Great Britain, just like the U.S., is going broke.  Entitlement spending will be their doom.  Their National Health Service costs 158 billion dollars a year to run.  ”But health care is free there!!”  These blokes have come up with an idea that might jolly well keep their system alive.  We bloody well can’t let the staff run out of the supplies necessary to euthanize the sick inpatients now can we?  Seriously.  The NHS admits that 1/3 of all patients that die in their hospitals are euthanized.  

So here’s their idea.  Public hospitals in England should set up profit-making branches in other countries!  Jill Lawless, writing for the Associated Press writes, “Officials said the country should capitalize on international respect for the British health care brand.”    Later, “Health Minister Anne Milton said that plan would create jobs and revenue, which would be channeled back into the health service.” 

Many of you are laughing right now.  Aren’t central planners fun?  Probably not when they deny you dialysis (remember it’s free) or murder a sick relative to free up a hospital bed.  I think they should give some thought to flying a “Jolly Roger” flag at each of these branch hospitals.  What a great logo for their “brand.”

Put yourself in the shoes of a patient walking in to one of these facilities.  However much you are charged, it will be too much, as the mission of this hospital will be to charge enough to cover the cost of your care and that of the folks back home.  Why would anyone patronize a facility with this mission?  Why wouldn’t someone else set up a hospital and charge a fair rate, charging only for your care?  How long would foreigners endure being overcharged to bail out the mother ship?

How will the NHS do a price calculation for their services?  I suggest that if they really want to make a profit they should contract with one of the “not for profit” hospital chains here in the states for a lesson in aggressive billing, or just sublet the facility out to them.  I suppose they will consider some “tax” like a VAT, added to the hospital bill but call it a TAB, for “thanks a bunch!”  

Will the British doctors operate in a for profit manner, or be salaried like back home, while the hospital acts in a “for profit” manner?  I’m thinking that if the doctors don’t care whether they are profitable, this hospital can call itself “for profit” all it wants….it will not make a dime!  On the other hand, if the doctors are offered a chance to work in a “for profit” fee for service manner in Dubai, there may not be any doctors left in England!  

What happens when a competitor hospital opens up, charging a fair rate, without the TAB?  If any talented British doctors go to Dubai, won’t they go to work for this facility not owned or operated by the NHS?  What sort of doctors would remain working in an NHS hospital when the competitor, charging probably half for better care, shows up, offering the doctors a fee for service setup?

Will they use the Liverpool Care Pathway to euthanize resource-intense patients who aren’t profitable in these new facilities?  Will they bring staff trained to simultaneously starve and sedate the sick?  Exporting these skills might actually be a good idea for the care of those remaining in England!

What does this arrangement say about the “free health care plan” back home in England?  What better evidence of failure could there be, that “for profit” hospitals need to be built all over the planet to support the bankrupt and failed system back on the home front?  Their socialism only works if allowed to piggyback onto a “for profit” system elsewhere.  What a message!

Or will the old British accent portray a higher IQ than justified, making this a brilliant marketing move, an unbeatable strategy?  Even so, what makes them think that the free market won’t create a better priced Harley Street in Dubai, as patients realize their scam? 

G. Keith Smith, M.D.