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Uproar Over U.S. Companies Contracting With NHS Should Instead Focus On Care Rationing


As expected, the American press has provided heavy coverage of President Trump’s visit to Europe, especially his time spent in Great Britain. But a row (that’s British for “argument”) that has gone under-reported on this side of the Atlantic also holds major implications for American health care patients.

Based on comments the president made earlier in the week, some British politicians now believe they need to protect the country’s National Health Service (NHS) from “privatization” at the hands of American corporations. Even as they do so, another controversy—about the ways Britain denies life-saving treatments to patients, solely due to cost—illustrates the problems with socialized medicine. Unfortunately, this is exactly the type of service the left wants to export to the United States.

A Post-Brexit ‘Trade Deal Is On the Table’

During a Tuesday press conference in London, a British reporter questioned Trump about a post-Brexit trade deal between the United States and Britain. The reporter specifically asked whether “the entire economy needs to be on the table” in those discussions, “including the NHS.” Trump responded that “everything with a trade deal is on the table.”

Those comments, which Trump later attempted to walk back, prompted outrage that Britain’s “beloved” NHS was at risk. British politicians across parties raised concern that American companies could receive NHS contracts (even though subsidiaries of U.S. corporations have already done so), or that a free trade agreement could supersede legislative efforts by Parliament to prohibit additional private contracting within the health service.

The U.K. health secretary, Matt Hancock—a candidate in the race to succeed Theresa May as Conservative Party leader and prime minister—epitomized the sentiments:

The NHS Denies Care to Patients 

The controversy continued on Wednesday during the prime minister’s question period in the House of Commons. In that hour-long session, no fewer than five questions asked whether the NHS was “for sale,” or some variation thereof. The sixth NHS-related question, courtesy of Labour Member of Parliament Karl Turner, proved the most revealing:

Twelve months ago, the prime minister told this House that she wanted a speedy resolution to the funding row between NHS England and Vertex regarding the drug Orkambi to treat cystic fibrosis. My seven-year-old constituent Oliver Ward wrote to the prime minister recently asking what progress she has made. Could the minister please give Oliver some good news and tell him that he need not get up every day worrying about this terrible injustice?

Orkambi is a drug that could help thousands of British patients suffering from cystic fibrosis. The NHS refuses to pay for the drug—not because it does not work, but because it does not meet cost thresholds that government bureaucrats have set.

Britain’s National Institute for Health and Clinical Excellence decided in 2016 that the NHS would not pay for Orkambi at the price its manufacturer set. For the three years since this decision, British patients have had to live with the awful consequences.

A Precursor of an American Single-Payer System?

Despite its denials of care to needy patients like this, liberals still want to bring the British model of rationing health care on cost grounds to the United States. Recall President Obama’s comments about the issue a decade ago:

The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here….There is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place.

Months after those comments, The New York Times ran an article, entitled “Why We Must Ration Health Care,” that argued for bringing a British-style rationing model to our shores.

This prevailing mentality among intellectual elites explains why neither the U.S. House nor Senate single-payer bills prohibit a government-run health plan from implementing cost-effectiveness research. In fact, because most liberals believe that bureaucrats should have the power to restrict access to care on cost grounds, the House bill explicitly provides for cost-effectiveness research as a method of determining drug prices. Most Americans, on the other hand, would strongly object to any sort of rationing of health care.

As for British politicians saying the NHS “isn’t for sale,” I wouldn’t want to buy it even if it were. The American health care system certainly has its flaws, but I have little interest in creating a system where government bureaucrats have almost total control over patients’ medical decisions—a power that can be used to deny access to life-saving care. I think most Americans would agree.