Just before COVID hit, the influential German neo-liberal lobby organisation Bertelsmann Foundation (yes, the international publishing corporation) launched a campaign to radically reduce the number of hospitals in Germany and “Americanise” them and maximise profits. The campaign has disappeared – for the time being.
Roger Steer is a Management Consultant working in the Healthcare sector as well as an Advisor to Local authorities scrutinising NHS plans. He is based in France but active in the UK.
At first sight this appears as a preposterous suggestion. After all American Healthcare is renowned for being not only outrageously expensive but also socially divisive and excludes cover to the people who need it most. Inputs are more expensive, outputs worse and the processes overly complex and costly.
Why then is it possible to even consider the possibility that European healthcare may be slipping down a slope with that destination as a possibility?
Following the neo-liberal textbook described so well by Nancy McClean in “Democracy in Chains” nobody leads a campaign advocating the achievement of the clear objective of the Americanisation of healthcare in Europe. Simply put no one would vote for it. This is why other means are found for this task involving tapping in to the desires of professionals for more pay and prestige and the desire of politicians to answers to seemingly unsolvable problems of meeting the demands for more, better healthcare but without raising taxes.
Persuasion of healthcare professionals: America has the highest paid medical staff in the world and there is an understandable envy in Europe and high regard amongst many professionals shown to the arrangements in the USA that have made it possible. These include high levels of professional control of entry into the profession and high levels of specialisation within that profession. The benefits are obvious: of limiting competition and price maintenance. That this persuasion works is evident in the high level of professional complicity to Americanisation of healthcare in the UK and other countries.
Aggressive marketing of superior managerial expertise.
A typical example is this extract from an old edition of the Harvard Business review Why American Management Rules the World (hbr.org):
In proclaiming “The American Management Century” statements are made as follows:…
” when it comes to overall management,