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The Transatlantic Health-Care Struggle

American advocates of Medicare for All should show our solidarity with Britain’s working class as it fights to save its National Health Service from privatization at the hands of Boris Johnson, Donald Trump, and the predatory American health-care industry — the same industry that’s fighting tooth and nail against Medicare for All here at home.

US president Donald Trump and Britain's prime minister, Boris Johnson, arrive for a bilateral meeting during the G7 summit on August 25, 2019 in Biarritz, France. Stefan Rousseau – Pool / Getty Images

In the United States, the demand for Medicare for All is growing. It feels like ancient history, but only three years ago the Democratic Party’s presidential front-runner promised that a single-payer health insurance system will “never, ever come to pass.”

Now, thanks in large part to the tireless insistence of two-time democratic socialist presidential candidate Bernie Sanders, most of the major contenders for the party’s presidential nomination are forced at the very least to rhetorically concede that Medicare for All is the goal — though all but Sanders are finding ways to kick the can down the road.

In Britain, meanwhile, the National Health Service (NHS) is widely regarded as the country’s finest political achievement, its jewel in the crown. A former Conservative Party chancellor once called it “the closest thing the English have to a religion,” while Conservative prime minister David Cameron once had to issue a groveling repudiation of one of his party’s MEPs, Daniel Hannan, after Hannan criticized it on Fox News while visiting the United States during the Obamacare debate.

The NHS is a universal public health-care service that guarantees that every person can receive the medical care they need, free at the point of service. But for decades, it has been subject to brutal austerity, deliberately harming its effectiveness so as to leave it vulnerable to criticism that can be used to justify creeping privatization. Now there is mounting fear that the privatizers will use Brexit to open up the British health-care system to for-profit American health-care companies.

Aneira Thomas was the first baby ever born under the NHS, named after its chief architect, the Labour stalwart Aneurin Bevan. Thomas, who went on to become a nurse in the NHS, worries that if the Tories win the upcoming election, Britain “will go back to the old days, before 1948, where it was only the privileged few who could afford health care.”

In a recent video in support of the Labour Party, Thomas asks, “Can you imagine somebody being ill and having to check their bank account?” Yes, many Americans can imagine that: 87 million are uninsured or underinsured.

On the surface, these might appear to be disparate struggles. The Left in Britain is seeking to defend its public health-care system, while the Left in the United States is merely trying to establish a right to universal public health insurance, only a fraction of what the NHS has accomplished.

But at base, they are constituent elements of the same fight. They both represent efforts to establish health care as a social right, not a commodity. Both British defenders of the NHS and American proponents of Medicare for All are operating from the basic principle that a health-care system should exist to heal the sick and care for the many, not line the pockets of a few.

The NHS for Sale

Britain’s Tory prime minister, Boris Johnson, swears up and down that he’s not interested in selling off the NHS to for-profit health-care companies based in the United States. “Under no circumstances will this government or any Conservative government do anything to put the NHS up for negotiation in trade talks, or privatizing, anything like that,” Johnson said last week.

His comments came amid a heated election contest, after his opponents in the Labour Party accused Johnson of seeking to do just that: broker a post-Brexit deal with the United States that renders parts of the British health-care system up for grabs.

Unfortunately for Johnson, Labour Party leader Jeremy Corbyn got his hands on some unredacted documents detailing six rounds of talks between London and Washington trade representatives over the last few months. The documents “leave Boris Johnson’s denials in absolute tatters,” Corbyn said. “We have now got evidence that under Boris Johnson the NHS is on the table and will be up for sale. He tried to cover it up in a secret agenda and today it has been exposed.”

Al Jazeera reports that the papers “do clearly indicate a range of public services have been discussed by trade representatives.” According to the Guardian, the documents show that US and UK trade representatives discussed “the NHS, drug patents, the pharmaceutical industry, health insurance and medical devices as part of the post-Brexit trade deal.” Corbyn accused the Johnson administration of issuing “a green light for breaking open Britain’s public services so corporations can profit” from them.

In a separate document, the US government lists one of its primary negotiating objectives as ensuring that the UK’s “state-owned enterprises” should “accord non-discriminatory treatment with respect to the purchase and sale of goods and services,” calling for “full market access for US products,” including pharmaceuticals. Donald Trump himself has made it clear that he wants the NHS “on the table.”

Johnson denies that he and Trump see eye to eye. But this is a politician who has previously claimed that other countries have better health care because “they do not rely exclusively on a top-down, monopolistic health care service of a kind we have in this country. The Chancellor has decided there is only one model for health care in this country. It’s the NHS model, and he’s decided that it’s unimprovable, except for the addition of more taxpayers’ money.”

In light of these comments — and the fact that Johnson has staffed his cabinet with several people who openly advocate entrusting public hospitals to private corporations — the notion that Johnson would like to use Brexit to privatize the NHS is far from unthinkable.

A Transatlantic Struggle

This week it was also revealed that lobbyists for the health-care industry have been ghostwriting op-eds against single-payer health care for US lawmakers. “Lobbyists either helped draft or made extensive revisions to opinion columns published by three state lawmakers in a way that warned against the dangers of Medicare-for-All and other government involvement in health care,” the Washington Post reported.

Winning Medicare for All in the United States will be an uphill battle. Drug and insurance companies will do everything within their power to avert a single-payer health insurance program, which will wipe private insurance off the map and make it possible for the federal government to negotiate pharmaceutical prices, ending the drug gold rush that has rendered many essential medicines unaffordable.

As the unsurprising example of ghost-written op-eds indicates, private health-care companies are working surreptitiously with allies within the state and the media to pump the brakes on Medicare for All. And the more traction the demand gains, the more their efforts will escalate.

Those same companies don’t just want to stop progressive legislation that will cut into their profits at home — they also want to grow abroad. “The US demand is they want access to what they euphemistically call our ‘health markets,’” said Jeremy Corbyn. “The last time I looked, we didn’t have a health market in Britain. We have something called the National Health Service.”

In other words, British defenders of the NHS are seeking to hold at bay exactly the same private interests that are battling Medicare for All at home.

The US and UK health-care fights fall along the same lines: the working class of each country wants universal high-quality health care that is free at the point of service, and the ruling class and their political allies in each country want corporations to profit from the provision of essential services. Not only are the political leaders of each country — the Johnson and Trump administrations — teaming up to appease corporate health-care giants, but the very same private firms stand to gain in the event of a working-class defeat both in the United States and in the UK.

The efforts to secure Medicare for All and to defend the NHS are the same struggle. Our society has the knowledge, technology, and capacity to care for all in their time of need. But if medicine is gatekept by corporations, then it will be operated for profit, which means that only those who can pay will get it.

Most Americans pay little attention to UK politics, but in this case we should. American advocates of Medicare for All should show our solidarity with those in Britain who are fighting to protect the NHS. A Johnson victory in the UK would be a blow not only to the British working class, but also to the American one — and a boon to our movement’s enemies here and abroad.

The health-care profiteers have an imagination that transcends national borders, and so should we.