It is easy to see healthcare purely as a debate between the right and left as to how much should be spent on healthcare and how it should be spent. Easy, but lazy.
 
The left right analysis ignores other trends. Perhaps the most interesting is the rise of patient groups – the idea that the patient should be empowered, should be made the customer.

Interestingly, patient empowerment often leads to a bigger role for the private sector. Take Sweden where thanks to organizations such as the Independent Living Institute severely ill patients who need massive amounts of care now have the right to choose their care provider. Private providers say this has led to a massive expansion in the private sector as around half of all such patients opt for private providers.

Patient choice is set to revolutionise many sectors in Sweden giving patients a choice of primary care provider, for instance. You can see the same trend elsewhere. The elderly in Finland are questioning rules which provide them with care homes only in their local municipality, which might leave them rotting many hundreds of miles from their offspring in Helsinki or Turku. And recent legal changes in Finland mean the severely handicapped there are likely to have similar rights to those enjoyed by Swedes. That could eventually create a market worth another EUR 1bn.

I think such movements are set to become far more powerful across Europe as patients become better informed. Take the UK. Today probably only 4% of seventy year olds were university educated, only a minority are web savvy and they automatically defer to healthcare professionals. In thirty years time, they will be far better educated and completely at home with the web. They will be fitter, more assertive and they will not put up with the appallingly low level of nursing care offered by the NHS.

Of course, the Brits are well-known to be Europe’s most ignorant healthcare consumers. Patients in Germany and France already have almost unlimited choice (often used badly). But everywhere choice will become something that patients feel they have a right to exercise. And patient groups and charities for the elderly will ensure that their voices are heard.

This has huge implications for the growth of the private sector.  It creates a new group of vociferous radicals who are colour blind when it comes to the ownership of healthcare assets.  And, once the principle of choice is established, it favours the more agile private players who are better at understanding and meeting consumer choice than lumbering public sector bureaucracies.