British Army is recruiting 12,000 men and women aged between 18 to 32 years to join their common army. They normally send an invitation letter to help easy processing of your VISA in Kenya.
Please note that Kenya is also a commonwealth country. Commonwealth countries are the ones that were ruled by the British during the colonial period
Qualification
- Residing in any commonwealth country from Africa and oversees
- Be between the age of 18 to 32 years
- You don’t need to have a VISA, they facilitate its processing
Importance
This is a very lucrative deal to serve the whole continent and be a queens soldier. You enjoy all the peace keeping missions and if you love traveling, this is your cup of coffee.
Besides military training, you receive other related professional training such as Medicine and Engineering
Application
Please click the link below to start your applications
Am ready for this seriously
here is the opportunity apply
This is not real – all applicants must be a BRITISH RESIDENT living in the UK.
Check the British Army Website
U are right…. U can’t apply while u are not British citizen or being lived there for 10+ years. I talked to the British Army Recruiting Centre and they confirmed that they are not recruiting Commonwealth citizens (Currently it is onhold)
Need this job seriously,it was my dream
This is my passion to be a soldier. Really need that job.
This is NOT REAL – you need to be a BRITISH RESIDENT which takes 5 years living in the UK
My dream job, kindly requesting for the chance. ready to serve
Am humblely requesting for the chance am aged 23 years odd from Kenya
greatg
I need this job.
Am Edwin working with hotpoint alliances limited but interested with this job please kindly enroll me on 0706428839
Like seriously? Apply yourself. If can’t follow simple instructions like apply then how can you be a soldier?
I wld like to work with you
I’m a 26years old I’ll be happy having my real talent job.
Am ready to serve. Make my dream came true.
I like being a solder.How can I get this job?
Am very much willing to join, being a soldier has been my dream Carrier.
Am from national youth service I love job.I have the passion of a soldier.Help me reach my dreams.
haye i am abdihakim adow also i am from national youth service
any asssistance who highly appreciated
Comment:This is my dream job kindly requesting for a chance.ready to serve
Interested
Looking forward to joining this force
am ready
Comment:
willing to join
That’s my dream job.I would like to get a chance
Interested
Interested
Comment:am in for this, seriously , contact me
Am ready for this job
Am will to get this chance and work for the world
I would wish to join
I’m much ready
Interested. 0722738982
My dream job am willing to join you
Am ready to join the force
I m 25year, with hieght of 5.8fits, Bieng a soldier is my dream, i will be greatfull to work with such vast oganaisation to realise my full dream, currently i m residing in Qatar and i m available willing and ready to join this force and work deligently . Thanks
I am very much interested, kindly consider me.
Am 25 years old,a nurse ,a blogger standing at 5’7 60kg this is definitely a job for me.I will be excited to hear from you.FInd me at kimunto2@gmail. Com 0710386388
Am interested
Interested
Very interested
I’m Samwel Kariuki 26years old being a soldier is my dream I have been in 4 recruitments but I have not yet got the chance ,,I’m a Kenyan citizen staying in Narobi I’m available and wiling to join the army because it has been my dream to be a miritaty man,,,,my number is 0720927854
Am 25years am ready for it Pliz help
Im willing to be part of the army
Comment:I hope I will get a chance.. I am very ready
Comment:My dream job
Comment:i am also very interested… to join
I am interested to join from Malawi this is Paul Kaduya eged 30 and single without children
I’m currently police officer
am interested
It has been one of my dreams and for this it is a true dream. Am ready
Comment:my dream carrier job please consider my request. thanks.0718383719.reside in Kenya.
Plz compare me thanks in advance
Comment:need that job .am from kenya
m definitely interested and millitary was my dream,have done SECURITY MANAGEMENT certificate level, and currently persuing FORENSIC and CRIMINAL INVESTIGATION diploma .any leads to get this job is highly appreciated
I need that opportunity
I need that job please
Am 27 years,currently working in kenya under Nps bt i would like to join britsh Army if concidered.
Interested and ready to join
Am humbly and willing to work, this my dream job, am waiting to here from you. Age 26 years.
Am interested and ready to work
Happy to work with You
Am interested,Am 5.7 feet tall.Being a soldier is my dream.please please consider me.Am ready to serve
Ready for the job
I’m 6 ft tall 22yrs old, I have been dreaming of working as a soldier and I will be delighted if given chance
I am 25years old a graduate and ready for the job…
I need this job
Am in dire need of this job.Please,I have ever looked forward to becoming a peace keeper.Thanks in advance for listening to me in advance
Am Nancy.
My email :nanciekilonzo
@gmail. Com
I have a passion for the forces.
Kindly consider me.
Regards.
Greetings.I have ever looked forward to becoming a peace keeper.Please consider me.Am Kenyan aged 29.I have the mentioned qualification.Thanks in advance.
I’m ready to serve our continent, to work with you and to follow all rules and respect everyone
I need this job please
Comment:
am Elias kimeli ready to join the job contacts is 0716799457
Im ever ready to serve.
Email me at paul5gichangi@gmail or whatsApp 0702399553
Am ready work as a soldier..am from Kenya
Interested
Please I have logged in but I have missed sponsor from UK ….can i get any help for am serious of it …..contact me via 0714894604
Am interested
Am interested,please consider me.
Need the job
Am edward from kenya and I like the job. When I get the job I will do it with my passion
Ready for the job please consider my request
Ready for the job please consider my request am 22 years
0792186864
Comment:am very interested, ready for the job.
Comment:am interested
I’m intrested in the recruitment and reday to work with you
Ready … Already undergone a paramilitary training
Always prepared
People under the advertisement there is a place written apply in red click that link and apply posting your interest here will not help with anything.
Interested and looking forward to working with you given the chance to be part of the army
am mwangi kimani currently working at kdf, am 32 yrs.at your service.
Comment:Am Kennedy Ayawo seriously looking forward this and may my fate land me on this chance.a kenyan citizen 23 years old .0791484569
Comment:am much intrested.
please I need a job
really interested in the army
Consider me 0722247989
I would love that job, I always dreamt of becoming a soldier, will be so grateful when accorded the chance
really need a job 0725793154
That’s been my dream all along,am 26years.please consider me thanks in advance.
it is with passion dat i serve d people
Am interested
I will be so happy and proud to work with the British army…have been logging for this, allow my dream come true
Am Joseph Masese from Kenya aged 28 a chef by proffession and am wiling to join the military
Am unable to apply via this link any other procedure please
Im pauline Okall ready for this-0798690540
interestd
Ready to serve
Good idea of recruiting young men and women from Africa!
Am john have worked with kenya defence forces for 5 years i would like to join you because that has been my dream
Am 6.2 feet aged 28
Ready for the role
Av 22yrx old.6.5ft tall Am interested in the job
Yani when the other Kenyans r leaving u guys want to join mmhhh
Am an ex-Siera Oscar Who served for 5yrs. Standing at 6ft. I definately need this chance. Contact me on 0741935866.
Interested
Seriously l need this job
Interested
I’m Otieno John of age 22yrs old and very much interested to join the army;currently I’m in National Youth Service of Kenya and wish to be faithful and serve the continent to my utmost ability
I would like to be considered during this recruitment and am ready to work a soldier and deployment to serve.
Am really eager to get this job
Am Eliud Mathenge this is my dream I have done some training with Nairobi, nanyuki ,Taekwondo club qualified black belt am humbled to have this job being a soldier is my dream
I’m Brian from kenya seriously seeking for chance to get an opportunity to British Army and have got all the qualifications that you need. My phone number is +254720774767
Ready to work with you
I do wish to join the military bt my God’s time not yet. I wish I can join ,I’m good in atretics and have done an trade based in welding and fabrication.
Am ready for the army
interested help me; am John Odera Oloo,Kenyan, ID 24410710,age 31years,phone 0727826621,height 5.7,weight 75kg
I’m willing to join. Still its my dream to be a,soldier.
I like it so much due to defend my country and others.
!Me too am medical engineer
Interested I am Henry 25 years old from kenya
Am Karisa Raphael charo a kenyan ate 23 and am interested to be a solidier will be grateful working with you
Interested in job, aged 27years.
I believe I am fit for all the training and to follow the rules, I want the job.
Interested
Comment Ready to serve the world
Ready fo the job it has been my dream since was young to serve with passion
Ready for the job
Comment:I believe this comes as a Surprise from God… #A peaceful world.
Please let me have the job so FYB will stop picking on me.
I work currently as a delivery driver, but do have army experience, you might remember the Iranian Embassy siege, I was second from the right.
Am Sylvester and am interested to join common wealth
Am 6.2feet tall..medically fit n am ready for tha job.. Being a soldier has been my dream….I’ll appreciated for ur feedback….am 25yrs old ..ready for instructions
How do u sign up
being a soldier is alwaysy dream ,,,, am ready to meet my dream thank you..
AMONG
AM about 5.3fit and ready to work with you thank you,,,,
Am pleased i really need this ,this has been my dream job ,looking forward for your positive response
Am humbly and in need of the job ,being soldier has been my dream since i wad fourteen years but current am twenty six years,am looking forward for your positive response
Am 28 years old, physical fit with bsc. I have Worked in security firm for more than 9 years. Ready for your interviews
Am 28 years old male, holds bsc, worked in security firm for more than 9 years old. Physicallly fit and ready to work responsibly with british army
I’m really in need of that job.
Am currently unemployed an will be willing to serve for the British army may contact me @3856730 thanks in advance.
Apply the damn job Esther than post interests here… you guys have already failed by not applying dah😟
Am ready
dreams are valid
willing to join so badly
Am ready for it
I want to join it this is my dream job looking forward to here from you
does this mean you’ll be posted in africa?
I have applied for regular soldier two days ago ad waits for your response. I’m currently serving police officer with paramilitary training and a driving experience from KIHBT.
My dream job. 0721502572
Comment:So much ready for the great chance, kindly enrol me. 0719284749
Being in the force was my dream job please make my dream come true . I will really appreciate 0792198892.looking forward for your feedbacks ,hope you will count me in!
I am ready to be a strong worker
I have problem registering
am joseph mwanza a kenyan aged 23 I will be huppy to gete this job
am a kenyan I have 23 years old ready to train as a solder
This has been my dream job since my childhood. Please consider me am ready to serve
Am ready for work with you
Am ready to work you
I need the job seriously I look forward working with you
Ready for the job
Interested too
I like to know more about this job, like where, duration, salary structure etc
Am Margaret mbeyu complete my studies at national youth service,its my dream to be a soldier plz add me and am 25yrs old 60kg 5.4height.
Am Margaret mbeyu complete my studies at national youth service,its my dream to be a soldier plz add me and am 25yrs old 60kg 5.4height.0707061342
Interested
I’m interested
I want to serve and get a new life ..
HOW DO WE APPLY
I realy need this job am 25 please consider me
Am willing to join and work for the world
am interested
Am very interesting and ready for that job, please consider me
Willing to serve.0703903396.kindly count mi in.
I ready for the job
Am 25yrz somali Ready for the work
Ready for it
I am 27 year am very serious in join the british army
Am 26 years and ready for the job please contact 0717178769
I’ll gladly love to serve our country and our queen..
Interested
I have always wanted to be an army,please this is my opportunity and my dream job
I’m interested
I’m from Grenada 🇬🇩,25 years old
Comment:fuck that, aint gonna serve no queen.
let her return what they have been stealing from us since colonial days
Am called Evans Cheruiyot from kenya,,, aged 20 am ready to work with you
Interested too,please do favour I am in need of it
I am a Kenyan aged 30.I have a valid passport n looking forward to seek a job overseas.n I am here to table my humble request to join my dreamcome true job.im ready to table my CV.yours faithfully Guchu Mwangi.
Please am in need of it
Comment:Woouw I real love this job
Ready for the job
Willing to serve the Queen to my fullest.I would like to be apart of the UK’s army
Am aged 28.my country is Kenya readty for the job Army.
Am Andrew munyambu form 4 leaver d- am interested with this job please if I get this job I’ll be hones also I have driving licence stubed class C,E,G,B,F thank you
I’m very interested in the job
Am Andrew munyambu form 4 leaver d- age 21yrs kenyan by birth am interested with this job please if I get this job I’ll be honest also I have driving licence stubed class C,E,G,B,F thank you
do i really need a sponsor because i can’t go further without that detail
This has been my dream job….humble that I will be 1 of the chosen ones …Thanks in advance 0723304697 in +254 Aged 26yrs.
It a fake news.The commonwealth application is closed till further notice
Comment: am Allan ready to serve the country
signs
I really need the job, and am ready to work with you.
Would like being apart its a opportunity i always wanted
I am from Guyana south Africa ….could I still join ???
Wish i could have the opportunity
An 100% willing to join the royal army. Hope this come true! Pls I am not seeing any link for the application form. Could anyone help me with it. Thanks and God bless.
32yrs n 10yrs service same field
im ready to work hard
I will joined this job thank god,0246283331
Am very ready
Comment:Am 24 years and cm ready to work with you. please contact me through +2540702899459
Comme
nt:ni raymond working with thé kenya prison lon
ging to join that please
ready to serve in the military plz consider me
I’m ready to server in all nation I’m happy to get that opportunity
Ready for that opportunity
I am ready and willing to join the army
Am a kenyan citizen aged 31yrs, willing to work in soldier department, its my dream. please enroll me. my contact 0720850606
Am interested, So count me in.
Very ready,its my dream career.
Am interested..
So serious with the job
It’s my pleasure to serve the British nation and a dream come true
Interested. What’s the process
So much Interested. What’s the process?
Am ready for the job
I am serious about this job
My name is kevon hazzard
Contact information:14734235425
14734431897
Comment:ready
I am very commited in joining the the British army where by am situated in Kenya Nanyuki town,and I promise to deliver with great Passion, it will be good favour to me us i get the job so that I will be able to rescue my family to poorness. May God bless British Army, thank you very much.
Am really in need of being soldier
Where can I sign up and will they come for people that want to join
I am well interested with the jop and to cooperate with my fellow work mates hand to hand in keeping peace and harmony in the world
invest 25 USD earn 5% daily goo.gl/2MmyWu
Ready for entering Queen’s Army and to serve her with all my heart.I am Rwandese.
I have learned to love and serve all my life,its not bout just getting the job and making money its about putting someone eles life before yours ,question to myself im i ready to do this and why :response yes why there are a lots of people out there whom people take advantage of and are helpless if i could make a difference then am ready to do so
question to myself im i ready to do this and why :response yes why there are a lots of people out there whom people take advantage of and are helpless if i could make a difference then am ready to do so.
Its been my dream to become an army… I’m ready for the job
Comment:Hellow I have applied for this post for awhile now but I get no response would really love to join the Army please consider me…I’m highily qualified with paramilitary skills I can be of good service Thank you….
Great opportunity to undertake without any form of delay.Serving the interest of Britain as an army personnel is always my dream as a patriotic commonwealth citizen.I am therefore optimistic.
Am Gabriel Karuru willing to join the forces,
Comment:am BARASA ERICK SIMIYU from Kenya. am really willing to get that chance. kindly award me
Comment:Hellow I have really tried to apply for this post for a while and I would really love to serve in the Army…please consider me Thank you
Am ready for the job am 6.2f
Well physically fit.
Strong
Smart mind
22 years of age
I will highly appreciate if I get a chance to work for the British side
Am Hesborn okemwa from Kenya, 24 Years Old.currently am working Doha,Qatar as a Security Guard. Kindly this was my dreams. I am ready for the job..This is my Number +97430558727.
Am Hesborn Ontuga 24 Years old.am a Kenyan currently working as A Security Guard in Doha,Qatar. Am ready for the job plz..This is my number: +97430558727
Im willing to join from nigeria
Am ready serve.look forward and consider me.I have 22 ,years.Kindly contact me through 0792003906
I am already miletry traid so this will be a gud opportunity for me Scen I have a diploma in physical training and Education instructor course an 6 others course under my belt like #1 brill instructor…..is my contact # 592.663.5815
Does this apply for those in Fiji islands too??
Reference number 18654982
Am ready for the job because my passion belong to KDF very interested indeed..Plz considered me.thankz
Wow,praying I get this offer.really interested. nanafordjourmichael@yahoo.com.
A dream come true,if granted this opportunity in my life!!…truly am interested!!
I’m not that much of a internet reader to be honest but your sites really nice,
keep it up! I’ll go ahead and bookmark your site to come
back in the future. All the best
im willing to join .my contacts 0775776941
I am much interested in this.It has always been my dream to become a soldier .
Interested with the job kindly give me one im ready for it
Ready for the drivers job
Comment:its a Surprise from God.. I believe
The passionate dream job I’ve waiting for
Need this job so much…it will be my dream come true n I bliv I’m worth it…BLESS
I’m Pauline Akinyi Onyango kenyan citizen I’m highly Interested in being military soldier girl I’ve been looking for this job since I left school . I’m highly interested and able to work under no one supervision.
The British Army is not recruiting Kenyans or commonwealth soldiers unless they are British Residents and have lived In Uk over 5 years.
Pauline Onyango very happy to be a soldier girl please give me a chance.
Willing to be among to maintain peace worldwide
Comment:Yes am ready for that job.
The World is full of wrong People and this is the time to get rid of the wrong one and we let the World be a better Place to live in
I’m ready to serve the People of the World to let it be a better Place
Am realy interested in this job i am a kenyan soldier and i belive i can make it in british army.My age is 26 years
Contact me on ” adestiekito53@gmail.com ” ASAP… I’m from the Solomon Islands…
I am ready to work with you, however I am trying to register and am unable. Every time I try they are telling me that there is a problem. I also tried calling a number that I got for your office and nothing still. 1-876-782-9294 is my number…..
Comment:I am ready to serve in Military for peace keeping
Interested in the job
I have the passion to be one of them…consider me please
Interested with the job i have that soldier heart.
Please remove this page. I represent the British Army Training Unit Kenya. This advert is incorrect and we know of cases where this is being used to cheat people of money.
Am interested..count me in
Am in
Am 27 years old, fit and ready for the job. +234-8162136466
Comment:ready and concern
Iam very intrested with all Qualifications with added advantages
I will love to be a member of the British army I’ll do whatever it takes to join this department I’ll be greatful for your assistant
kindly guys apply on the link provided above..
Am happy with it waiting for your reply thanks in advance
Ready
Am ready to serve the whole world if given the job since this was my dream job.
Am ready to serve the world
Hi I am interested in joining the army am ready when you’re ready please contact me
Hi am ready to join your team am willing to work with the army
Am ready 22yrs
I’m 25 and I’d like to be a queen’s soldier
Ready to join
looking forward to work with you.
Looking forward to work with you
am ready for the job
Am 27 yrs and am willing to join
Please contact me on 0738055121
Am ready for the job
Ready for the job
Interested in job. Aged 27 years.
Interested in job, aged 27 years.
Wow if it’s dependable am in and ready to serve around the world
I like the profession. Pls help me to reach my dream.
Am 27yrs ready to train as a solder.
Am ready to join or for the job.Am in Ghana
Iam ready for the job, I have a higher diploma in Intelligence and Forensic management.Thanks in advance
I am intrested
14735384545
Comment:i am a kenyan citizen aged 23 years, iam really passionate about the job but I tried to apply, registered but still I didn’t have the address for the UK. Please help me
on this matter
Very determined
am 27 yrs at age and
am ready to train as a soldier
Much interested in army work
I applied for the British army and lam very much interested ,l think God will answer my prayers.
Very interest
Really need this job
Intrested.
Any other requirements needed?
This is a very very…………great career!!!!…..Am very Intrested about this……career. I would love to be part of this opportunity……I will make the best out of this opportunity.I have the passion it takes for this career.
Am ready..for the job
Ready for the job like yesterday
Will like to join
I have applied a few times please consider my request and help me fulfill my dream.
I’m very interested this Is my dream job I have always wanted to be an soldier I’m very grateful for this opportunity
Comment:i would like to get this opportunity to be in the army.it has been my dream
Ready for the job .
I am interested to join this opportunity
I am serious about this am willing to work within your metaphor and comply with your rules and regulation
Wow great
22yrs old lady with all qualities of being solder
Passionate about the job are ready for it.
Ready please
Ready
I’m a Kenyan aged 18,a male of height 6fit tall,I finished my highschool School education 2016.I am interested to work in the British army.
I would like to be enrolled in this job
Ready
Ready for the job to defend my continent
Am very grateful to have this opportunity to look forward to have this job.
I have faith in this job and I wish to be part of those who will take and work with it
Am willing to to work within your metaphor and comply with your rules and regulations and accept it.
Am a guy of 20 years and am serious about the work
This is my number +233554257313 and am serious about the work
I see you don’t monetize your page, don’t waste your
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For the your short list, please consider me.This is my dream from the past years ago, up to now. I want to be a soldier please help me to be the one of the short listed.am willing to work in all environment.
Am leady to join. To being a solder
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Comment:interested and ready
cell no.0710551075
Interested and ready to join.Joseph Ngei.looking forward to be considered. Tanks.
Interested and ready to join.Joseph Ngei.looking forward to be considered. Tanks.
Why are commonwealth countries not allowed at the moment yet you wrote that you recruit all anyone from commonwealth countries in Africa and overseas, and when will you be recruiting within commonwealth countries?
Interested and ready to join.will glad to b considered. Thank you.Joseph Ngei.
Comment:Ready
Comment:Am ready
Comment:Ready for it
Comment:ready
something i always dream of doing
Im from Belize ..age 22 ..already have my associates degree in Sociology & Economics and this is something I always dream of doing .
Much interested am 24yrs if I may get a chance much appreciate
Comment:Ricky wajewa age 26,serving th
e NYS it is my wish to join the British Army.
Am only 19 years ready to serve if given a chance
I love the job but am not sure about it, help me
Comment: I really looking for this position as is a part of my dream I’m
23yrs and I’m ready to do it.
I really looking for this position as is a part of my dream I’m
23yrs and I’m ready to do it.
Comment:To delight in war for peace is a merit in the soildier.i pray to God that he gives me this Chance.
First, let’s get a little historical perspective on American health care. This is not intended to be an exhausted look into that history but it will give us an appreciation of how the health care system and our expectations for it developed. What drove costs higher and higher?
To begin, let’s turn to the American civil war. In that war, dated tactics and the carnage inflicted by modern weapons of the era combined to cause ghastly results. Not generally known is that most of the deaths on both sides of that war were not the result of actual combat but to what happened after a battlefield wound was inflicted. To begin with, evacuation of the wounded moved at a snail’s pace and this caused severe delays in treating the wounded. Secondly, many wounds were subjected to wound care, related surgeries and/or amputations of the affected limbs and this often resulted in the onset of massive infection. So you might survive a battle wound only to die at the hands of medical care providers who although well-intentioned, their interventions were often quite lethal. High death tolls can also be ascribed to everyday sicknesses and diseases in a time when no antibiotics existed. In total something like 600,000 deaths occurred from all causes, over 2% of the U.S. population at the time!
Let’s skip to the first half of the 20th century for some additional perspective and to bring us up to more modern times. After the civil war there were steady improvements in American medicine in both the understanding and treatment of certain diseases, new surgical techniques and in physician education and training. But for the most part the best that doctors could offer their patients was a “wait and see” approach. Medicine could handle bone fractures and increasingly attempt risky surgeries (now largely performed in sterile surgical environments) but medicines were not yet available to handle serious illnesses. The majority of deaths remained the result of untreatable conditions such as tuberculosis, pneumonia, scarlet fever and measles and/or related complications. Doctors were increasingly aware of heart and vascular conditions, and cancer but they had almost nothing with which to treat these conditions.
This very basic review of American medical history helps us to understand that until quite recently (around the 1950’s) we had virtually no technologies with which to treat serious or even minor ailments. Here is a critical point we need to understand; “nothing to treat you with means that visits to the doctor if at all were relegated to emergencies so in such a scenario costs are curtailed. The simple fact is that there was little for doctors to offer and therefore virtually nothing to drive health care spending. A second factor holding down costs was that medical treatments that were provided were paid for out-of-pocket, meaning by way of an individuals personal resources. There was no such thing as health insurance and certainly not health insurance paid by an employer. Except for the very destitute who were lucky to find their way into a charity hospital, health care costs were the responsibility of the individual.
What does health care insurance have to do with health care costs? Its impact on health care costs has been, and remains to this day, absolutely enormous. When health insurance for individuals and families emerged as a means for corporations to escape wage freezes and to attract and retain employees after World War II, almost overnight a great pool of money became available to pay for health care. Money, as a result of the availability of billions of dollars from health insurance pools, encouraged an innovative America to increase medical research efforts. More Americans became insured not only through private, employer sponsored health insurance but through increased government funding that created Medicare and Medicaid (1965). In addition funding became available for expanded veterans health care benefits. Finding a cure for almost anything has consequently become very lucrative. This is also the primary reason for the vast array of treatments we have available today.
I do not wish to convey that medical innovations are a bad thing. Think of the tens of millions of lives that have been saved, extended, enhanced and made more productive as a result. But with a funding source grown to its current magnitude (hundreds of billions of dollars annually) upward pressure on health care costs are inevitable. Doctor’s offer and most of us demand and get access to the latest available health care technology in the form of pharmaceuticals, medical devices, diagnostic tools and surgical procedures. So the result is that there is more health care to spend our money on and until very recently most of us were insured and the costs were largely covered by a third-party (government, employers). Add an insatiable and unrealistic public demand for access and treatment and we have the “perfect storm” for higher and higher health care costs. And by and large the storm is only intensifying.
At this point, let’s turn to the key questions that will lead us into a review and hopefully a better understanding of the health care reform proposals in the news today. Is the current trajectory of U.S. health care spending sustainable? Can America maintain its world competitiveness when 16%, heading for 20% of our gross national product is being spent on health care? What are the other industrialized countries spending on health care and is it even close to these numbers? When we add politics and an election year to the debate, information to help us answer these questions become critical. We need to spend some effort in understanding health care and sorting out how we think about it. Properly armed we can more intelligently determine whether certain health care proposals might solve or worsen some of these problems. What can be done about the challenges? How can we as individuals contribute to the solutions?
The Obama health care plan is complex for sure – I have never seen a health care plan that isn’t. But through a variety of programs his plan attempts to deal with a) increasing the number of American that are covered by adequate insurance (almost 50 million are not), and b) managing costs in such a manner that quality and our access to health care is not adversely affected. Republicans seek to achieve these same basic and broad goals, but their approach is proposed as being more market driven than government driven. Let’s look at what the Obama plan does to accomplish the two objectives above. Remember, by the way, that his plan was passed by congress, and begins to seriously kick-in starting in 2014. So this is the direction we are currently taking as we attempt to reform health care.
Through insurance exchanges and an expansion of Medicaid,the Obama plan dramatically expands the number of Americans that will be covered by health insurance.
To cover the cost of this expansion the plan requires everyone to have health insurance with a penalty to be paid if we don’t comply. It will purportedly send money to the states to cover those individuals added to state-based Medicaid programs.
To cover the added costs there were a number of new taxes introduced, one being a 2.5% tax on new medical technologies and another increases taxes on interest and dividend income for wealthier Americans.
The Obama plan also uses concepts such as evidence-based medicine, accountable care organizations, comparative effectiveness research and reduced reimbursement to health care providers (doctors and hospitals) to control costs.
The insurance mandate covered by points 1 and 2 above is a worthy goal and most industrialized countries outside of the U.S. provide “free” (paid for by rather high individual and corporate taxes) health care to most if not all of their citizens. It is important to note, however, that there are a number of restrictions for which many Americans would be culturally unprepared. Here is the primary controversial aspect of the Obama plan, the insurance mandate. The U.S. Supreme Court recently decided to hear arguments as to the constitutionality of the health insurance mandate as a result of a petition by 26 states attorney’s general that congress exceeded its authority under the commerce clause of the U.S. constitution by passing this element of the plan. The problem is that if the Supreme Court should rule against the mandate, it is generally believed that the Obama plan as we know it is doomed. This is because its major goal of providing health insurance to all would be severely limited if not terminated altogether by such a decision.
As you would guess, the taxes covered by point 3 above are rather unpopular with those entities and individuals that have to pay them. Medical device companies, pharmaceutical companies, hospitals, doctors and insurance companies all had to “give up” something that would either create new revenue or would reduce costs within their spheres of control. As an example, Stryker Corporation, a large medical device company, recently announced at least a 1,000 employee reduction in part to cover these new fees. This is being experienced by other medical device companies and pharmaceutical companies as well. The reduction in good paying jobs in these sectors and in the hospital sector may rise as former cost structures will have to be dealt with in order to accommodate the reduced rate of reimbursement to hospitals. Over the next ten years some estimates put the cost reductions to hospitals and physicians at half a trillion dollars and this will flow directly to and affect the companies that supply hospitals and doctors with the latest medical technologies. None of this is to say that efficiencies will not be realized by these changes or that other jobs will in turn be created but this will represent painful change for a while. It helps us to understand that health care reform does have an effect both positive and negative.
Finally, the Obama plan seeks to change the way medical decisions are made. While clinical and basic research underpins almost everything done in medicine today, doctors are creatures of habit like the rest of us and their training and day-to-day experiences dictate to a great extent how they go about diagnosing and treating our conditions. Enter the concept of evidence-based medicine and comparative effectiveness research. Both of these seek to develop and utilize data bases from electronic health records and other sources to give better and more timely information and feedback to physicians as to the outcomes and costs of the treatments they are providing. There is great waste in health care today, estimated at perhaps a third of an over 2 trillion dollar health care spend annually. Imagine the savings that are possible from a reduction in unnecessary test and procedures that do not compare favorably with health care interventions that are better documented as effective. Now the Republicans and others don’t generally like these ideas as they tend to characterize them as “big government control” of your and my health care. But to be fair, regardless of their political persuasions, most people who understand health care at all, know that better data for the purposes described above will be crucial to getting health care efficiencies, patient safety and costs headed in the right direction.
A brief review of how Republicans and more conservative individuals think about health care reform. I believe they would agree that costs must come under control and that more, not fewer Americans should have access to health care regardless of their ability to pay. But the main difference is that these folks see market forces and competition as the way to creating the cost reductions and efficiencies we need. There are a number of ideas with regard to driving more competition among health insurance companies and health care providers (doctors and hospitals) so that the consumer would begin to drive cost down by the choices we make. This works in many sectors of our economy but this formula has shown that improvements are illusive when applied to health care. Primarily the problem is that health care choices are difficult even for those who understand it and are connected. The general population, however, is not so informed and besides we have all been brought up to “go to the doctor” when we feel it is necessary and we also have a cultural heritage that has engendered within most of us the feeling that health care is something that is just there and there really isn’t any reason not to access it for whatever the reason and worse we all feel that there is nothing we can do to affect its costs to insure its availability to those with serious problems.
OK, this article was not intended to be an exhaustive study as I needed to keep it short in an attempt to hold my audience’s attention and to leave some room for discussing what we can do contribute mightily to solving some of the problems. First we must understand that the dollars available for health care are not limitless. Any changes that are put in place to provide better insurance coverage and access to care will cost more. And somehow we have to find the revenues to pay for these changes. At the same time we have to pay less for medical treatments and procedures and do something to restrict the availability of unproven or poorly documented treatments as we are the highest cost health care system in the world and don’t necessarily have the best results in terms of longevity or avoiding chronic diseases much earlier than necessary.
I believe that we need a revolutionary change in the way we think about health care, its availability, its costs and who pays for it. And if you think I am about to say we should arbitrarily and drastically reduce spending on health care you would be wrong. Here it is fellow citizens – health care spending needs to be preserved and protected for those who need it. And to free up these dollars those of us who don’t need it or can delay it or avoid it need to act. First, we need to convince our politicians that this country needs sustained public education with regard to the value of preventive health strategies. This should be a top priority and it has worked to reduce the number of U.S. smokers for example. If prevention were to take hold, it is reasonable to assume that those needing health care for the myriad of life style engendered chronic diseases would decrease dramatically. Millions of Americans are experiencing these diseases far earlier than in decades past and much of this is due to poor life style choices. This change alone would free up plenty of money to handle the health care costs of those in dire need of treatment, whether due to an acute emergency or chronic condition.
Let’s go deeper on the first issue. Most of us refuse do something about implementing basic wellness strategies into our daily lives. We don’t exercise but we offer a lot of excuses. We don’t eat right but we offer a lot of excuses. We smoke and/or we drink alcohol to excess and we offer a lot of excuses as to why we can’t do anything about managing these known to be destructive personal health habits. We don’t take advantage of preventive health check-ups that look at blood pressure, cholesterol readings and body weight but we offer a lot of excuses. In short we neglect these things and the result is that we succumb much earlier than necessary to chronic diseases like heart problems, diabetes and high blood pressure. We wind up accessing doctors for these and more routine matters because “health care is there” and somehow we think we have no responsibility for reducing our demand on it.
It is difficult for us to listen to these truths but easy to blame the sick. Maybe they should take better care of themselves! Well, that might be true or maybe they have a genetic condition and they have become among the unfortunate through absolutely no fault of their own. But the point is that you and I can implement personalized preventive disease measures as a way of dramatically improving health care access for others while reducing its costs. It is far better to be productive by doing something we can control then shifting the blame.
There are a huge number of free web sites available that can steer us to a more healthful life style. A soon as you can, “Google” “preventive health care strategies”, look up your local hospital’s web site and you will find more than enough help to get you started. Finally, there is a lot to think about here and I have tried to outline the challenges but also the very powerful effect we could have on preserving the best of America’s health care system now and into the future. I am anxious to hear from you and until then – take charge and increase your chances for good health while making sure that health care is there when we need it.
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