I recently spent a week in the UK talking to unions, think tanks, and organizers. I learned a lot but I had a few particular questions that I wanted to try to dig into.
For example, the UK has been led by the conservative Tories since 2010. That’s the party of Margaret Thatcher, the free-market disciple who unleashed a wave of privatization and crushed industrial labor unions. The Tories haven’t strayed far from Maggie’s ideas—if at all.
This year, the UK has been hit with rolling strikes in vital public services: transport, education, and above all, the National Health Service (NHS), its universal health care system. It is free at point of use, paid for through taxes, and it’s a “third rail” in British politics. Even the Tories have to proclaim publicly their “love” for the NHS (but that doesn’t stop their efforts to advance privatization).
Even former conservative leader Nigel Lawson, whom Margaret Thatcher once called “my golden boy,” was famously quoted in 1992 saying “The National Health Service is the closest thing the English have to a religion.”
Thirty years of austerity later, the doctors, nurses, and health professionals are overworked, understaffed, and underpaid. Covid made that worse, but it’s a long time coming. The NHS is still popular, but signs of trouble are mounting. Waiting lists for appointments stand at nearly 8 million people in a country of 56 million people.
Austerity is creeping the country towards privatization. I came across an article in The Economist (I read it regularly) that nailed it:
People tend to use the word “collapse” to describe the end of the NHS. It will not. It will do something worse: it will ebb. Those who can afford to leave, will. Those who can’t, will stand and queue and suffer. “Our NHS” will, almost imperceptibly, become “Their NHS.”
That’s what privatization looks like: cut taxes or fail to increase them to adequately cover need, cut costs, create waiting lists, steadily shift costs to individuals, allow frustration to grow, and know that those who can afford it will find private care. That’s what’s happening in the UK.
Once that use of private care becomes normalized, it only spreads.
“[W]e could be seeing the beginning of a significant behavioral shift with people feeling it’s perfectly normal and sensible to use private healthcare when they need it, in addition to, or separate from, their NHS,” David Hare, chief executive of the Independent Healthcare Provider Network, said.
It’s a slow and steady dismantling of a system, even one that polls show has overwhelming popular support. And that certainly guarantees that broad popular support will, over time, erode along with the system. If that sounds like a plan, it’s because it is one, and has been since the Thatcher era.
It’ll become “their NHS.” In the U.S. we know exactly what that means. “Those people.” The “other.” It means the dismantling of the few things that keep us connected to one another, like Social Security, Medicare, and public education.
I think it’s worth acknowledging that going outside the NHS to see a doctor if you can afford it is a normal human reaction. It’s exactly what I would do because my health is important. We all would. It wouldn’t necessarily mean that I didn’t support universal health care or the NHS, but step by step, my connection–and perhaps even my commitment–to it could ever so slowly loosen.
Back in the U.S., our system of universal public education is under full-scale assault. School voucher policies are expanding in many states, charter schools are seeing rapid growth, home schooling is on the rise, and all of it is now being supercharged by right wing culture wars against knowledge (book and curriculum bans), inclusion (anti-LGTBQ), and even mask mandates during Covid.
Put all that on top of decades of underfunding—now accelerating as families leave to vouchers and charters—and you can see the same game plan as the British are experiencing in the NHS.
There’s clearly a right-wing goal of dismantling the system. Culture warrior Chris Rufo calls their strategy “Laying Siege To The Institutions.” But parents who choose charters or private schools aren’t to blame. We all know kids in those types of schools, and I’d do it also if I thought my kid could get a better education.
That’s what makes the right-wing assault so effective. The more leavers, the more loss of resources, the more leavers…. You get the point. And above all, the steady erosion of the commitment from all of us to support public education spending that we need to create an educated nation regardless of whether you have kids in public schools.
It’s what Sam Pizzigati, coeditor at Inequality.org, calls the Iron Law of Decaying Public Services.
So, what’s the answer? There are no quick fixes, but there are some things that are clearly part of the solution.
- Expose the game plan and the financial impact on public schools where the vast majority of children still learn.
- Fund public education—for real. We need more and we need to expose those who want to reform schools by bleeding school districts. There’s no school improvement approach that includes taking away funding.
- Establish clear rules and accountability for any public dollars (to vouchers, charters, or anything else for that matter). Among other things, that means no public funding for discrimination.
And the bottom line: Fight like democracy is at stake. Because it is.