The current furore over the crisis in A&E and the poor regulation of hospitals, tells us less about the future of the NHS than two recent documents which demonstrate how, despite the ringfencing of its budget in yesterday's spending review, the NHS will effectively be dismantled by 2020 if policy is not radically changed.

One document relates to social care. If you were living in a care home, what would it be worth to you not to be worried that the homeowner might become bankrupt, so that you might have to move at short notice? You have no idea? Well, the Department of Health (DoH) does: £6,510. How did it arrive at this figure? According to its recent impact assessment, a "quality-adjusted life year" (QALY) for a care home resident is worth £60,000. Avoiding an assumed three months of stress when a care home company "exits the market" is estimated to be worth 0.1085 of a QALY, or £6,510.

The reason for this bizarre bit of pseudoscience is that the government wants to avoid the political fallout of another Southern Cross-type failure. Many care home companies are deeply in debt, and some of the larger ones are owned by private equity funds. The DoH estimates that 19,000 frail elderly or disabled people will experience a disruption in the course of every decade. In the looking-glass world of market-think it has to show that the benefits of regulating the care home industry will outweigh the cost; and to do this it is required to put a cash value on the benefits.

But instead of trying just to reduce the stress that disruptions cause, shouldn't the aim be to prevent the stress happening in the first place by replacing private with public providers? No, that's out of the question. The government is not about to ask the ingenious arithmeticians in the DoH to calculate the potential benefit of eliminating disruption this way.

Another document that reveals where the NHS is destined to go is Monitor's fair playing field review. The review sets out what the healthcare financial watchdog considers fair competition between NHS and other providers. Its evidence base is negligible – unstated calculations, plus the claims or opinions of unnamed interviewees, or participants in "deep dive workshops". It doesn't say whose opinions were sought, or give the numbers of each kind of interested party it listened to.

It makes judgments about what should happen and makes it clear it thinks most of them will become policy – and since Monitor's remit is to regulate the "market" in which healthcare operates in England, most of them will.

It says a fair playing field is "for the benefit of NHS patients", but any benefits patients might get from the NHS having advantages on the playing field it sees as market "distortions". For example, the fact that public providers can borrow more cheaply than private ones is treated not as a benefit to patients, but as a "distortion" of the market which must be rectified – in other words, to enable private providers to compete, we will have to pay more.

Similarly with medical training. The government pays NHS teaching hospitals and GP practices in full for all the training they do, so you would think that private companies employing NHS-trained staff for free are actually getting a competitive advantage. But from Monitor's purely market standpoint, the fact that this represents a massive public subsidy to private shareholders is irrelevant.

The fair playing field document also reveals – unintentionally – some of the huge costs of operating the market. It complains that finalising a contract for each service put out to tender can take NHS commissioners anything from three weeks to 22 months. It doesn't mention the additional work of performance monitoring, auditing, etc. The amount of expensive NHS staff time involved is clearly immense, and the equivalent costs incurred by the company that wins the contract must also be recouped via the price that is agreed. But Monitor wants more and more services "unbundled" and put out to tender.

The benefits of the market are simply assumed to outweigh all these costs, Does anyone outside the current policymaking bubble really believe they do? As John Lister notes in his important new book on health policy reform, the overwhelming consensus of researchers is that markets in healthcare globally either lower quality or increase costs, and often do both. But in the UK, we are supposed to stop worrying and love the market, while the NHS unravels.