Why do Farage and other Right-wing politicians keep attacking the NHS, suggesting that we should move to an insurance-based system? The reason is simple – the NHS provides health security for everyone, and undermining it would not only make most people extremely vulnerable in the face of corporate whims, but enable profiteers to make billions at the expense of people worried about their health.
But many people in the UK, especially among the young, have forgotten how the underfunding of the NHS that went on during Conservative-led governments from 2010 to 2024, has severely weakened our health services, and led to growing complaints about its shortcomings. The devious mantra is now “you can’t keep throwing money at it”, with the insinuation that something like the US insurance system should take its place.
In order to save the NHS, we must let as many people as possible know what a shift to an insurance system such as the one in the US would mean for us. To begin with, instead of having a free to access health service funded by taxes paid according to citizens’ wealth and income, people would have to try to buy health insurance coverage when the best coverage would be unaffordable for most, while many would not be able to even pay for the most patchy unreliable coverage. In the US, tens of millions of people cannot afford health insurance, and when sick, they cannot even see a doctor.
It is often said the US system is impressive in being the one that spends the most per person on healthcare in the entire world. But in practice, a vast portion of that money goes to treatment for the rich who have the best insurance coverage, and to the profit column of the health insurance companies. Not surprisingly, health outcomes in the US (with lower life expectancy and higher maternal mortality) are worse than comparable countries.
Between the very rich who can sit back and relax, and the poor who have no choice but to suffer in silence, the majority have to set aside money to buy some form of mediocre health insurance. The coverage and claims processing are all designed to minimise what the health insurance companies have to pay out to help people in need. Deductibles, exclusions, copayment clauses, all come into play to leave people without sufficient funds to pay for diagnosis, scan, treatment, medication, or operation.
With claims delayed or even outright denied, people have to go into terrible debt, and some end up bankrupt. According to studies published in the American Journal of Medicine and the American Journal of Public Health, almost two-thirds of all bankruptcy filings in the US were linked to medical expenses or illness-related loss of work. With health insurance often linked to employment, losing one’s job when one is sick is compounded by the loss of one’s health insurance as well.
Unlike the NHS which enables patients to contact doctors and hospitals directly for help, US style insurance system requires people who are not well (and their families) to navigate a highly complex bureaucratic maze to claim insurance coverage to pay to be helped by doctors or treatment in hospitals. It can take a long time, with claims rejected, and substantial medical bills to pay when the necessary funds are not covered by insurance after all.
Under the NHS, any nationally approved medication can be obtained through a subsidised prescription from the GP. With the US approach, pharmaceutical companies can charge whatever they want (and the medical drug costs in the US are among the highest in the world), and it is up to the private insurance companies to decide how much of the cost, if any, they would cover on any given claim.
People may want to moan about the NHS, and Right-wing politicians may do all they can to starve it of the funding it needs, but if we make it abundantly clear to everyone what a deathtrap the profiteering insurance-based alternative would be, we can keep the political focus on strengthening the NHS.
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