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.