Will current NHS cuts raise prices and lower quality?


Most, if not all economic and political decisions have two prime factors – price and quality. And this includes national healthcare. Decision making involves information. Most, if not all information can be placed on a continuum between the verifiable and the fake. (Ditto “News”!) Here are some verifiable items of information relevant to our NHS.

PRICE: Some national average healthcare costs/prices per person per year:

  • The British pay $3,364
  • The Japanese pay $3,713
  • The French pay $4,361
  • The Germans pay$4,920
  • The Americans pay $9,086

Source: OECD Health data 2013

QUALITY: Some healthcare rankings:

  • United Kingdom 18
  • Canada                 30
  • Japan                    10
  • Germany              25
  • France                    1
  • USA                      37
  • Cambodia          174

Source: The Patient Factor

For less than $1000 more per person per year than we pay, the French have the best national healthcare system in the World! Cambodians have low cost, low quality. Americans have a high cost, low quality service.

We use the “Beveridge Model”, by which the government provides and finances healthcare through tax payments, plus some private provision. NHS patients do not get healthcare bills. This model has low average costs per person because the government, as sole payer, controls services and charges.

The French use the “Bismark Model”, an insurance system, usually financed through pay deductions, to cover everybody. Unlike the US insurance industry, “Bismark” health insurance is on a “not for profit” basis. Although this is a multi-payer system, firm regulation gives the government much of the cost control of the Beveridge single payer model. In practice it is a single payer system.

Canada uses the “National Health Insurance Model”, a mix of the “Beveridge” and the “Bismark,” which uses private-sector providers but payment comes from a government –run insurance programme into which every citizen pays. This is a “not for profit” single payer system which keeps down costs through simplicity, control of services and the power to negotiate affordable prices.

The US has a unique “Hybrid Model” with many separate systems for different groups. For veterans it’s the “Beveridge”, for those on Medicare it’s the “National Health Insurance Model”, for working Americans with insurance it’s the “Bismark” and for the rest of the population (15%?) it’s the “Out-of- Pocket.” (See below)

Cambodia and other “Third World Countries” have the “Out-of-Pocket Model” whereby the rich get medical care, the poor stay sick and/or die and the inbetweeners get something in between, depending upon their finances at the time.

“Single Payer Systems” result in the best healthcare at the lowest prices.

Assuming that “Out-of- Pocket” is not a hidden planned option, we are left with the comparison and choice, between the “Single Payer” and the “Hybrid”. The “Single Payer”, of whichever type, much higher healthcare quality and much lower cost to the US Hybrid.

Why are we being persuaded that we cannot afford our lower cost, higher value NHS?

Is it relevant that in 2014/5, some 70 MPs had connections with private health-care businesses and by May 2016, 6 out of 9 ex-health ministers took jobs with private health purveyors?

Are there plans and moves for deep shifts from our single payer NHS towards the US Hybrid, which costs much more and is much less efficient and caring?

Find out for yourself and speak up!

* Steve Trevathan is chairperson of Lyme Regis and Marshwood Vale Liberal Democrats.