker.uk/whats-wrong-with-the-idea-of-opening-the-nhs-to-us-traders-plenty/

mark
mark
Jun 8, 2019 4:02 AM
Reply to  DunGroanin

No, you’re quite wrong. It’s all the fault of Brexit. Everything that goes wrong in the UK for the next 20 years will be “because of Brexit.”

Wilmers31
Wilmers31
Jun 8, 2019 1:03 PM
Reply to  mark

indeed – but I also think in 20 years time you will want to re-join as an equal member. I won’t be here but you will find that the wind out there can be quite cold when standing alone. Uncle will be increasingly incapable and unwilling to help you.

mark
mark
Jun 10, 2019 2:01 AM
Reply to  Wilmers31

It won’t exist in 20 years time.

Gary Wilson
Gary Wilson
Jun 7, 2019 12:01 PM

It’s sickness care, not health care. If the “health care” experts knew anything about health creation they wouldn’t have as many patients. That would be bad for business. Wealth is more important than health in society today.

William HBonney
William HBonney
Jun 7, 2019 10:51 AM

There can be no free market in health, electricity generation, rail, and the penal system.

For health, free market dogma would posit that a patient (customer) is fully able to make an informed decision about their health are provider:- something that is rarely the case.

A large part of what makes health care so expensive is the need to account for litigation.. I, for one, am in awe of the medical profession, and would indemnify them against legal action, in the same way airlines are indemnified against legal action. If a loved one is killed in a plane crash, you cannot sue the airline, or the airframe manufacturer (airlines wouldn’t survive a single hull loss, otherwise). Healthcare needs to be the same.

Wilmers31
Wilmers31
Jun 9, 2019 2:59 AM

That would be excessive. No problem with hanging the bar high but nobody should be exempt when making mistakes through carelessness.

On the airline issue, the boeing 737 issue has got a very long time to run and I don’t think they can get away with it, even though they were deceived by boeing. Monsanto got away with it for a long time – not forever though.

In essence these things follow ideology, not practical considerations seeking good outcomes.

In Australia they obeyed the IMF to deregulate the dairy industry more than 20 years ago. We all had to pay a levy, amounting to 8 billion AUD (1999 $$) and the result was dismal. Countless suicides and what’s left of the industry is concentrated in the hands of two companies. There was nothing wrong with the dairy industry before, or the one desk wheat policy.

Monopolies just need to be supervised properly. Now they introduce another levy on milk because ….. obviously their deregulation has not had a beneficial result.

Sackerson
Sackerson
Jun 7, 2019 9:17 AM

I am confused about these figures. You say 28% of US government spending goes on healthcare, but my cursory internet search says:

Federal budget: “The OMB estimated FY2018 would involve outlays of $4.094 trillion”, of which “$1.891T for healthcare” = 46%. [https://en.wikipedia.org/wiki/2018_United_States_federal_budget]

Could you clarify, please?

George
George
Jun 7, 2019 8:14 AM

I was intrigued about Trump’s comment about the NHS and carried out a few searches which led to a James Kirkup article in the Spectator which had this:

“…trade is good and makes the world richer and safer. But free trade ain’t free: if you want a deal, you’re going to have give things up, including possibly some things you hold very dear indeed. Sooner or later, Brexit Britain was always going to collide with that painful reality.”

This kind of contradictory statement is so familiar. And the contradictions can easily be solved by realising that the word “you” – like the words “we” and “us” – is a confidence trick which is meant to give the impression that “we’re all in it together”. We are not. Thus the words “we” and “us” refer to Kirkup and his cronies. The word “you” refers to everyone else. Thus the statement really means:

“…trade is good and makes the world richer and safer FOR US.But free trade ain’t free FOR YOU: if WE want a deal, YOU’RE going to have to give things up, including possibly some things YOU hold very dear indeed. Sooner or later, Brexit Britain was always going to collide with that painful reality FOR YOU.”

Wilmers31
Wilmers31
Jun 9, 2019 3:03 AM
Reply to  George

It reminds me of the banners which I saw in East Berlin visiting my aunt there. There was always salvation in the future.

Make sacrifices today, in 5 years time …. And then there will be new banners promising a rosy future in another 5 years time. Tomorrow …. don’t bet on it.

Harry Stotle
Harry Stotle
Jun 7, 2019 6:22 AM

Sustaining the benefits of America’s inefficient health care system relies heavily on propaganda, replete with heavy anti-left wing bias.

US citizens are led to believe ‘socialised’ health care is tantamount to political inteference, in other words state actors afforded power to intefere with freedom-loving doctors in the delivery of health care.

Despite exhorbitant costs, disappointing outcomes, lack of access and financial ruin (unpaid health care bills are are the biggest cause of bankruptcy in America) some US citizens still think it is a price worth paying rather than handing health care over to the Commies (i.e everyone who is not a right wing fruit case).

Here Jimmy Dore tears the repulsive Ben Shapiro a new one

Trond
Trond
Jun 7, 2019 5:03 PM
Reply to  Harry Stotle

Ben Shapiro Reveals His Inner Bigot

Headlice
Headlice
Jun 7, 2019 2:06 AM

Don’t fret bloke,! the Moron from the Shire you voted for a few weeks ago is hell bent in opening up Australia’s health system for US investors. If you take a look at the NSW Labor campaign implosion and the national Labor implosion a few weeks later you might notice similarities and then ponder whether both campaigns were destroyed by their principal leader as if on command. Shorten knew Hawke was in his last throws. Shorten’s presser upon Hawke’s deaf was the final nail in Labor’s chance.

Fair dinkum
Fair dinkum
Jun 7, 2019 3:18 AM
Reply to  Headlice

It was Labor, under Keating and Hawke, that started the $ell off of public assets.
Corporate lobbyists make offers that ambitious narcissists cannot/dare not refuse.

Fair dinkum
Fair dinkum
Jun 7, 2019 1:45 AM

Privatisation has too many bloated PIGS at the trough slurping blood money from wage slaves.

Ash
Ash
Jun 7, 2019 8:49 AM
Reply to  Fair dinkum

Great article
But who are the private companies and the players who are controlling USA so effectively?
It seems that the US people are just pawns and easily manipulated even if their health depended on it!

Brian harry
Brian harry
Jun 8, 2019 4:59 AM
Reply to  Ash

The American people are trapped in the “Trickle Down” nightmare…….