By Stewart Player and Bob Gill
Special to Consortium News
“It is safe to say that, far from being overstated, the Americanization of the NHS is very nearly complete.”
One of the recent roles of the Parliamentary Healthcare Committee has been to reassure the British public that any claims regarding the ‘Americanization’ of the National Health Service (NHS) were wildly overstated, “creating a climate that risks blocking the joining up of services in the interests of patients.”
In fact, the penetration of the healthcare system by the giant U.S. insurer UnitedHealth reveals the opposite to be true, with the full extent of its influence capable of surprising even seasoned NHS watchers.
The Health and Care Bill making its way through official channels simply reinforces this, with the bill’s centerpiece, the 42 regional-scale Integrated Care Systems (ICSs), aimed at bringing together GPs, hospitals, mental healthcare and council services. It is being effectively designed and fast-tracked by the private UnitedHealth.
The U.S. healthcare system is of course a thing of nightmares. Insurance payments extract almost half the income of an average family, in return for which the nation consistently ranks last for access, equity, and outcomes of care in periodic studies by the Commonwealth Fund.
Not content with employer — or individual-based customers — giant insurers now see as much as 50 percent of their revenues coming from federally-funded services, with studies from Texas revealing the greatest profits within the privatized Medicaid system resulting from denying care to medically fragile children and the severely disabled.
Fraud, scandal, bloated executive salaries and minimal care constitute the norm, yet, owing to the state-capital symbiosis that defines the U.S., the cyclical clamor for reform only sees the industry emerge stronger every time.
This was nowhere more evident than the Affordable Care Act (ACA) of 2010 – also known as Obamacare. Less one thinks this is a digression, it is arguable that one can’t understand the position of the British NHS without also understanding the ACA.
According to BusinessWeek, the leading role in ensuring that ‘reform’ doesn’t happened and that ACA proved a bonanza for health insurers was played by the largest of them, UnitedHealth.
While superficially progressive, those newly insured under Obamacare were all channelled either to subsidized marketplaces or to privatized Medicaid to the extent that within a few years these programs had become the main artery of corporate profits.
The Role of Simon Stevens
Serving as point man in the process was the Briton Simon Stevens. Newly promoted as UnitedHealth’s vice-president, he was also charged with leading the company’s “strategic positioning for national health reform.” The company was nothing if not forward thinking when it also appointed him head of UnitedHealth’s Global Health Division.
With capital’s position secure in the heartland, United began to think of further expansion. In his new role, Stevens first helped set up in September 2011 the Alliance for Healthcare Competitiveness, a high-level lobby group with the aim of deregulating trade laws and forcing other nations to open up their health systems to U.S. for-profit insurers, hospitals, pharmaceutical firms, IT companies and other investor-owned firms.
However, it makes little sense to open up national systems unless these conform to standardized templates, and within the year, Stevens was acting as project steward within the World Economic Forum’s (WEF) project on sustainable health systems.
Advocating new care models – though in effect rebranded U.S. Health Maintenance Organizations (HMOs) – the WEF envisaged a climate where “health schemes and insurance markets boom as people seek to cover their health costs,” while governments “focus on regulating large integrated health providers in a complex expanding global marketplace.”
It only remained for Stevens to return to Britain – “my heart is in the NHS and in U.K. public services,” he said – and in October 2013 he was duly appointed as chief executive of NHS England. Since then he has pursued to the letter the aims of the World Economic Forum and U.S. capital’s.