It has come to light, quite formally, what the government plans to do with the NHS. David Cameron’s senior health advisor, Mark Britnell, declared that the NHS will be “shown no mercy” to a conference of health executives eager for news of how deep the axe will fall in their sector. It seems for them, the harvest will be good this year.

For us, this will not only mean a facelift for an institution which we are rightly proud of stand loyally by, but a complete revaluation of what health care actually means in this country.

Britnell has said the National Health Service will no longer be a service, but an insurance provider, identifying the next couple of years of imposed economic hardship and austerity as being the “best time” for the NHS to undergo this transition. Needless to say, The Shock Doctrine comes to mind.

The question we have to ask ourselves is one the Americans are painfully mulling over now – is health care a right or a privilege? Granted the natural distrust Americans have with any inward expansion of government thanks to their barking mad corporate media outlets, the British population have an altogether different problem relating to the demographics of opinion: general apathy with pockets of condensed yet ostracised outrage. This of course can be attributed to the national experience with the political process in general, but that is another rant.

What is important to measure is what will happen to the cost of health care and medication if the sweeping privatisation is enforced. The government is priding itself on its incredibly debt driven education policy at the moment, but what will happen if the proposed health insurance is abused by escalating and uncontrollable health care costs, unmitigated by the state and completely determined by private monetary profit margins? Yup, insurance denied, loopholes are found, tragic stories are born and a new norm takes shape. And that will happen, no ifs and buts.

Anyway, it doesn’t actually matter if I’m paying the bill or not; how much does it cost? is the more pertinent and determinative question which is central to the issue.

There is a reason why Britain has similar performance in health care when compared to the U.S. despite spending almost half of what the U.S. does in terms of %GDP on it – as expensive as our private option is here, it is nothing compared to the astronomical costs in the U.S. To offer an anecdote, I recently had an ACL reconstruction here through BUPA, and received all the receipts for the hospital room, anaesthetic, the surgical procedure and medication. The actual medical costs amounted to £4,500. Curious to U.S. alternatives afterwards, I researched and received a few quotes regarding the price of the exact same procedure in a U.S. hospital for a U.S. resident. The average sum in this instance amounted to $35,000 without medication. Looking at it now, a website has stated that actual costs can range from $20,000-$50,000, which seems in line with what I found 2 years ago.

Health professionals and administrators have a lot to gain with figures like that, as do the insurers who broker the price behind closed doors. There is absolutely no reason why such a gulf in cost exists between the procedure in the U.K. and the U.S., but under the U.S. model, health care is perceived as a privilege so the costs are measured accordingly.

Our private health care market has yet to be properly exploited because of the size and functionality of the free, state provided alternative, which provides a counter-balance in terms of said costs. By diluting its effectiveness, capabilities, and manpower, the free marketeers wish to expand the private arm of the sector to become dominant – which will, contrary to their whimsical meanderings about the economy and what is good for it, mean health care costs will rocket as the free option disappears. There is good evidence for this given the model the U.S. has been operating under; when health care is privatised in its entirety, we are at the mercy of businessmen who are driven by monetary profit at the real cost of our actual wellbeing, regardless of insurance or not.

The costs are and will be the issue, and the costs will determine coverage and dictate the law governing it.

Massachusetts was not won by the Republicans, it was lost by Obama

Yesterday’s big news from the far side of the Atlantic was the loss of one of the safest Democratic seats to Scott Brown, a man who represents possibly everything that should make us very worried about the Republicans. In Ted Kennedy’s former seat, which has been blue since 1952, it was the Democrats’ to lose. And they lost it.

They didn’t lose because their opponent drives a truck, because his daughters were available or because it was, after all, the people’s seat and not Ted Kennedy’s as was far too confidently assumed. By all accounts, it was not the number of Republicans voting which swung it, but the number of independents backing Brown and the number of Democrats staying at home. It might be tempting for observers this side of the pond to blame the unerring potential for American political stupidity in falling behind a resurgent GOP just one year after the worst president in living memory retired to Crawford. Obama’s ratings are now lower than any president since Eisenhower at the same stage. But for all the fire and spittle and mad dog hysteria thrown at him by the likes of Glenn Beck and Sean Hannity, the largest part of the blame has to lie with himself.

He is perhaps a victim of the power of his own voice. Obama could probably recount what he had on his toast this morning and turn it into a dazzling charismatic performance that lifts the spirits of the world. But the problem with hot rhetoric is that it does not sit too well with cold pragmatism. Only a fool would have thought Obama’s election meant a fundamental change in the nature of American politics. But he has played too close to the centre to truly capitalise on the yearning for ‘yes we can’. He was never going to appeal to the right in America. But with his lukewarm proposals for reform failing to match up to his lofty words, as speechcraft gets bogged down in statecraft, he is increasingly alienating his left-wing base.

It’s a tragedy for the poor in America that Scott Brown will likely derail even the tiniest table scraps of health care reform that are being thrown to them from Washington. It is a greater tragedy for the poor across the rest of the planet that Obama’s meagre proposals for emissions cuts will fall flat. But it’s a tragedy that Obama has brought on himself. There’s no guarantee that a left-ward swing will prevent him from becoming a one-term president. But at least he could say he tried. At least he could say ‘yes I did’. Because one thing’s for sure. If you sit on the fence, you get splinters.

The Obama administration will be breathing a sigh of relied today as the House of Representatives narrowly approved the President’s flagship health reforms. A battle still remains in the Senate, of course, and amongst the crazed zealots in the country crying ‘freedom’ whilst attempting to deny millions of the poorest Americans the right to basic health care. But this is the first victory for progressives in what, for anyone on this side of the Atlantic who isn’t a slapheaded idiot like Daniel Hannan, is one of the most bafflingly incomprehensible arguments in history.

It was Sun Tzu who, all those centuries ago, argued that to achieve victory, one must know one’s enemies. But I simply cannot understand anyone who refuses to recognise health care as a universal human right. Not least those FOX News fanatics opposed to a bill that does not even come close to free state-run health care, which should be a basic requirement for any developed nation, and indeed is a treasured asset of many developing nations. Whilst proclaiming their right to choose – an utterly irrelevant criticism in light of Obama’s reforms – they would deny hundreds of thousands of people any choice save death or bankruptcy. And that is not just for the poor and uninsured. That goes for all those whose policies just don’t want to pay out, who pick holes in every claim, because saving money is more important than saving a life in this most inhumane of models.

I can begin to understand the neo-liberals of the New Right who believe society should be orientated around a free market philosophy. I can even begin to understand social conservatives opposed to abortion and stem cell research on the grounds of their own moral compass. But I can never understand anyone who argues that human life should be left to the naked principles of the market. But then, perhaps Glenn Beck will be able to draw me a map of the retarded right-winger’s mind on his blackboard. It’s the only way I’m ever going to get it.