The NHS is likely to take centre stage in next month’s election. Debate to date has focused on what the health service might look like in a post-Brexit world if America’s for-profit buccaneer “big pharma” gain a significant foothold following a US-UK trade deal. Jeremy Corbyn was spot on when he launched a salvo during PMQs charging that the NHS was in “greater danger” than at any time since its inception, whatever mealy-mouthed pledges Boris Johnson makes. The financial vultures have been circling for some time. And, as Channel 4’s Dispatches programme revealed, secret trade discussions have been under way with a view to ramping up the cost of drugs sold by US corporations to the NHS, which could cost the health service a whopping £27bn.
If you are in the UK and not deeply concerned about the prospect of the NHS coming to mirror the US healthcare system after Brexit, think again. Take it from someone who has what would be regarded as “good” health insurance cover by US standards: don’t go there. Studies have shown that US healthcare costs have been spiralling for years and that as a percentage of GDP, are as much as double those of other wealthy nations. Yet, on a number of crucial health outcome measures, including maternal and infant mortality, the country performs much worse than other rich countries. In the US, millions of people have gone bankrupt because they can’t afford to pay medical bills, while the price of drugs, such as insulin, have gone through the roof. Many people ration medicines, or have to choose between paying for them or the rent.
On a recent visit to a doctor’s office I got into a conversation with one of the administrative staff while I filled out (yet another) huge pile of paperwork repeating information I’d previously provided multiple times. When I explained how prescription charges worked in the UK and how much they cost, the woman’s jaw dropped. She confided in me that she had diabetes and had been rationing her insulin for the previous three months– despite all the serious health risks that entailed – because the price had gone up so fast she could no longer afford what she needed. And this was a woman who works in the health sector.
The labyrinthine US health care “system” is a wallet-busting, utterly bewildering, anxiety-inducing rollercoaster of an experience set in a perpetual loop. Over the past few months I’ve had to visit doctors a lot. Sometimes the provision has been excellent but every single time it involves mind-boggling levels of administration as well as the shocking expense. I’ve spent whole afternoons, while ill, trying to make sense of huge bills because I can’t get my head around why, even after shelling out a small fortune each month for insurance, I’m still not fully covered.
But at least I’m covered. It’s a whole lot worse for the millions of people without insurance or with coverage far inferior to mine. Talking in the summer about her own experience of being uninsured, the Democratic congresswoman Alexandria Ocasio Cortez summed up the obscenely stressful everyday reality. “It is the stress, and it is the anxiety, when you wake up every morning and you don’t know if you’re going to slip on a kerb, if you’re going to find something on your body that you want to get checked out, if your knee starts to ache. Everything becomes a spiral of anxiety because you don’t know how you’re going to afford it.”
In America, this is what millions of people contend with – in fact, 7 million more people in the US have to contend with this than four years ago despite Barack’s Obama’s Affordable Care Act providing 20 million more Americans with access to health insurance. This follows relentless attacks against it by Republicans and on other government-backed health programmes like Medicare. It is telling that positive moves to transform healthcare – including Elizabeth Warren’s latest proposal for Medicare for All to fix the system – are on the table stateside. The NHS is a special, precious thing. But if the Tories get their way, it won’t just be on the table in US-UK trade deals, it will be on a very expensive menu.
• Mary O’Hara lives in Los Angeles. She is the author of Austerity Bites
