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What the NHS Could and Should Be in a Post-Brexit World

by John Brian Shannon

One of the great things about a post-Brexit Britain is that almost everything in the UK can begin anew, with a clean sheet as it were, and number one on that list should be the country’s excellent National Health Service (NHS).

At present, the UK contributes £12 billion more to the annual EU budget than it receives, and that’s a nice round number to spend on the NHS once Brexit occurs. Although there are certainly other sectors of the UK economy that could use that amount of funding.

But, for now, let’s concentrate on what the post-Brexit world could (and should) mean for Britain’s NHS.

And since we’re starting with a clean sheet, let’s not be limited by our present thinking and instead focus on how the NHS could provide better healthcare to Britons, and how the NHS could better serve the UK.


How to Maximize the NHS

The NHS should be required by UK legislation to begin operating at a 10% profit within 10-years of Brexit

How can the NHS operate at a profit when it can’t even hit break-even now, you ask?

Simple.

Secret Ingredient #1 – Cost savings through energy efficiency

At present, the NHS operates a large number of old hospitals, which at the time they were built were probably considered world-class hospital and administration buildings. But I guarantee that none were built to the LEED Gold nor the LEED Silver energy efficiency standard — let alone the net-zero energy usage standard called LEED Platinum as those standards were only developed in recent years.

Many NHS hospitals face energy bills of more than £1 million per month because they’re old buildings and were never worth the cost of renovating them to LEED energy efficiency standards.

As there are over 1600 NHS hospitals, clinics, and administration buildings (but nobody knows for certain because there’s so much overlap and duplication) and if each of those buildings are costing an average of £1 million per month to heat, light, and air-condition, that totals £‭19,200,000,000‬ annually.

Here’s the arithmetic: 1600 x (£1,000,000. x 12 months) = £‭19,200,000,000.

So, £‭19 billion is going straight out the window every year in wasted energy. And let’s pretend there’s another £‭1 billion in other inefficiencies in these older, no longer fit for purpose hospitals, for a grand total of £‭20 billion worth of wasted NHS funding annually.

That’s a lot of wasted money.

However, the NHS has never been asked to turn a profit, and therefore, didn’t have the money to build newer, more fit for purpose buildings over the decades — or to throw good money after bad trying to turn old, unfit for purpose buildings into LEED Certified energy efficient buildings that require zero (net) energy from the grid.

Indeed, some buildings in the United States contribute more energy to the grid than they consume due to their LEED Platinum certification, which results in a net zero energy cost annually, and such buildings can provide a tidy return on investment each February 1 when the utility companies are obligated by law (California) to settle-up with minor power producers connected to the grid. Granted, there’s a lot more sunshine in California and making it easier for a building to produce more power than it uses over the course of a year.

But UK wind turbines add power to the grid all year (particularly in autumn, winter and spring) and as for solar power in the UK, the solar insolation value (the amount of sun that falls on one square metre) is dramatically higher during the summer in the UK.

So, on the one hand, we have a cash-strapped NHS that can’t afford new buildings that would allow them to save £‭20 billion in wasted energy per year, nor can they afford to refit their existing buildings to make them energy efficient because that’s even more expensive than building new, energy compliant hospitals and administration buildings.

Should the UK continue to throw good money after bad in the NHS, or should the government use taxpayer money to turn the NHS into a profit-making venture?

The answer couldn’t be clearer.


So Far, We’ve Talked About Saving £20 Billion Annually; But How Can the NHS Earn 10% Profit Annually?

Almost every developed country in the world has a universal healthcare system that charges their citizens a monthly healthcare insurance premium.

In Canada, that premium tends to be $65.00 – $100.00 per month/per adult — although some provinces in Canada pay the monthly premiums for their residents out of general (tax) revenue.

Here’s the monthly healthcare insurance premiums in the province of British Columbia, Canada:

BC monthly healthcare insurance premium chart 2018

BC monthly healthcare insurance premium chart 2018. Image courtesy of the British Columbia Medical Services Plan. Click the image to visit their website.

Yet, as reasonable as those premiums are, the full cost of care is covered by the Medical Services Plan (MSP) whether those injuries/sudden onset disease/chronic disease or other maladies befall the patient while in British Columbia or anywhere else in Canada — or while travelling abroad.

Further, whenever wait times for patient care become extended within the BC (MSP) system, British Columbia’s Medical Services Plan authorizes Doctors and Surgeons to outsource patient treatment to Canada’s other provincial healthcare systems, or patients may be sent for treatment to the United States where MSP pays the full cost of treatment — even if said treatment costs more in the U.S. than it would in British Columbia.

Which is a typical model that developed nation healthcare systems follow.

Secret Ingredient #2 – Accepting Foreign Patients to Add Revenue to the NHS

Some developing nations also follow this model with their national healthcare systems (outsourcing and paying for medically necessary procedures they can’t perform in their own country, or when they can’t perform necessary procedures in a reasonable timeframe due to scheduling issues) and private insurers often shop for a better rate or timeframe for insured persons so that the patient receives expert and more timely care — which creates better healthcare outcomes for their clients.

So, why wouldn’t the UK government fund dozens of brand-new, state of the art, energy efficient NHS hospitals specially designed with additional capacity to accept planeloads of patients sent to the UK by foreign healthcare providers?

In that way, over time — and let’s be realistic, this is a 10-year programme to capture every possible foreign healthcare opportunity and payment from overseas healthcare systems — the NHS could begin to show a profit, thereby helping to subsidize the astonishingly high cost of providing healthcare services to Britons.

Even if accepting foreign patients earns the NHS only adds 5% to their revenues in year-5 of this proposal, that’s still 5% more funding than the NHS presently receives from the UK government.

Therefore, a massive new hospital spending programme is a sensible way to improve the NHS budget picture and help them fund the purchase of expensive diagnostic and other medical equipment. Not to mention better healthcare outcomes for Britons and for Commonwealth nation citizens who will travel to the UK to receive treatment paid-for by their respective healthcare insurer, whether private or public.

Let’s hope that British politicians are wise enough to see the value of such a proposition and that they’re larger than life — because that’s what it’s going to take to get the job done.

In previous generations British politicians were up to the challenges of their time; Wouldn’t it be great if this generation of UK politicians were up to the challenges of our time?

UK and 10 other countries, Health Care System Performance Rankings

UK and 10 other countries, Health Care System Performance Rankings 2018. International Health Policy Center. Image courtesy of the Commonwealth Fund.

The above chart demonstrates why foreign countries could and should send their overflow patients to the NHS… as every year since rankings began, the NHS has scored either #1 or #2 in the annual Commonwealth Healthcare Performance Rankings.


Next week, we’ll talk about doing a similar thing with the UK education system.

Have a great week, everyone!

Getting Brexit Done Will Allow the UK to Get onto ‘the Good Stuff’

by John Brian Shannon

‘What Could be Better than Brexit?’ You Ask

Once Brexit is completed, the UK will be perfectly positioned to sign free trade deals with every country in the world. Indeed, some countries are eagerly anticipating signing free trade agreements with the United Kingdom post-Brexit.

Here in Canada, free trade with Britain is viewed as nothing more than the natural and obvious progression in our centuries-old relationship, and Australia, New Zealand, Singapore and India see free trade with the UK as a true Win-Win situation where all sides benefit from membership in that free trading relationship.

But in the UK for some inexplicable reason, free trade with Commonwealth nations is seen as a long-shot, something Britons would like to have but feel is almost impossible, and some seem to think the UK is ‘unworthy’ of such treatment by other Commonwealth countries and their 2.3 billion citizens.

‘The British really need to get out more, and see the world for what it is instead of seeing it through the prism of an imperial guilt trip’ seems to be the prevailing wisdom in the former colonies.

Get out there, UK! And, welcome to the 21st-century. We need to trade with you.


The Post-Brexit Domestic Agenda

Once freedom is established across the land, the UK government can rightly turn its attention to how citizens are faring. Spending on the NHS, education, housing, the manufacturing sector, agriculture and transportation networks can be improved from the present (underfunded) model.

How? Easy!

Presently, UK taxpayers dutifully send their money off to the government, which then sends a substantial portion of it on to Brussels. And every month, UK taxpayers send £1 billion more than they receive back from the EU. Which, as you’ve guessed, means that UK taxpayers send £12 billion more annually to the EU than they receive in return.

With an extra £12 billion a year to spend on the NHS post-Brexit — that’s £230 million a week — the NHS would eventually recover from being cash-starved since 2010 or thereabout.

But if the government elected to spend that £12 billion per year on education — British students would be in for a world-class education where no student gets left behind and every one of them would receive a tuition-free PhD-level education or tuition-free trade-certificate education — just as many European and some South American countries already offer. What a great leg-up for the country! Every British student turns into a highly-educated intellectual or tradesperson with the relevant documentation to prove their dedication to their profession or trade.

Or, if the government decided to solve the UK housing crisis by building tens-of-thousands of low-income homes for Britons. Which (housing crisis) is in the process of being solved anyway, as thousands of EU citizens return to the continent prior to the final Brexit date — thereby freeing-up housing in the UK market — whether rental or purchased.


And similar applies to other sectors of the UK economy. Once Brexit finally happens, the UK will have an extra £12 billion to spend annually. How the UK government chooses to spend it, is down to the priorities of the post-election government.

One thing is for certain, leaving the EU will allow an extra £12 billion to be spent every year in the UK economy. Which means that ONE major problem can be solved per year (NHS, education, housing, manufacturing, agriculture, transportation networks, high taxation) but not ALL major problems at once!


The Piecemeal Approach is the Wrong Approach!

To my mind, dropping a few billion here and there throughout the economy in an attempt to please everyone… definitely ISN’T the way to proceed.

With an extra £12 billion, the next government should decide which problem to solve in year-1 (£12 billion) then, in year-2, another major problem can be nailed-down to a satisfying conclusion (the second £12 billion spend), and in the 3rd-year something else can be solved once and for all time with the third £12 billion spend.

Typically, democratic governments seek to please the largest number of voters by dispersing such economic windfalls (a £12 billion annual windfall in this case) relatively evenly throughout the economy. But in the UK, each major problem in the country could be permanently solved via a single-year £12 billion spend in each problem area.

And that should galvanize British minds into prioritizing the next 5-year spending round.


How Would YOU Spend It?

Maybe you’re an overworked healthcare worker. We know how you’d spend the money. And we don’t blame you. Thank you again! for all the great work you do saving lives and dramatically improving the lives of the sick and elderly with your fulsome commitment. We salute you!

Or, maybe you’re a social worker who sees lives being wasted because there aren’t enough entry-level jobs, or safe housing, or supports in place to help the young, the elderly, the infirm, or the marginalized, to help them progress out of their poverty-based existence. In such cases, even relatively small amounts of money can make a huge difference in their lives — lifting them out of poverty and into work in a matter of weeks.

Every country needs more taxpayers and lifting people from UC to employment results in a double benefit for the economy — instead of the government paying such people to basically stay alive until they’re needed in the workforce, those people will then begin to pay into the tax revenue stream. Entire towns and boroughs could be revolutionized by the addition of a relatively inexpensive 1-year spending programme to the mix.


Brexit Can Work for Farmers!

Maybe you’re a farmer/rancher worrying about your EU subsidies going away. (And they will) Of course it would be great if the UK government decided to pay you the same subsidies that you enjoyed when the UK was a member of the EU.

But even better solutions await.

Why grow a crop that doesn’t earn any money? Why continue to stay in the dairy business competing with the heavily-subsidized EU, U.S., and Canadian dairy industries? Maybe it’s time to switch gears and raise animals or grow crops that don’t need subsidies.

Or, maybe it’s time for you to rent your land to the utility companies for the installation of wind turbines for £4000. per year/per turbine? In that way, you’re earning income instead of waiting for government subsidies to suddenly fall, as we’ve seen over the decades.

In the case of wind turbine installations, most of your land remains available to you, it’s just that you lose the footprint of the turbine tower and the utility company needs a gravel access laneway to each turbine which translates to an average loss of 1-acre of land per turbine for the farmer.

Some land is too rocky to grow crops/graze cattle anyway, so that isn’t much of a loss in some cases. Certainly, receiving £4000. per year/per acre from a utility company in land lease fees beats all the work that goes into growing crops, only to gain £800. to £1200. per acre annually! And, as for grazing cattle or sheep on marginal land, an acre of that land might only be worth £60. to £100. annually to your farm. Or less.

Yes, you can tell that I love farmers and ranchers because I’ve devoted all this space to them. But it illustrates how Britons and the government need to think differently in the post-Brexit world.

Instead of competing against highly-subsidized countries (and bigger countries will always win as they have more taxpayers to pay those high subsidies) it’s time to change gears and switch towards a more sustainable and more profitable economic model.

Grow those high-demand/no-subsidy crops! Raise those animals that don’t require subsidies! Rent your less-productive farmland to utility companies for more profitable wind turbine or solar panel installations — where your profits aren’t decided in a closed-door backroom in the EU, America, or Canada.


Britons: Compete on Your Strengths, Not on Your Weaknesses!

In short, dear Britons, compete on your strengths and cease competing on your weaknesses against much larger and more highly-subsidized blocs. The degree to which you can succeed in that is the degree to which you, your family, and the UK itself, will prosper.

And in case I didn’t make it clear enough, above;

In a post-Brexit UK economy, innovation ruled by merit-based thinking is the best way for individual Britons, British families, and the UK to succeed.

Lead, Follow, or Get Out of the Way! Brexit 2.0 is Eleven Days Away

by John Brian Shannon

I have a question:

Why did almost one-million people protest in London on Saturday?

Apparently, almost one-million people turned-up to protest Boris Johnson’s Brexit 2.0 deal which was scheduled to be passed later in the day in the UK House of Commons.

But because it’s unwise to anger one-million protesters milling about on London’s streets… the vote was postponed until Monday, October 20th. Smart thinking!

Can you imagine the security nightmare and the damage to shops, double-decker buses, personal vehicles, and (possibly) to life and limb had the vote gone ahead and be approved with one-million hostile protesters waiting just outside the House of Commons?

A million revellers could cause a lot of damage — and played across the world’s TV screens, the entire scene would’ve made the UK look like a country that hadn’t yet come of age and still didn’t understand how democracy works.

I noticed some UK news outlets were trying to play-down the number of protesters, with some saying “thousands” or “tens of thousands”. But why do that? We all know that 16-million people voted against leaving the EU in 2016, and it’s probably safe to assume that 1/16th of them are still unhappy about the outcome of the EU referendum.

That’s how democracy works: Sometimes you win. Sometimes you lose.

But the time to expend all your effort to get the result you want, kids, is in the run-up to a vote, not after the fact.

And let’s face it, in a country of 66-million people you could raise one-million protesters against Vegemite-on-toast if you were as well-financed as that particular Remainer cohort.

I can hear the shouts rising to a crescendo: “Taxi Drivers Against Vegemite!” and chants of, “Vegemite, OK!… Toast, OK!… But No Vegemite On Toast!… HEY! HEY!”


I have a message for yesterday’s anti-Brexit protestors:

Are you aware that on June 23, 2016 Britons voted to leave the EU (the 1st ‘People’s Vote’ on Brexit) and that British MP’s voted 498-114 to leave the EU on February 1, 2017, and that on June 8, 2018 Theresa May won a General Election a.k.a. the 2nd ‘People’s Vote’ (as a General Election is the purest form of a ‘People’s Vote’) an election in which all parties campaigned on a promise to deliver Brexit?

And, are you aware that the EU’s own Jean-Claude Juncker, the EC’s Donald Tusk, the EU’s Chief Brexit Negotiator Michel Barnier, and every single head of government in the EU27 have agreed that the new Brexit deal proposed by PM Boris Johnson (Brexit 2.0) is the best way forward for the EU27?

If you think you’re working for the European Union when you’re protesting against Brexit 2.0, you’re not. EU leaders have accepted this deal. And they wouldn’t have accepted it… if it didn’t work for their EU27.

If you think you’re working for the UK, you’re not. A majority of Britons still want Brexit to happen according to recent polls.

If you think you’re working for democracy, you’re not. How can you be working for democracy when you’re seeking to overturn the democratic choice of The People?

You need to stop and think; Why are you trying to overthrow something that a majority of Britons voted for, what the UK government itself proposed to the EU, and what the EU/EC accepted as the best way forward?

So, who or what are you working for?

My guess is that 1/3rd of you are professional (paid) protestors who travel all over Europe protesting anything that pays your travel expenses (How do I know that? Because I see the same faces protesting in Paris, Berlin, London, and Dublin, and not just on the topic of Brexit!) another 1/3rd of you are associated with a UK political party that once voted for Brexit but since it now looks like it might actually happen they don’t want any part of it, and the last 1/3rd of you are simply poor losers since the 2016 referendum.

To the first-third I say: Enjoy!
To the middle-third I say: Support democracy instead!
To the final-third I say: Grow Up!

By the way, I strongly support your right to peaceful democratic protest. That’s not the issue here. Brexiteers are trying to understand you!


If I’m wrong and it’s simply a generational thing, then, please consider this line of thought:

The older generations built the country you now live in.

They did it with blood (wars) sweat (labour) and tears (several recessions) and they did it (mostly) without cars, air conditioning, computers, the internet, TV’s, the Chunnel, scheduled airline service, or hundreds of other things that we all take for granted these days.

Since the signing of the Treaty of Maastricht when the UK illegally joined the EU in 1993 (according to the UK constitution it is illegal to hand any amount of UK sovereignty over to any foreign power) Britons weren’t given a vote on EU membership.

And the first time that they did get a vote on EU membership, they voted to leave — mind you, that opportunity took 23-years to arrive! Which is hardly democratic.

If you study demographics or are equipped to do a Google search, you can see yourself that approximately 500,000 Britons die every year (mostly from old age) so you can extrapolate for yourself how many older people have died since the UK joined the EU. (500,000 per year x 23 years = 11,500,000 UK deaths since joining the EU)

Therefore, eleven million Britons died waiting for the chance to vote on whether they wanted to join the EU, or not. But nobody asked.

Surely most of them would’ve voted against EU membership as it contravened the UK constitution, nor did they want to be ruled from a continent that caused two world wars, and later, the Cold War (a consequence of WWII) which was also costly for UK taxpayers in blood and treasure.

In fact, all they ever wanted to do was to recover from war, from postwar poverty, and rebuild their broken lives and broken country.

Everything you see in the UK was built by them. Every road you drive on, every bridge you drive over, every airport you fly out of to Spain or Malta for your annual holidaymaking, and every major building in the country. And so much more.

So, who are you, who’ve yet to accomplish anything like that, to try to take away from what’s left of them and their families, the opportunity to have a real vote for or against membership in a foreign political bloc?

And while I agree that it was a fine thing for the UK to join the EEC in 1973 (the EEC was a trading union, not a political union like the EU) it’s even better from a democratic perspective that Britons were able to vote on EEC membership within 3-years of joining.

Nothing wrong with trying it out for a couple of years so that Britons could see if it was a good or bad thing for them! In 1975, UK citizens voted enthusiastically to join the EEC and it did a world of good for both the UK and continental Europe.

In any event, Britons voted to leave the EU in 2016, the UK Parliament voted to leave the EU in 2017, and the UK held a General Election where all parties ran on a platform to deliver Brexit (and a pro-Brexit party did win on June 8, 2018) and EU and EC leaders have approved Prime Minister Boris Johnson’s Brexit 2.0 deal, and now a relatively small number of British MP’s suddenly have ‘cold feet’ after campaigning for Brexit in 2016, 2017 and in 2018.

So, again, who are you… to try to overthrow the will of the UK people as expressed in 2016, the will of Parliament which voted for the European Union bill in 2017, the will of the present UK government which won an election in 2018 based on their promise to deliver Brexit, the will of the EU leaders and negotiators, and the will of the leaders of the EU27 countries?

Who are you? And why do you hate democracy?

Please tell us in the comments below — we’re genuinely interested to know.

As always, abusive comments won’t be published.