Trump’s remarks followed those made by the US Ambassador to the United Kingdom and Trump pal, Woody Johnson, earlier in the week.
Does President Trump want to take over and privatise the NHS, as Jeremy Corbyn has suggested? No.
Neither does the US want to limit the scope of services the NHS provides to UK citizens.
But many in the US want to see changes at the NHS and NICE and a possible post-Brexit trade agreement would be the most likely avenue for such a discussion.
'Privatisation' of the NHS
While Trump was in London, Corbyn said he and Labour oppose US involvement in the NHS.
However, some US companies are already working with the NHS, such as the Health Corporation of America (HCA), a large investor-owned hospital company based in Nashville, Tennessee, which runs some private services under contract with the NHS.
Optum, the health management/pharmacy benefit manager arm of US insurer United Healthcare, is already providing medication management services to the NHS.
Privatisation, in one form or another, is already happening.
But US healthcare firms would like to do more in the UK and they will likely seek ways to make their participation easier and more profitable in any trade agreement between the two nations.
Lobbying by big pharma
Big pharmaceutical companies are keenly interested in using a potential bilateral trade agreement to amend the health technology assessment process relied upon by NICE and the NHS to set drug prices in the UK.
President Trump has complained about European nations "freeloading" on much higher US drug prices, suggesting that Americans are underwriting much of the cost of research and discovery while Europe benefits from government-negotiated lower prices.
The Pharmaceutical Research and Manufacturers Association (PhRMA), the drug company lobby in the US, has urged government trade representatives to include changes to the health technology assessment process, valuation and pricing.
High prices for drugs remain a huge issue in American politics.
And while the US would like to see higher prices for drugs paid across the pond, it is also seeking to leverage the lower prices European health systems pay by indexing the price of some drugs in the US to those in the UK and elsewhere.
Pharma companies oppose such indexing, of course.
But Trump’s team argues that what they really want is a level playing field for drug prices which, in their mind, means higher prices in the UK and Europe and lower prices in the US.
Before he departed London, Trump suggested that his interest in the NHS is limited. He does want to see a trade deal between the UK and US, but doesn’t see the NHS as being on the table.
The US does not want to take over the NHS, but it is clear that healthcare, drug prices and access to markets will be a part of any post-Brexit trade agreement.
Al Jackson is a partner at Portland’s Washington DC office
Thumbnail credit: David Rose - WPA Pool /Getty Images
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