Not a European Private Healthcare Bill- the Crossborder Healthcare Bill

All my fellow bloggers are blogging about Europe tonight and I’m feeling slightly left out, so I’ve decided to write a post which I had put on the back burner for sometime. It’s regarding a rather obscurely named bill going through the European Parliament just now called ‘The Cross Border Healthcare Bill’ . Don’t be fooled by its fuzzy name. It is the most insidious, ill-thought out, dangerous bill since the NHS Improvement Plan, which left the NHS almost completely exposed to the private market. This bill is going to do much the same, but on a Europe wide scale and it is going to open a European battleground for health.

So what’s it about? Well, its basic premise is this; European citizens should be able to go to any country in the EU to receive medical treatment. If there is a waiting list in one country, then a patient should be able to travel to another to receive the treatment required.The member state that the patient comes from will fund the patient up to what it would cost in their own country; if it costs more, then the patient will fund the difference. This is an extension of ‘the four freedoms’; freedom of movement of goods, services, capital and persons. On the face of it, it looks like a good idea. It’s not.

Each country in the EU has its own social insurance system. The NHS in Britain is pretty monolithic, despite the government’s best attempts to break it down, but it is a health system that has relatively few variations in it and the burden of funding comes from central taxation and social insurance. This is not the case in other European countries. They vary far more in organisational structure, and a significant amount of the funding is employer based. The most popular structure is the Bismarkian system, which as the name suggests, originates in Germany. The Bismarkian system usually consists of several not-for-profit health organisations based round occupations; for example, there are farmers’ health unions, miners health unions and so on. They are funded by employers and the government also gives them money, but the burden is split between government and employer. Many of these not-for-profit organisations are in trouble just now, because of the rising costs of healthcare and also rising unemployment. In Germany Angela Merkel applied the blunderbuss approach to raising funding for healthcare; she raised the rate of VAT and she also allowed people to ‘opt out’ of health unions and buy cheaper private healthcare. The latter proved to be a very expensive mistake, as those who paid a higher contribution to the healthcare opted out and left the health unions struggling even more.

So what has all this got to do with this bill? Well, what this bill would allow these unions to do, is to take patients from other countries and charge the bill to the patient’s member state instead of to its own union. If it skimped on a few essentials, it could make a good profit on it. It would also allow them to tout for business in other European countries. In short, you would be turning a not-for-profit organisation into a private healthcare business. For struggling health unions at the moment, it must look irresistable.

What would it mean for us here? Well, we’ve got a waiting list. We could send off patients to cheaper countries in the EU to get treatment and pay less for them. Never mind that some poor Romanian isn’t going to get his operation because a rich Brit has turned up instead; in the EU all citizens are equal and therefore a patient that actually comes from the member state does not get preferred. And we could take patients from other countries and get them to cough up their own cash for treatment. This bill is going to involve the setting of tariffs and therefore the establishing of a private market in health by default.

It doesn’t stop there. Another of the proposals is the recognition of prescriptions issued in other countries. Now, the bill is rather vague on what this means. Does it mean that a prescription written, say in France will be valid here simply for medicines approved for prescription by NICE? Does it mean that it will be valid also for medicines that are not available on prescription here, and if so, who’s going to pay for them? The French, the NHS or the patient? I suspect it will be the patient.

Finally (and please don’t groan) no evil masterplan would be complete without a supercomputer. Yep, just when you thought the SH had been put into IT by ‘Connecting for Health’ along comes yet another super duper IT plan, but this time it’s going to be Europe wide. The EU are planning to set up a European IT system for the transfer of patient records, medical data and ‘e-health services‘, whatever the hell that might be. Microsoft are already bidding for the contract. You know, I thought that Doctor Who was being simplistic, when the goodies only had to find the master Dalek to kill off all of them, and that some baddie would work out that you shouldn’t connect them all to a central system. It seems that Dr Who was simply prophetic. How many times do these systems have to crash and how much money do we have to spend, before governments realise that big single servers do-not-work? Not to mention the implications for patient confidentiality. But hey, if you’re going to have a private European market, it makes sense to have European access to patient information so that you can pitch your services more effectively to the market, eh?

What is galling about this bill is how it denies all along that it is about undermining health social insurance systems. It is about freeing up the internal market, it will let private healthcare in, it will turn your prescribing into a cocked hat, it will build another big computerised Black Hole of Calcutta for all our money to disappear into, but it is absolutely, categorically, emphatically not about a European private health care market and absolutely not about letting in all those American health care companies take over not-for-profit organisations and allowing them to work cross border in Europe. No sir.

When I was about ten, my sister was given a Kermit frog as a Christmas present.
‘So are you going to call it Kermit then?’ I asked.
‘No’ my sister replied.
‘But it is Kermit.’
‘Well, I’m calling it Not-Kermit,’ my sister replied and went off. She grew up to become a lawyer.

There’s an awful lot of Not-Kermit about this Not-a-European-Private-Healthcare-Bill..