The American Kaiser Permanente model of healthcare is the acknowledged template for the controversial NHS and social care changes that are hitting Calderdale and Huddersfield, as well as the rest of England.

In this American model, so-called Health Maintenance Organisations  (HMOs) provide relatively low-cost health services that are based on short hospital stays and cherry-picking patients with health care needs that are not too costly.

In 1971, when the Nixon administration was looking for ways to cut the costs of healthcare, White House domestic affairs adviser John Ehrlichman explained to President Nixon why he should promote the Kaiser Permanente system of healthcare:

“All the incentives are toward less medical care, because the less care they give them, the more money they make.”

This was enough to persuade Nixon that HMOs were the future for American healthcare.