Will Boris Johnson's resignation affect the NHS?
Friday Pulse Check
Good morning, happy Friday, and welcome to the Friday Pulse Check. We have been off for a few weeks here at FLATLINING.net, but that should all be coming to a close today.
Given the news that British Prime Minister Boris Johnson has chosen to resign from his post and that the UK has one of the largest single-payer healthcare systems in the world, I wanted to take a look at how it might be affected by it by a new prime minister. I also want to offer some comparison to how that might change if we had Senator Bernie Sander’s Medicare for All and President Biden chose to resign.
But first the news:
A couple very excited columnists in the Boston Herald this week discussed with eager anticipation that insurance companies are now required to disclose certain information regarding how much they pay for healthcare. It is true Centers for Medicare and Medicaid Services (CMS) is supposed to begin enforcing a rule that requires insurance companies to disclose in-network rates and allowed amounts. Sorry to burst some bubbles, but I’m not confident they will. HHS hasn’t even enforced hospital price transparency rules that went into effect in January 2021. Secretary Xavier Becerra said that they had sent hundreds of “warnings” but no fines. So, yay we have new rules, I guess, but until CMS and HHS show their teeth in enforcing them, I’m not holding my breath.
While we were on break, a report was published in the Pillar about a Christian health-sharing ministry called Solidarity HealthShare that is reportedly not paying some of its members’ medical bills. Health shares are a creative way to lower healthcare costs for healthy people, but they are significantly less regulated than insurance companies. Former employers told the Pillar that the organization is significantly understaffed and some members say that they can no longer see their doctor because of outstanding bills. Ron and I will have a further discussion on Solidarity HealthShare and health shares in general on the FLATLINING Podcast next week.
(The poll is a new feature here on Substack. If you fill it out, we can use the results on future Friday Pulse Checks and on the FLATLINING Podcast.)
In this Kaiser Health News article that we re-published at FLATLINING.net this week, Lauren Weber reports that CMS wants to hide from the public a rating that lets consumers compare hospitals’ safety records and to waive approximately $350 million in financial penalties for roughly 750 hospitals with the worst patient-safety track records. Remember earlier when I said I was skeptical about HHS and CMS enforcing transparency? Yeah, that comes to mind again here.
PM Johnson is out. What does that mean for the NHS?
Imagine for a moment that Senator Bernie Sanders’ recent Medicare for All proposal was law in the United States and its implementation was complete. Every resident has a Medicare card, HHS determines how much services cost in each market, and private health insurance that duplicates Medicare is illegal. For the sake of this thought experiment, we’ll say Joseph Biden is still president.
If President Biden were to resign from his post, the vice president would assume office. This probably wouldn’t shake up the executive cabinet too much, but when an election comes around and someone new is elected, there would be a near-complete turnover. This includes the Secretary for Health and Human Services, who under Sen. Sanders’ Medicare for All bill, has a significant amount of power to control healthcare in the United States.
A resignation (or even a regular election) if we had Sen. Sanders’ Medicare for All would significantly impact the healthcare of all Americans. A new administration/HHS secretary could unilaterally change how much doctors get paid for a service, who counts as a resident eligible to receive Medicare for All, and what types of claims are routinely denied as unnecessary care.
Sen. Sanders has said in the past that he wants a healthcare system in the United States similar to what the Canadians and the British have. We have discussed here on FLATLINING and the FLATLINING Podcast that even his own proposals differ greatly from how those countries operate their healthcare.
When British Prime Minister Boris Johnson announced his resignation yesterday, it got me thinking about how that might affect the UK’s National Health Service. After all, he is the de facto head of state for the UK and his cabinet would have the authority to change the NHS right?
Well, it isn’t so simple. Yes, the NHS receives its funding from the Department of Health and Social Care which is headed up by a member of Parliament, but the NHS is run by a board that is appointed by the Secretary of State for the Department of Health and Social Care. Think of it sort of like the Federal Reserve. The President appoints people to chair the board, but it operates independently.
Additionally, despite the fact that the majority government in the UK has flipped between Conservative and Labour (a friendly reminder that these do not equal Republican and Democrat), the NHS’s funding has increase every year. Here is a helpful infographic to show this created by the King’s Fund:
So how much will Boris Johnson’s resignation affect the average Englishman’s healthcare (or spending for the NHS)? Not much. We can’t say the same about what would happen in a regular election, much less a resignation, if we implement Sen. Sanders’ Medicare for All.
Ukraine already had a higher amount of strokes on average prior to the Russian invasion of that country. As Euronews reports, however, stroke cases have increased since the February invasion. This, unfortunately, is more bad news for a country that has decreased access to drugs because of the war and a healthcare system that has been impacted by Russian shelling.
As always, we appreciate you taking the time to read our short newsletter. I hope that you find them informative and a good way to stay connected to some of the most pressing healthcare issues of our day. If you do, please consider sharing it on social media or forwarding this email to your friends and colleagues.
Have a good weekend,