Brexit discussion thread IX (Please read OP before posting)

Call me Al

[Deleted User] wrote: »

I'm not getting the link; why, and in what way, would the NHS of all organisations be "sacrificed" in a British-US trade deal? Where's this story coming from?

At a press conference today Trump was asked about the NHS in the context of it being a part of a US/UK trade deal. He replied that it had to be on the table.

Popeleo

It was also in the news after the Andrew Marr interview last weekend with Woody Johnson, the US ambassador to the UK.

The NHS is specifically mentioned as being up for negotiation in a trade deal at the end of the short video below:

https://www.bbc.com/news/av/uk-48489524/us-ambassador-woody-johnson-on-us-food-if-the-british-people-like-it-they-can-buy-it

Peregrinus

This is all very vague. What does it mean to say that the NHS is "on the table" or "up for negotiation"? I can't imagine a trade deal committing the UK to privatise the NHS; that would be a bizarre provision to include in any trade deal and, if it were included, there would be zero chance of Parliament ratifying the deal.

I think a trade deal might contain two relevant provisions:

1. If and to the extent that the UK does choose to privatise or part-privatise (or further part-privatise; it's already partly privatised through contracting-out) the NHS, US tenderers can compete on an equal footing with US tenderers to take on whatever services are being privatised.

2. (Much more worrying) a change to the current purchasing system whereby the NHS evaluates drugs and decides what it will pay for them, given their clinical benefits and the cost of developing/producing them. The NHS is such a huge purchaser of drugs that it can basically set prices. Big Pharma would much prefer that the prices were set by the sellers, not the buyers.

Peregrinus

Beechwoodspark wrote: »

He reportedly met with the ERG, and Farage earlier today. No doubt they mentioned the backstop to him as one of the obstacles to a deal

He will raise it with LV tomorrow I would think.

Not at all. The more obstacles to the deal the better, as far as Trump is concerned. A no-deal Brexit would appeal to him, since it leaves the UK more vulnerable and needy, and therefore increases the advantages and opportunities for the US.

Rain Ascending

An Ciarraioch wrote: »

ChUK, we hardly knew you - would the Lib Dems even want Umunna or Allen now?

https://www.theguardian.com/politics/2019/jun/04/change-uk-poised-to-lose-at-least-half-its-mps-heidi-allen-chuka-umunna-lib-dems

And Brexit claims the scalp of yet another party. So far UKIP and Change UK have failed to adapt quickly and effectively to the challenge -- each out-maneuvered by a party with a clearer, simpler message: the Brexit Party in the case of UKIP; the LibDems in the case of Change UK.

I'm beginning to suspect that things won't stop there. The UUP lost their MEP seat by pivoting the wrong way. The Conservatives and Labour are in turmoil.

Of these three, the Conservatives are most at risk. Have a look at the excellent analysis of MP seat majorities by Peter Donaghy (Salmon of Data) on Slugger O'Toole a few days ago -- see this link. Essentially, his point is that the Conservatives have a more efficient, even vote distribution across the UK maximizing their seat returns in normal circumstances. However, if they lose significant vote share, their lower majorities mean they have less of a buffer to fall back on and in the FPTP voting system, this could lead to a Canada Conservative-style wipe-out.

Labour are less vulnerable since they have a larger number of seats with very large majorities. This normally a waste under FPTP, but here would allow them to limp on event in even the event of the LibDems overtaking them in vote share in a general election.

Brexit could prove to be an extinction event for British political parties. Don't find a (political) ecological niche that is big enough to sustain your population of MPs, MEPs, councillors, etc. and a party will struggle to survive. This has been discussed as a theoretical possibility for a number of months, as parties re-align not on traditional left-right terms, but on how they approach Brexit. Since the European elections, however, it has now become very real and is, for example, beginning to shape the Tory leadership debate.

Dinosaurs beware.

Peregrinus

devnull wrote: »

Really they should have joined the Lib Dems in the first place or just called themselves the Remain Party, the fact that the remainers are so divided is a problem - sitting as independents will just dillute those peoples influence and the remain course.

The Brexiteers for all their faults at least are aligning under a single cause with Farage.

But, remember, until a couple of months ago the Lib Dems seemed moribund, and everybody was commenting on the fact that they had utterly failed over two years to capitalise on the substantial dissastisfied remainer vote out there. The conventional explanation was that they still were too tarred by their former coalition with the Tories. So I think the Change strategy was to offer a non-LibDem alternative for remainers.

It hasn't worked, obviously, and that's implicitly recognised by the Change MPs who are leaving, and who hope to joint the Lib Dems. But it's at least arguable that the Change defections were one of the cracks in the party system that opened up the possiblity of realignment, and that without them the LibDem revival might not have occurred, or at any right might not have occurred when it did.

I think it's correct to say that the Brexit party is hoovering up the bulk of the hard-Brexit vote - at least for the purposes of the European elections. I think in a general election it will probably be more splintered. And the Lib Dems aren't doing a bad job of hoovering up the Remain vote. If they can form some kind of electoral alliance with the Greens my guess is that they will do better than the Brexit Party in a general election, in terms of both votes and seats. But of course we won't know unless and until there's a general election

Anteayer

Beechwoodspark wrote: »

I’d say trump will put some pressure on varadkar tomorrow regarding brexit

If he does that we simply raise the issue with every Irish American representative in the House and Senate and contact every Irish American group who might listen.

From a vote getting point of view, keeping Irish American voters on side is far more significant than placating the Tories. I'm assuming he realises that attempting to throw Ireland under a bus in favour of English establishment figures could play VERY badly with a US electorate. While the Irish American lobby isn't organised in a very formal way, trying to screw over Ireland tends to go down badly with Irish Americans on both sides of the political divide. His own core vote and kitchen cabinet seems to contain a big chunk of blue collar Irish Americans and many of those votes were borrowed from the historical organised labour type democrats.

At the end of the day, while the US and UK have a relationship that's been built up on military grounds since WWII, culturally they're not all that aligned and the US does actually share having declared independence from the crown. There's a big chunk of Irish history that resonates in the states in a way that is fairly unique.

Zubeneschamali

funkey_monkey wrote: »

Just how realistic do people think it is that the NHS will be sacrificed and safety standards dropped in the UK in order to get a US trade deal?

If it happens, the PM will jump past Blair and Thatcher to be the most hated PM ever.

volchitsa

Peregrinus wrote: »

Not at all. The more obstacles to the deal the better, as far as Trump is concerned. A no-deal Brexit would appeal to him, since it leaves the UK more vulnerable and needy, and therefore increases the advantages and opportunities for the US.

Yes, I'm certain his interest in Brexit is not so much in helping it succeed as in seeing it fail, hard. One of the few constants that show up in his record is that his instincts are purely predatory and anyone who expects anything else from him is fooling themselves.

robinph

Call me Al wrote: »

At a press conference today Trump was asked about the NHS in the context of it being a part of a US/UK trade deal. He replied that it had to be on the table.

And priot to Trumps comments yesterday the US Ambassador said the same things a couple of days ago. The US Ambassador happening to be part of Johnson & Johnson so has a significant interest in getting his hands on any medical deals coming up for grabs.

Christy42

Can't imagine Trump putting pressure on Leo. It is in Trump's interest to get a no deal and cripple the UK.

If they go with the WA the UK will avoid the worst of a no deal outcome. The only they give up the NHS is if the UK government is under pressure to solve severe economic problems without dealing with the EU.

The man suggested Farage as a negotiator. He does not want this deal going down. Hard border or not.

Enzokk

Peregrinus wrote: »

This is all very vague. What does it mean to say that the NHS is "on the table" or "up for negotiation"? I can't imagine a trade deal committing the UK to privatise the NHS; that would be a bizarre provision to include in any trade deal and, if it were included, there would be zero chance of Parliament ratifying the deal.

I think a trade deal might contain two relevant provisions:

1. If and to the extent that the UK does choose to privatise or part-privatise (or further part-privatise; it's already partly privatised through contracting-out) the NHS, US tenderers can compete on an equal footing with US tenderers to take on whatever services are being privatised.

2. (Much more worrying) a change to the current purchasing system whereby the NHS evaluates drugs and decides what it will pay for them, given their clinical benefits and the cost of developing/producing them. The NHS is such a huge purchaser of drugs that it can basically set prices. Big Pharma would much prefer that the prices were set by the sellers, not the buyers.

I think the imagery when we talk of the NHS being up for sale is part of the countries hospitals being sold. That is not what it means, it does mean opening up more aspects for contracts and the US could shut out other countries from bidding in their trade deal. And as you mention there is the drugs that is bought as well. If the NHS is weakened and the country as well where putting in money into it is not feasible for the government, then there will be contracts up for grabs and that is where I suppose the US companies would be interested.

Zubeneschamali wrote: »

If it happens, the PM will jump past Blair and Thatcher to be the most hated PM ever.

I honestly think if the price for Brexit is the NHS, a lot of Brexit Party MPs will be happy to let it go at this stage.

MrMusician18

Enzokk wrote: »

I think the imagery when we talk of the NHS being up for sale is part of the countries hospitals being sold. That is not what it means, it does mean opening up more aspects for contracts and the US could shut out other countries from bidding in their trade deal. And as you mention there is the drugs that is bought as well. If the NHS is weakened and the country as well where putting in money into it is not feasible for the government, then there will be contracts up for grabs and that is where I suppose the US companies would be interested.





I honestly think if the price for Brexit is the NHS, a lot of Brexit Party MPs will be happy to let it go at this stage.

The argument would be that does it matter if American companies provide services within the NHS framework as long as it remains free at point of use?

Zubeneschamali

Enzokk wrote: »

I honestly think if the price for Brexit is the NHS, a lot of Brexit Party MPs will be happy to let it go at this stage.

I think they will be emigrating in short order if they bring about the privatization of the NHS.

Peregrinus

MrMusician18 wrote: »

The argument would be that does it matter if American companies provide services within the NHS framework as long as it remains free at point of use?

It may not matter, as long as the decision to contract out the particular service was driven by patient needs or other considerations of the public good.

The concern is that, if services are capable of being privatised, then potential providers have a vested interest in seeing that they are privatised, and will lobby and press for this. And the US health providers have huge financial muscle and can and do lobby very effectively.

So if they can make money out of the privitations of NHS services, they will try very hard to do so. And the first step will be to seek more privatisation of the services.

This is an issue with privatisation generally - private sector providers have an economic interest in getting government services privatised which may not align with the interests either of the taxpayers who fund the services or the citizens who use them. But their financial interest in privatisation does align with the ideological commitment of many of the backers of the Brexit movement and of the right wing of the Tory party. So it looks like a potentially powerfully toxic combination.

This is particularly sensitive in relation to health services in the UK whether the public nature of the universal health service is a matter of (justifiable) national pride, and has a totemic signficance.

robinph

robinph wrote: »

And priot to Trumps comments yesterday the US Ambassador said the same things a couple of days ago. The US Ambassador happening to be part of Johnson & Johnson so has a significant interest in getting his hands on any medical deals coming up for grabs.

Jesus. How naïve I was to think he was just somebody named Johnson. A plutocracy. You really, really couldn't invent this stuff.

Bloomberg billionaires: Woody Johnson

Shelga

When Trump turned to May and said “I didn’t understand what he said” and she explained about “the NHS, our national health service”- was I the only one who thought he didn’t understand what the NHS is??

robinph

Shelga wrote: »

When Trump turned to May and said “I didn’t understand what he said” and she explained about “the NHS, our national health service”- was I the only one who thought he didn’t understand what the NHS is??

I can let him off that one, whilst the NHS is a well known term over here when there is a million different acronyms flying around you'd want to be sure you were replying to the question about the health service rather than a nuclear missile system at the right moment.


Seems that him mentioning the NHS being on the table in negotiations is a big enough deal though that this morning he's already rolled back on that and claiming that he didn't mean it in an interview with Piers Morgan, despite Woody Johnson saying it was a couple of days earlier without any retraction. I guess that Piers realised that a quote from Trump about the NHS being for sale on the red tops was a bit more damaging for their cause than some mere ambassador, who happens to be the person who'd probably make the most from any deals regarding the health service.

Leroy42

As Trevor Noah pointed out yesterday, clearly Trump has no idea what the NHS is. So when he says it on the table and that everything is it is not some slip of the tongue to let the cat out of the bag! but merely him saying that everything (including whatever that NHS is) should be open to discussion.

In terms of whether the UK public will accept it, they have accepted the vilification of the judiciary, the HoL, MP's, the Speaker, the Ref Comm, the BBC and many many others things. There have been a number of surveys undertaken which show that many in England would be happy to let NI go to ensure Brexit.

So seem to have accepted a medium term economic impact at the altar of Brexit so why would they baulk at privitasation of the NHS, particularly since most of it will actually be unseen by the general public.

Quin_Dub

Fundamentally - The UK have nothing to offer the US in a trade deal other than the 2 areas that they are currently blocked/restricted from under EU trade deals.

Health and Agriculture.

The EU tightly controls the prices that US drug companies can charge in the EU and it's been one of the excuses that Trump and the GOP have been using for healthcare costs in the US - "If we were allowed to charge proper prices in Europe then the US customers would see a decrease in prices" is the line they have used. (not a chance that the companies would lower prices in the US , but still)

The limits on US agriculture are well documented due to their , shall we say less than robust quality control and the use of GMO's etc.

The absolute minimum that the US would accept in any new US/UK trade deal would be the removal of the pricing limits on drugs and the lowering of Food Safety standards

If the NHS suddenly is being charged 10X or 100X the price for various drugs , where does that money come from?

UK Farmers will not be able to compete with the US on price and scale and will get wiped out.

Any Post Brexit US/UK trade deal will result in the NHS and the UK farming sector being shadows of their current selves , if they survive at all longer term.

CelticRambler

Quin_Dub wrote: »

If the NHS suddenly is being charged 10X or 100X the price for various drugs , where does that money come from?

UK Farmers will not be able to compete with the US on price and scale and will get wiped out.

Any Post Brexit US/UK trade deal will result in the NHS and the UK farming sector being shadows of their current selves , if they survive at all longer term.

This is where Brexit will come back to bite the English nationalists on their well-padded behinds. Take the NHS and farming out of Northern Ireland, and you've destroyed the Unionists => reunification of Ireland. Take the NHS and farming out of Scotland, and you've given IndyRef2 a whacking majority => break-up of GB. Take the NHS and farming out of Wales, with NI and Scotland already gone, and the Welsh will start thinking the unthinkable.

54and56

CelticRambler wrote: »

This is where Brexit will come back to bite the English nationalists on their well-padded behinds. Take the NHS and farming out of Northern Ireland, and you've destroyed the Unionists => reunification of Ireland. Take the NHS and farming out of Scotland, and you've given IndyRef2 a whacking majority => break-up of GB. Take the NHS and farming out of Wales, with NI and Scotland already gone, and the Welsh will start thinking the unthinkable.

Sometimes a picture paints a thousand words.

Enzokk

Enzokk wrote: »

I honestly think if the price for Brexit is the NHS, a lot of Brexit Party MPs will be happy to let it go at this stage.

Zubeneschamali wrote: »

I think they will be emigrating in short order if they bring about the privatization of the NHS.

I typed this in a hurry earlier, I mean Brexit Party voters and some Conservative MP's would gladly let the NHS go for Brexit as they are too far in to back out now. They have become so entrenched in the idea that they have to leave the UK that at any cost will not include the NHS, where just after the referendum they would not have entertained the idea.

Peregrinus wrote: »

It may not matter, as long as the decision to contract out the particular service was driven by patient needs or other considerations of the public good.

The concern is that, if services are capable of being privatised, then potential providers have a vested interest in seeing that they are privatised, and will lobby and press for this. And the US health providers have huge financial muscle and can and do lobby very effectively.

So if they can make money out of the privitations of NHS services, they will try very hard to do so. And the first step will be to seek more privatisation of the services.

This is an issue with privatisation generally - private sector providers have an economic interest in getting government services privatised which may not align with the interests either of the taxpayers who fund the services or the citizens who use them. But their financial interest in privatisation does align with the ideological commitment of many of the backers of the Brexit movement and of the right wing of the Tory party. So it looks like a potentially powerfully toxic combination.

This is particularly sensitive in relation to health services in the UK whether the public nature of the universal health service is a matter of (justifiable) national pride, and has a totemic signficance.

I still wonder whether you are able to provide a public service at a profit for companies? It seems at odds where the cost of health for the public will not have a budget, but putting some services up for bidding by private companies would either mean that you are wasting money away that could be spent elsewhere, or the bidding companies will try to subtract a profit from the public by either overcharging or cutting the service they provide.

There is a video of Alexandria Ocasio-Cortez questioning a CEO of a company supplying parts for the military. The part costs $32 to produce and they charge more than $1400 for the part. If you have $750b budget per year to spend then you can allow this type of gouging to happen, but the UK will not be able to absorb this and they will have to eventually move to an insurance based health care system. It is what Farage has said before.

Shelga wrote: »

When Trump turned to May and said “I didn’t understand what he said” and she explained about “the NHS, our national health service”- was I the only one who thought he didn’t understand what the NHS is??

I am 100% sure he doesn't know what the NHS is. I am also almost 100% sure that even if he did know he would have said it in any case. He said everything is on the table and not knowing what the health service is called doesn't mean it doesn't fall under the "everything will be up for negotiation".

As an aside, I am baffled why we are spending 10m euro for Trump's golfing trip. When we talk about waste and the homeless crises, should we really spend money on him when this is obviously not an official trip as he is not meeting officials in Dublin and will only spend a pitiful 30 minutes with Varadkar at Shannon Airport.

Professor Moriarty

CelticRambler wrote: »

This is where Brexit will come back to bite the English nationalists on their well-padded behinds. Take the NHS and farming out of Northern Ireland, and you've destroyed the Unionists => reunification of Ireland. Take the NHS and farming out of Scotland, and you've given IndyRef2 a whacking majority => break-up of GB. Take the NHS and farming out of Wales, with NI and Scotland already gone, and the Welsh will start thinking the unthinkable.

Indeed but English nationalists only care about England and will gladly trade the UK for a 'free England'. A 'free England' that is a vassal state in thrall to the US but we won't talk about that...

CelticRambler

Enzokk wrote: »

I still wonder whether you are able to provide a public service at a profit for companies? It seems at odds where the cost of health for the public will not have a budget, but putting some services up for bidding by private companies would either mean that you are wasting money away that could be spent elsewhere, or the bidding companies will try to subtract a profit from the public by either overcharging or cutting the service they provide.

Several yeas ago, I saw a report on Public-Private Partnerships in the UK and the terrible negative effect it had on local finances and local communities, mainly because any physical infrastructure (especially buildings and recreational spaces) was immediately tied up in a long-term contract. Where the local needs had changed within a couple of years of signing the deal (even before one building was completed, iirc) the local authority was locked into T&Cs that prevented them from making better use of the facility.

ArmaniJeanss

Enzokk wrote: »

As an aside, I am baffled why we are spending 10m euro for Trump's golfing trip. When we talk about waste and the homeless crises, should we really spend money on him when this is obviously not an official trip as he is not meeting officials in Dublin and will only spend a pitiful 30 minutes with Varadkar at Shannon Airport.

It's probably theoretical money, in that a lot of it wouldn't actually be saved if he didn't visit. e.g., guards would still be paid whether they are working in Dunbeg or on their normal duties.

Enzokk

ArmaniJeanss wrote: »

It's probably theoretical money, in that a lot of it wouldn't actually be saved if he didn't visit. e.g., guards would still be paid whether they are working in Dunbeg or on their normal duties.

I know, especially when we talk about the HSE being over budget by hundreds of millions. Still, that is a lot of money to be spending on someone visiting their own golf course. Then again those getting overtime will not be complaining I suppose.

Quin_Dub

ArmaniJeanss wrote: »

It's probably theoretical money, in that a lot of it wouldn't actually be saved if he didn't visit. e.g., guards would still be paid whether they are working in Dunbeg or on their normal duties.

I don't know about that , a garda friend of mine reckons he's going to make huge extra money off the Trump visit in terms of overtime.

They aren't taking any Gardai off regular duty , with the exception of those specialist groups (fire-arms trained officers etc.). the rest are all working overtime and given that quite a few have been drafted in from other areas there will be significant food/accommodation expenses.

Not to mention the rental of every piece of temporary fencing west of the Shannon - The entire roadway coming out of Shannon airport is fenced off with 8-10" high barriers all the way out to the motorway.

And he probably won't be travelling by road as that was only a fall back if weather grounded the helicopter.

This is all extra money being spent here.

Walter Bishop

ArmaniJeanss wrote: »

It's probably theoretical money, in that a lot of it wouldn't actually be saved if he didn't visit. e.g., guards would still be paid whether they are working in Dunbeg or on their normal duties.

They're getting overtime they wouldn't be getting otherwise (mostly), 8500 dinners have to be provided, 40,000 bottles of water etc. etc. according to the Times.

That's not theoretical at all.

A Dub in Glasgo

ArmaniJeanss wrote: »

It's probably theoretical money, in that a lot of it wouldn't actually be saved if he didn't visit. e.g., guards would still be paid whether they are working in Dunbeg or on their normal duties.

It will not be theoretical money, it will mostly be additional expense incurred by the state because Trump is visiting his golf course. The same thing happened last year in Scotland