Trump

[Kendhni]

What is the concern about the NHS and a US trade deal, is someone suggesting that we could be forced to privatise it as part of a trade deal? I doubt that very much, so what could they do, since most NHS trusts run a large deficit there would be little support for anyone taking over their running. I suppose drugs and medical supplies from the USA would become duty free putting UK suppliers under more competition, but that's what free trade deals do anyway. So just what is the concern?

What will happen is that NHS costs will rise, not drop. The US pharma companies will force the use of their drugs instead of cheaper generic drugs.
Why would this happen Ken? As an ex buyer why would the NHS no longer be allowed to source their drugs from the most competitive source?
Similarly the insurance companies will squeeze the NHS on how much will be paid for treatment.
I thought the government (or we taxpayers) paid for all NHS services, why do you believe that a free trade deal would allow insurance companies to squeeze NHS costs?
Both of those are very bad news for the NHS and the British tax payer. If these companies get that foothold then it will only be a matter of a few years before we start seeing a two tier NHS between the haves and have nots (which sort of already exists) that will not be free at point-of-service.

Do not under-estimate the possible impact of this. There are a lot of senators in America with a vested interest in both Pharma and Medical insurance (not forgetting the farming, manufacturing and other industries) that have pretty much already spelled out exactly what they expect from an anglo-american trade deal.

I am hoping for a negotiated deal which should allow the status quo, or at least something very close, to continue for all our EU imports and for any ROW imports that we currently import under EU trade deals; and although I hope we will be able to negotiate our own new free trade deals, these would need to consider any impact they might have on existing trade.
If you have hard facts that support a different point of view I would really like to hear them.

towny, you need to read the "PUBLIC HEARING ON NEGOTIATING OBJECTIVES FOR A U.S.-U.K. TRADE AGREEMENT" (Jan 29,2019). Unfortunately it is almost 300 pages long but it lays out the stance of various departments within the American administration (and it is dull as dishwater to read) - but there are some very worrying 'demands' in there. That is a starter document and there are many other more focussed documents.

One the big blockers for US pharma companies has been the sheer bulk buying power of the NHS and its willingness to utilise generic drugs. The pharmas companies are heavily invested into various senators in getting their way and they have made it clear that they want this on the agenda for any trade deal negotiations.

I am still trying to get my head around how the insurance companies will affect the market, but it appears that if they can get a foothold in the UK then they can set up their own private clinics pushing prices up and taking the 'cream' from the market. They could also limit payments for NHS services meaning the government/tax payer has to subsidise the NHS even more.

I know the NHS cannot continue indefinitely in its current form and it will have to probably move to a copay type of operation. The problem is do you really want the extortionate pricing that we see in the US coming over to the UK?

I have the same hopes for you of a good negotiated settlement, but having seen how well our negotiating team did in the 'easiest of negotiations' I am, not surprisingly, somewhat concerned about their abilities in the much more complex trade deal negotiations. The impact of an American trade agreement could seriously hamper our ability to trade with the EU due to possible enforced employment laws, health and safety, food standards and other elements that effectively come up for grabs (and it is easy to say that such things are up to us, but that only shows a lack of understanding of how trade agreements work).

[Manoverboard]

Ken reckons …. " the NHS will not be free at point-of-service. "

Whatever the trade deal it will be the Brits not the Americans who make that decision.

No way, in my opinion, will the not haves be hung out to dry as per the traditional American system.

[gfwgfw]

President Trump is not so bad . . . . but the First Lady is a cracker ! !

[Kendhni]

President Trump is not so bad . . . . but the First Lady is a cracker ! !

Would the right honourable member please go to the back of the queue

[Mervyn and Trish]

Back to dress codes. I hope I never meet Corbyn and Abbot on a cruise!

No chance. Cruising will be shut down by Jezza's labour government "to save the planet environmentally" and because "only the rich can afford it"

Not that Jezza is rich or anything!

[Kendhni]

Ken reckons …. " the NHS will not be free at point-of-service. "

Whatever the trade deal it will be the Brits not the Americans who make that decision.

Remind me again how did the 'easiest of negotiations' where 'we hold all the cards' allowing us to 'have our cake and eat it' go?

When you make your consideration remember that we do not have a single person in the UK that has 'international trade agreement' skills - some people refer to business men that do deals all the time, that is a totally different skill set. So given the record of the past 3 years I wonder how a team of untrained civil servants is going to perform against teams of highly skilled trade negotiators from other countries.

No way, in my opinion, will the not haves be hung out to dry as per the traditional American system.

I have your same optimism, however someone somewhere will have to pay for the 'not haves'. At the minute the American Medicare and Medicaid budgets are stressed to the limit, similar could happen over here. The 'haves' will be expected to contribute more (either through taxation or through a surcharge on their insurance policies) and the 'have nots' may well be spending time with the 'Patient Financial Services' department working out payment plans for uncovered services.

[barney]

All of that is possible but not in our lifetime.
The future is what it is.

[towny44]

Remind me again how did the 'easiest of negotiations' where 'we hold all the cards' allowing us to 'have our cake and eat it' go?

When you make your consideration remember that we do not have a single person in the UK that has 'international trade agreement' skills - some people refer to business men that do deals all the time, that is a totally different skill set. So given the record of the past 3 years I wonder how a team of untrained civil servants is going to perform against teams of highly skilled trade negotiators from other countries.

Ken, you are tying up future costing needs for the NHS and Social care with Brexit, which I guess fits your game plan but they exist already and, although Brexit might impact them in how Brexit affects our economic growth, they have not been caused by Brexit or by any future trade deal with anyone.
I have your same optimism, however someone somewhere will have to pay for the 'not haves'. At the minute the American Medicare and Medicaid budgets are stressed to the limit, similar could happen over here. The 'haves' will be expected to contribute more (either through taxation or through a surcharge on their insurance policies) and the 'have nots' may well be spending time with the 'Patient Financial Services' department working out payment plans for uncovered services.

[towny44]

Remind me again how did the 'easiest of negotiations' where 'we hold all the cards' allowing us to 'have our cake and eat it' go?

When you make your consideration remember that we do not have a single person in the UK that has 'international trade agreement' skills - some people refer to business men that do deals all the time, that is a totally different skill set. So given the record of the past 3 years I wonder how a team of untrained civil servants is going to perform against teams of highly skilled trade negotiators from other countries.
I have your same optimism, however someone somewhere will have to pay for the 'not haves'. At the minute the American Medicare and Medicaid budgets are stressed to the limit, similar could happen over here. The 'haves' will be expected to contribute more (either through taxation or through a surcharge on their insurance policies) and the 'have nots' may well be spending time with the 'Patient Financial Services' department working out payment plans for uncovered services.

Ken, you are tying up future costing needs for the NHS and Social care with Brexit, which I guess fits your game plan but they exist already and, although Brexit might impact them in how Brexit affects our economic growth, they have not been caused by Brexit or by any future trade deal with anyone.

[Not sure how the above happened but this should have been how it looked.]

[Manoverboard]

Ken reckons …. " the NHS will not be free at point-of-service. "

Whatever the trade deal it will be the Brits not the Americans who make that decision.

Remind me again how did the 'easiest of negotiations' where 'we hold all the cards' allowing us to 'have our cake and eat it' go?

When you make your consideration remember that we do not have a single person in the UK that has 'international trade agreement' skills - some people refer to business men that do deals all the time, that is a totally different skill set. So given the record of the past 3 years I wonder how a team of untrained civil servants is going to perform against teams of highly skilled trade negotiators from other countries.

But … when it comes to the NHS don'tcha think that those untrained Civil Servants will have a bunch of highly trained Union negotiators to refer to ?

[towny44]

Why do remainers run down the abilities of everything in the UK to try and justify staying the EU?

[oldbluefox]

Are we really so incompetent that nowadays we cannot do anything for ourselves without hanging on the apron strings of the EU? This is the impression I get from the Remain camp and may explain the reason why so many of our MPs are happy to remain in order that they can just rubber stamp anything the EU says. Just my opinion of course but we seemingly are incapable any more of negotiating our own trade deals, or even of exiting this controlling power.
Here we have the 5th largest economy in the world, bigger than the rest of Europe apart from Germany yet we are supposedly incapable of negotiating for ourselves. It seems to me we must be doing something right.

[Manoverboard]

Why do remainers run down the abilities of everything in the UK to try and justify staying the EU?

Desperation, fear of change or unable to step out of their comfort zones … I would guess.

[barney]

Ken reckons …. " the NHS will not be free at point-of-service. "

Whatever the trade deal it will be the Brits not the Americans who make that decision.

Remind me again how did the 'easiest of negotiations' where 'we hold all the cards' allowing us to 'have our cake and eat it' go?

When you make your consideration remember that we do not have a single person in the UK that has 'international trade agreement' skills - some people refer to business men that do deals all the time, that is a totally different skill set. So given the record of the past 3 years I wonder how a team of untrained civil servants is going to perform against teams of highly skilled trade negotiators from other countries.

But … when it comes to the NHS don'tcha think that those untrained Civil Servants will have a bunch of highly trained Union negotiators to refer to ?

It's yet another red herring in my opinion Moby.

Governments agree trade deals but ultimately, the consumer decides.

Just imagine that we did a trade deal with China, and part of that deal was for the Chinese to be allowed to export say, deep fired scorpion to the UK.
Do you seriously think that overnight, the good people of north devon would develop a taste for the fried critter?
Highly unlikely in my opinion.

So, with ref to the USA meat standards, as long as produce is marked with country of origin, then the comsumer has the choice as to whether to purchase.
I must admit that I've been to the states numerous times and always ate chicken, oblivious to the chlorine wash.
It sure doesn''t affect the taste

So, as for USA drug companies, well the NHS procurement teams are obliged to get the best deal that they can.
If that's imported, then so be it.
We currently import some drugs from the EU but export far more than we buy in.

i'm surprised that some on this forum have such a low opinion of their own country and our ability to thrive.
Surely today's service in France should have remined them that we are a resilient nation, come hell or high water.

[oldbluefox]

i'm surprised that some on this forum have such a low opinion of their own country and our ability to thrive.
Surely today's service in France should have reminded them that we are a resilient nation, come hell or high water.

[Mervyn and Trish]

Is this Trump thread morphing into a pseudo Brexit thread?

[oldbluefox]

I did wonder Merv but Trump's suggested deal is inextricably linked with Brexit so it's difficult to see where the dividing line comes.

[Kendhni]

Ken reckons …. " the NHS will not be free at point-of-service. "

Whatever the trade deal it will be the Brits not the Americans who make that decision.

Remind me again how did the 'easiest of negotiations' where 'we hold all the cards' allowing us to 'have our cake and eat it' go?

When you make your consideration remember that we do not have a single person in the UK that has 'international trade agreement' skills - some people refer to business men that do deals all the time, that is a totally different skill set. So given the record of the past 3 years I wonder how a team of untrained civil servants is going to perform against teams of highly skilled trade negotiators from other countries.

But … when it comes to the NHS don'tcha think that those untrained Civil Servants will have a bunch of highly trained Union negotiators to refer to ?

That is like saying you have toothache so you talked to the receptionist who had highly trained physiotherapists to refer to. It is a totally different skillset. The unions primary aim will be to look after its members, not the NHS.

[Kendhni]

Remind me again how did the 'easiest of negotiations' where 'we hold all the cards' allowing us to 'have our cake and eat it' go?

When you make your consideration remember that we do not have a single person in the UK that has 'international trade agreement' skills - some people refer to business men that do deals all the time, that is a totally different skill set. So given the record of the past 3 years I wonder how a team of untrained civil servants is going to perform against teams of highly skilled trade negotiators from other countries.
I have your same optimism, however someone somewhere will have to pay for the 'not haves'. At the minute the American Medicare and Medicaid budgets are stressed to the limit, similar could happen over here. The 'haves' will be expected to contribute more (either through taxation or through a surcharge on their insurance policies) and the 'have nots' may well be spending time with the 'Patient Financial Services' department working out payment plans for uncovered services.

Ken, you are tying up future costing needs for the NHS and Social care with Brexit, which I guess fits your game plan but they exist already and, although Brexit might impact them in how Brexit affects our economic growth, they have not been caused by Brexit or by any future trade deal with anyone.

The only game plan I have is trying to get brexiteers to tell me what their game plan is so that I can make an informed judgement, because at the minute there is absolutely no concrete coherent plan for brexit, not to worry post-brexit Britain. You can only phaff about in the dark waving flags and telling fairy tales for so long, eventually reality is going to set in, and I would like to have some knowledge about what shape that reality might take.

You could be right about conflating future costing, but that would only emphasize my argument that the NHS is currently very much at risk - so why make things worse. A couple of years ago I attended an event in Boston looking at the future of healthcare in America and one of the sessions was presented by John Gorman (who used to be the head honcho of the regulator group). He did not mince his words and many aspects came under fire, but the one thing that worried me most is that by 2030 the cost of prescription drugs will be more than the entire current budget for health - and he showed similar projections elsewhere in the world (including the impact to the NHS). It is very worrying and I know that there is no way the NHS can continue as currently, the question is whether or not we go to a government controlled copay model or let outside commercial interests take the cream off the top.

The document I referred you to in an earlier post highlights that the American Healthcare and pharma companies want access to the UK market with guarantees written into any trade agreement (over simplification). That in itself is not an issue, but once they gain a foothold they will be able to 'manipulate' the market and government thinking (as they do in America).

[Not sure how the above happened but this should have been how it looked.]

Fortunately there was nothing incriminating in your paste buffer

[Kendhni]

Is this Trump thread morphing into a pseudo Brexit thread?

More of a warning about the threats to our NHS and future healthcare thread - which could come from the EU or future trade negotiations.

[Kendhni]

So, with ref to the USA meat standards, as long as produce is marked with country of origin, then the comsumer has the choice as to whether to purchase.

I am glad you picked that one, that is exactly one of the points mentioned in the American outline of negotiations - that country of origin does not have to be stated.

So, as for USA drug companies, well the NHS procurement teams are obliged to get the best deal that they can.
If that's imported, then so be it.

And again that is something that will be negotiated as a trade deal - the American pharmas are looking to block the use of generics. You can not
assume that the status quo on anything will be retained as part of trade negotiations - that is just burying your head in the sand.

We currently import some drugs from the EU but export far more than we buy in.

I guess that all depends on which drugs you need. it is no good saying we have plenty of drug-A if what the patient needs is drug-B which has to be imported. For example one of the drugs Julie requires daily is imported, with the medication she leads a normal life, without she will basically become a bed blocker within the NHS (because the drug company that makes the alternative have banned her from access unless it is administered within a hospital - she took a very bad reaction when they tried her on it).

i'm surprised that some on this forum have such a low opinion of their own country and our ability to thrive.

I agree totally, brexiteers have often told me they want to make Britain Great again and I have said that I think the UK is already Great - at which point I receive a litany of (mostly irrelevant) reasons why it isn't great.

Surely today's service in France should have remined them that we are a resilient nation, come hell or high water.

Hiding behind waving flags from 75 years ago is totally irrelevant to what is going to happen tomorrow.