Jul 29, 2026 · 37 min · 11 segments
Andy Burnham has set out plans to fix England’s struggling social care system - promising a new National Care Service, cross-party talks and a review designed to tackle a system he says is no longer…
Lewis GoodallHost
Ed ConwayGuest
Jon SopelHost
When he was health secretary at the tail end of the last, uh, Labour government, he tried to affect some reform.
By his own admission in the speech today, it was a bit too late in the day for that government.
He has signaled today, among other things, that he is potentially at some point willing to raise taxes to pay for a better elderly care system.
So what we have is basically a system where if you have a healthcare problem of almost any description or kind, the NHS, however imperfect it can be, and however sometimes you might have to wait for care and it's rationed or whatever, but ultimately you will be able to get some care free at the point of use.
Unless, of course, you end up with something like dementia or some other problem connected to your old age, and it means you have to move into a care home, where suddenly, unless you have assets of less than £23,000 or so, you yourself are expected to pick up the entire tab, which has led, has led to the financial ruin of many families.
And I think that it's just worth dwelling on, uh, the attempts to change the healthcare system in America, because if that's the comparison you're making, then the obvious kind of person you would compare Burnham to now is Barack Obama when he was trying to reform healthcare and introduced Obamacare, the Affordable Care Act, which, I mean, took a real political toll on Obama, uh, where, you know, he was saying that, "Look, we've got millions of people in America who don't have any health insurance at all, and unless they turn up in a hospital in an emergency room with an emergency, they're not gonna be treated essentially." And y- you have in America now people who, if they've got lousy insurance, still struggle to get the basics of, you know, if you need insulin because you're a diabetic and you haven't got the right insurance policy.
And the number of times I stood behind people in the queues at pharmacies where they would say, "Right, well, your, your insurance cover is, gives you so much, but you've still gotta pay $140 for this bit of medicine." And they'd say, "I haven't got $140." And the pharmacist says, "Well, I'm very sorry, then you can't have it." Now, Obama nearly kind of was taken apart by Obamacare.
However, Donald Trump has promised to reform it and change it, and actually it is an enduring symbol of Obama's success that the Affordable Care Act is still there, and that Republicans have not been able to find anything that would politically be as acceptable to so many Americans.
I mean, I thought that, um, comparison that he made with, with, uh, American healthcare was deeply interesting, not least because, exactly, John, it brought to mind exactly that sort of 2009, '10 period with, with Obama where there was huge public support for reforming healthcare, given that so many tens of millions of Americans were completely ineligible, basically, for healthcare.
In some cases, literally ineligible to even get insurance if they had preexisting conditions.
Perfectly legal for insurance companies to refuse to insure someone because they had a preexisting health condition, et cetera, et cetera, et cetera.
But it was used in those early days tremendously successfully by the Republicans, but also the Tea Party movement, which was incubating that time.
When he was health secretary at the tail end of the last, uh, Labour government, he tried to affect some reform.
By his own admission in the speech today, it was a bit too late in the day for that government.
He has signaled today, among other things, that he is potentially at some point willing to raise taxes to pay for a better elderly care system.
So what we have is basically a system where if you have a healthcare problem of almost any description or kind, the NHS, however imperfect it can be, and however sometimes you might have to wait for care and it's rationed or whatever, but ultimately you will be able to get some care free at the point of use.
Unless, of course, you end up with something like dementia or some other problem connected to your old age, and it means you have to move into a care home, where suddenly, unless you have assets of less than £23,000 or so, you yourself are expected to pick up the entire tab, which has led, has led to the financial ruin of many families.
And I think that it's just worth dwelling on, uh, the attempts to change the healthcare system in America, because if that's the comparison you're making, then the obvious kind of person you would compare Burnham to now is Barack Obama when he was trying to reform healthcare and introduced Obamacare, the Affordable Care Act, which, I mean, took a real political toll on Obama, uh, where, you know, he was saying that, "Look, we've got millions of people in America who don't have any health insurance at all, and unless they turn up in a hospital in an emergency room with an emergency, they're not gonna be treated essentially." And y- you have in America now people who, if they've got lousy insurance, still struggle to get the basics of, you know, if you need insulin because you're a diabetic and you haven't got the right insurance policy.
And the number of times I stood behind people in the queues at pharmacies where they would say, "Right, well, your, your insurance cover is, gives you so much, but you've still gotta pay $140 for this bit of medicine." And they'd say, "I haven't got $140." And the pharmacist says, "Well, I'm very sorry, then you can't have it." Now, Obama nearly kind of was taken apart by Obamacare.
However, Donald Trump has promised to reform it and change it, and actually it is an enduring symbol of Obama's success that the Affordable Care Act is still there, and that Republicans have not been able to find anything that would politically be as acceptable to so many Americans.
I mean, I thought that, um, comparison that he made with, with, uh, American healthcare was deeply interesting, not least because, exactly, John, it brought to mind exactly that sort of 2009, '10 period with, with Obama where there was huge public support for reforming healthcare, given that so many tens of millions of Americans were completely ineligible, basically, for healthcare.
In some cases, literally ineligible to even get insurance if they had preexisting conditions.
Perfectly legal for insurance companies to refuse to insure someone because they had a preexisting health condition, et cetera, et cetera, et cetera.
But it was used in those early days tremendously successfully by the Republicans, but also the Tea Party movement, which was incubating that time.
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Lewis tallies government spending promises and consequences
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