Boris Johnson held a lavish party to sell our NHS, and used taxpayer money to pay for it

Perhaps Daniel Ikenson would care to explain the reasoning behind his statement quoted below?

“The purpose of liberalising trade is to expose incumbent businesses to competition, including healthcare providers,”

In what respect is the taxpayer funded NHS a business? Does it have owners to whom a dividend is issued? Is it quoted on an exchange? Is its declared primary motivation generation of profit? Does it operate under a legally sanctioned monopoly?

The answer about monopoly, if indeed that it be, is the only one conceivably relevant to to making a case based on competition. However it is not a monopoly provider of services. Nothing has prevented private enterprise and privately working healthcare professionals from setting up services. Individual citizens are free to spend their money as they wish on healthcare. They are not empowered to opt out of funding via taxation the NHS, but that is no greater burden than not being able to opt out of funding state provided education and a host of communal infrastructure services (e.g. roads, the factory inspectorate, public health surveillance, food safety standards enforcement, the military, and keeping our beloved royal family in the style to which it claims entitlement).

Perhaps the NHS is so large that it stifles competition and innovation? Yet, it might be the UK private sector is small because many who could afford to access it choose not to do so; arguably that is because private providers do not offer an attractive value for money service. There is no evidence of private healthcare providers (for profit) in the USA or elsewhere being anywhere near the forefront of any kind of innovation; in the USA they do tend to be early adopters of new technologies (made available for a price with extensive profit margin) but when adequate pre-rolling-out evaluation (clinical and in other regards too) has not taken place the result is wasted resource (the patients’) and iatrogenesis.

All that said, the argument is unproductive for two reasons. The first is that onus for demonstrating private healthcare provision in the context of the UK would be production of ‘better’ results rests entirely with Ikenson, Hannan, and self-proclaimed geniuses employed by ‘think tanks’. Their first task is to promulgate widely acceptable criteria for what ‘better’ means. These must include measures of promoting public health, timely and universal access to health services, clinical outcomes, and value for money whatever its source may be.

Of course ‘a picture speaks a thousand words’. So, proponents of privatising UK health services ought present an exemplar of excellence in that regard. As the push is coming mainly from US financial interests it should be obvious home grown US healthcare provision must be wondrous to behold. Show the British how well it performs according to criteria of excellence. Demonstrate that vocal political demand (e.g. among candidates for the presidency) for restructuring the finances of health emanates only from the mouths of knaves.

The second reason why countering assertions from Ikenson and his ilk with argument is unproductive rests with the nature of the discourse. It is a clash of two incommensurable ideologies. That to which I subscribe centres on the existence of ‘society’ as mutual interdependence among people; in the UK political parties since the mid-nineteenth century have gone along with, at least mouthed, this sentiment; they differed with respect to degree of mutual dependence and responsibility devolved to the individual. Conservatives, Liberals, and Labour supporters, had commonality of many core values. Perhaps two major wars helped shape a largely agreed concept of decency.

Consensus slowly evaporated from the 1980’s until recently. In government now are uncompromising ideologues of the nastiest kind; that need not imply that most people hitherto members or supporters of the Conservative party have crossed to the ‘dark side’.

The incommensurable ideologies may simply be summed up as neo-liberalism versus pretty much all the rest. Tenets of neo-liberalism demand blind faith in markets left to their own devices. They assume each individual acts according to a ruthless game-theory scenario wherein the Devil takes the hindmost. The ‘fittest’ survive in a crude parody of Darwinism; subtleties of that great theory, even as originally written about by Darwin, fly over their heads.

Neo-liberals are base materialists unaware of values transcending possessions and power. No wonder so many neo-liberals admire writings of Ayn Rand, she who among other things wrote a defence of ‘selfishness’ (I could do that quite convincingly in the role of Devil’s advocate but Rand was a true believer); the USA Ayn Rand Institute serves to proselytise her dismal pseudo-philosophy as evinced from the following quotation from its website.

“Discover how reason, rational self-interest and laissez-faire capitalism can make a positive impact on our world.”

I would consign the Institute’s credo to the dustbin of cults along with the likes of Scientology were it not for its appeal to powerful people (rather than Hollywood actors). Without wishing to stretch the point too far, Ayn Rand’s views along with those of Hayek (as interpreted by non-economists) rank with those of Nazism (but not Fascism): their application in neo-liberalism implies clear distinction between the worthy and others not even meriting charitable succour.

The upshot is, that the malignant works of neo-liberalism cannot be countered by reason alone. Thus, neither can its particular project concerning our NHS.

Neo-liberalism must be vanquished at the ballot box, assuming that facility lasts much longer. Failing that, other measures are necessary but not for discussion in front of the squeamish.

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