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As scandals go, this one erupted with more of a whimper than a bang. Documents unsealed in February in the U.S revealed details of a five-year-old lawsuit against Minneapolis-based Healthcare behemoth United Health after the U.S Department of Justice joined the case against the company.

The lawsuit alleges United Health overcharged Federal Health Insurance provider Medicare by billions of dollars by overstating it’s member’s illnesses. The suit was brought by a whistleblower, named in the documents as former United Health executive Benjamin Poehling. In the U.S, it is normal for the specifics of such lawsuits to be sealed against public disclosure while the allegations are investigated by the Justice Department.

The specifics of the case involve Medicare Advantage, a 2003 scheme in which the over-65’s can access healthcare through Medicare-approved private Health Maintenance Organisations (HMO’s) – such as United Health and it’s subsidiaries – who are then reimbursed by the Government. The scheme was devised after private health insurers successfully argued they could help contain the spiralling costs of Medicare.

United Health, however, is accused of overcharging Medicare by billions of dollars by claiming their patients were sicker than they actually were. Unsurprisingly, the company rejects the accusations.

So far, so standard for a system in which corporate profits appear to hold sway over the actual care of patients, or so you might think. But here’s the rub: As an increasingly desperate Theresa May begs for post-Brexit trade deals, this lawsuit lays bare what may be in store for the already beleaguered NHS.

Here’s why; From 2006 to 2009 (which includes the period under investigation), the Chief Executive of Ovations, United Health’s Medicare arm, was Simon Stevens. Stevens later served as Executive Vice President of United Health, responsible for, among other things, global healthcare interests, where he lobbied for the Transatlantic Trade and Investment Partnership (TTIP). TTIP would have seen the NHS potentially opened up to US Healthcare companies.

Simon Stevens is now Chief Executive of NHS England.

On his appointment, Stevens refused to be drawn on the apparent conflict of interest between his new and past roles, and yet a mere glance at his record shows him to be not just pro-TTIP, but a veritable cheerleader for the deal. Stevens was a founding member of lobby group The Alliance for Healthcare Competitiveness (AHC), which pushed for the inclusion of health in TTIP. In its 2014 submission to the U.S negotiations, the AHC stated;

“The proposed TTIP is of great interest to our members as the European Union is the site of nearly a third of world health spending, the principal buyer of American exports of health products, and is experimenting with new approaches to health care systems… The health sector is the largest single component of the world economy…This gives the United States a significant opportunity…”

In his past role, Stevens also lobbied for the inclusion in TTIP of the Investor-State Dispute Settlement (ISDS), which would allow corporations legal protections for their profits (i.e. corporations could sue Governments which threatened their interests), regardless of patient care. To quote Stevens’ catchphrase, ‘Think like a patient, act like a taxpayer’, or to put it another way, money trumps care.

As the Government seems intent on leading Britain out of the single market post-Brexit, it appears likely, given the importance of the US to UK trade, that a deal similar to TTIP will be back on the table. A deal in which regulatory barriers to trade will be severely reduced. The Government and the Press will dress it up as cutting red tape, but the consequences will be severe. The NHS will become a marketplace and will cease to exist as we know it.

As Britain limps towards Brexit, the future of the NHS has never been so uncertain. We have a Government which has made clear its thoughts on the role of private companies in healthcare. For all the talk of the NHS not being for sale, the statistics tell a different tale. In February, the Financial Times reported a 14% increase in private companies being invited to tender for NHS contracts, compared to last year. Healthcare provision in the UK is evolving right under our noses, and it is doing so under the leadership of a man who not only sees nationalised healthcare systems as a ripe market but led a corporation which is now accused of defrauding Government healthcare in the U.S. by billions of dollars. The NHS is in serious trouble.

Real Media

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Disqus for Ste Matthew Murray


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