Sunday, July 13, 2008

Richard Smith on Comment is Free

Richard Smith, Chief Exec of United Heath Europe has a piece on the Guardian's Comment is Free site. He is, of course, putting the case for companies like his to get more profit from taxpayers. Advertising they used to call it... Anyway his posting does not mention his vested interest at all and has sparked a deluge of criticism.

This is a selection:


Richard Smith is executive director of Unitedhealth Europe, a private healthcare provider seeking to make huge inroads into the UK NHS 'market'.

Yet again the Guardian has somehow decided to give him a platform to tout for business.

n.b. Unitedhealth in the US (tha parent company) don't do universal provision, have a record of trying to wriggle out of treaing those taking up its policies, and in February 2008, New York State Attorney General Andrew M. Cuomo announced that he was conducting an industry-wide investigation into a scheme by health insurers to defraud consumers by manipulating reimbursement rates. The announcement included a statement that Cuomo intended "to file suit against Ingenix, Inc, its parent UnitedHealth Group (NYSE: UNH), and three additional subsidiaries."

Just what the UK needs. Richard Smith can dress it up all he likes, and theorise that the private sector can do public service ethos, universal provision, all cheaper, and still return a profit for shareholders. The specific corporations looking to storm into the UK do NOT have a track record to justify this idealised view that the private sector is always best.

BishopHill (this is brilliant):

Private companies undoubtedly improved delivery of gas and electricity services.

viridios (me):

I must say firstly that the lack of acknowledgment of Richard Smith's position in United Health is bizarre. It took me two clicks to find the page where his seriously vested interest is shown. While the bias in the article was clearly evident, there was no clear declaration of the interest behind it. CIF should do better than this.

To suggest that the NHS is inefficient and needs propping up by bringing in the private sector is simply untrue. The lack of historic investment has meant that the excellent service the NHS has provided over the last 60 years has been done so on a fraction of the funding of most comparable countries. Low levels of funding are not indicative of inefficiency of the organisation - in this case the opposite is of course true.

Private provision of health care is wrong for many reasons, most of which have been covered already (cost, profit, inefficiency - I smiled at the comment that the electricity is supplied more efficiently now that it is privatised, I noticed such an increase in the quality of the electrons coming out of the fuse box!!!).

If anyone wants an example of a world class health care system that is completely state funded and state provided, yet spends less as a proportion of GDP and far less in cash terms than the UK, then look at Cuba.

Two issues need further highlighting in this debate. Firstly the lack of accountability already in the NHS suffers further erosion with private companies. For example, who is held to account for the problems that United Health may cause for patients? The professional bodies are certainly still there and do a useful job, but what if it is a more systemic issue - how can people effect change?

Private provision adds another barrier to an already unaccountable system. What people want (and need) is more of a say in local health care services not less.

Secondly, the principle of what health care should be has received little attention. Are we looking for cash cows for shareholder? Do we want to buy and sell bits of health care? Do we want to know that part our care comes from one provider and another part from another company, neither of which share information? Do we want to accept that taxes go to shareholders? Do we want health care to be a commodity to be bought and sold?

I want health care to be focussed on providing effective, efficient and seamless care to those who need it. You don't get this with the private sector.

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