Mark Steel: Sign up now and win a heart bypass!

It rests on the premise that society can't provide adequate care without a profit motive

At last this Bill has been passed, to enable our Health Service, the envy of the world, to become more like the American system, universally derided as a chaotic disaster. Now they can introduce bills to make our ferry service more like the one in Italy, and our record on child abuse more like that of the Vatican. It takes inventive thinking to hear that in the US, drugs companies spend twice as much on advertising as they do on research, and say, "That's MARVELLOUS, why can't WE do that"? Because, instead of expensive anaesthetics and medicines which no one can be sure make any difference, there's nothing like a cheery advert with a smiley doctor to ease away your leukaemia and get you running about.

One of the strange facts to emerge from the debates around this bill is that nearly all the medical side of the Health Service has opposed it, but those who stand to make money out of it have supported it. Isn't it strange how these statistical quirks are thrown up that no one can explain? If you were cynical, you might suggest that private companies sometimes show more concern for making a profit than taking pride in their service. But I'm sure at AGMs of health companies, the CEO announces, "This has been a marvellous year for our company. We didn't make a penny so there are no dividends, I'm afraid, but you should have seen the looks on people's faces once we'd removed their gallstones, that was a dividend in itself."

There's no alternative, apparently, to this vast extension of private finance because, as with everything else, "It's the only way to attract investment." The argument rests on the premise that society can't provide adequate healthcare without a profit motive. In this case, first aid courses should be amended, so the instructor says, "What's the first thing you do if a child is bleeding profusely? No, before the tourniquet, ask them how much they're willing to cough up. If you get a decent offer, stop the bleeding, give them some fruit and let them watch your telly for another three quid. Otherwise, you're being a fool to yourself to bother."

So private companies are now free to bring in fresh ideas to raise finance. People with weak hearts can be offered deals such as 20 pumps on the chest and two jolts of a defibrillator per month on a 12-month contract, PLUS a monthly entry into a draw to win a bypass. Tourette's sufferers can be sponsored so, instead of being cured, they'll receive £3 a day for shouting "DFS sofas" at random moments. And when a documentary exposes a ward in which old people were left for eight hours face down in a bowl of soup, the managing director can explain, "We are deeply ashamed at this dreadful waste of soup." No wonder ministers banged their fists on the table as it was passed. They can't believe they're getting away with this stuff.