I am very lucky; I live in Scotland, where healthcare is a fully devolved issue under the control of the Scottish parliament.

If I lived in England, though, I would be getting alarmed right now.

If you live in England (and not under a rock) you can't possibly be unaware of the Health and Social Care Bill (2011) that is working its way through parliament. Short version for foreigners: the Conservatives are unhappy to be presiding over a socialist healthcare system that works, so they've decided to break it by turning it into a single payer insurance system. Or so they say: the truth is actually rather worse.

Various medical folks have spoken out against it, including the Royal College of Surgeons, the British Medical Association, the Royal College of Nursing ... it's not a short list.

Anyway, this paper (PDF) is the lead item in the British Medical Journal today. I'm going to crib from its preamble, per Dr Ben Goldacre's blog:

"Entitlement to free health services in England will be curtailed by the Health and Social Care Bill currently before parliament. The bill sets out a new statutory framework that would abolish the duty of primary care trusts (PCTs) to secure health services for everyone living in a defined geographical area. New clinical commissioning groups (CCGs) will arrange provision of fewer government funded health services and determine the scope of these services independently of the secretary of state for health. They may delegate this decision to commercial companies. The bill also provides for health services to be arranged by local authorities, with provision for new charging powers for services currently provided free through the NHS (clauses 1, 12, 13, 17, and 49), and it will give the secretary of state an extraordinary power to exclude people from the health service. Taken together the measures would facilitate the transition from tax financed healthcare to the mixed financing model of the United States. [my emphasis] We provide an analysis of the key legal reforms that will govern policy development and implementation if the bill is enacted."

Note that the authors of this paper are a professor and a senior research fellow at one of the leading medical teaching colleges in London.

Yes, it's worse than you thought. They're not merely trying to turn the NHS into a single-payer insurance system, they're trying to turn it into a copy of the most notoriously bad private healthcare system in the world (as measured by the ratio of inputs to outcomes).

Allegations of corruption and conflict of interest surrounding the bill have not been addressed. Meanwhile, the government refuses to publish the risk register relating to the bill despite a court order to do so. Finally, if you're wondering why copying the US system at this point would be so very, very bad, read this RIGHT NOW. (TL:DR; the US insurance system is doomed, thanks to the impending arrival — within the next two years — of cheap genome sequencers. Massive insurance premium inflation will ensue. And Lansley thinks the UK should copy a system that's about to collapse ...?)