Prime Minister David Cameron on Monday waded into terrain where past British governments have foundered, promising fundamental changes to the country's expensive and over-stressed public health care system.
Cameron said the reforms would cut red tape and improve treatment, but critics claim they will cause chaos and could lead to backdoor privatization of the much-criticized but widely popular National Health Service.
The British leader, whose Conservative Party heads the country's coalition government, said he would save money and cut red tape by giving control over management to family practitioners rather than bureaucrats, and allow private companies, charities and social enterprises to bid for contracts within the public health service.
Making health care more efficient has proved an elusive goal for successive British governments. The previous Labour administration vowed to reduce waiting times for treatment, and succeeded — but at the cost, say critics, of wasteful bureaucracy.
In a speech outlining the government's plans to overhaul public services, Cameron promised to get rid of "topdown, command-and-control bureaucracy and targets." He said that with an aging population and growing demand for new medical treatments, "pretending that there is some easy option of sticking with the status quo and hoping that a little bit of extra money will smooth over the challenges is a complete fiction."
The government is due to publish details of its reforms in a Health and Social Care Bill on Wednesday. Socialized medicine is as much an article of faith in Britain as it is a divisive flashpoint in the United States.
The health service is Britain's biggest employer, costs more than 100 billion pounds ($158 billion) a year — and is a political football, reformed and criticized by governments since it was established in 1948.
How...does the [Affordable Care Act] magically convert $1 trillion in new spending into painless deficit reduction? It's all about budget gimmicks, deceptive accounting, and implausible assumptions used to create the false impression of fiscal discipline.
For starters, that $1 trillion price is a low-ball estimate, covering only six – not ten – years of subsidies that don't begin until 2014. The uninsured were clearly less of a priority than the deception of making the law look less expensive than it really is over its first decade. Over ten years of full implementation, it's more like $2.3 trillion.
Even if CBO's analysis were flawless, the authors of the ACA guaranteed a misleading bottom line. Their legislative prescriptions were written to create deficit reduction only on paper -- not in reality.
Repeal isn't a budget buster; keeping the ACA is. Assertions to the contrary are, well, audacious.