Donald Trump's habit of testing the US relationship with Britain took a new turn Monday when he attacked the UK's National Health Service, claiming it is "going broke and not working."
The US President hit out on Twitter minutes after a segment aired on Fox News that highlighted winter strains on the UK health care system. Trump accused Democrats of pushing a similar universal healthcare system for the US.
"The Democrats are pushing for Universal HealthCare while thousands of people are marching in the UK because their U system is going broke and not working. Dems want to greatly raise taxes for really bad and non-personal medical care. No thanks," Trump wrote.
Trump drew swift condemnation from Britain's Health Secretary Jeremy Hunt, who has been under fire for the government's handling of a winter health crisis that prompted a protest march in London at the weekend.
Tweeting back at the President, Hunt said he was "proud" of Britain's universal coverage, which allows patients free healthcare at the point of access.
"I may disagree with claims made on that march but not ONE of them wants to live in a system where 28m people have no cover," he tweeted, referring to the 28 million people in the US who lack health insurance.
"NHS may have challenges but I'm proud to be from the country that invented universal coverage -- where all get care no matter the size of their bank balance."
Asked about Trump's comments, a spokesperson for UK Prime Minister Theresa May said she was "proud" of Britain's health care system.
"The prime minister is proud of having an NHS that is free at the point of delivery," the spokesperson said, adding that NHS funding is "at a record high" and was prioritized in the fall budget with an extra -2.8 billion (about $3.9 billion.)
Trump, whose relationship with Britain and May has been punctuated by Twitter tussles, was also criticized by opposition Labour leader Jeremy Corbyn. "People were marching because we love our NHS and hate what the Tories are doing to it," Corbyn said, using a colloquialism for the Conservative Party. "Healthcare is a human right."
NHS funding is one of the most hotly contested topics in British politics and Trump's comments highlight a sensitive subject in the UK -- how to maintain universal access to health care at a time of rising costs and demand.
On the one hand, the system is creaking at the sames. Hundreds of non-emergency procedures were canceled amid a winter flu crisis which pushed the service to its limit.
However, it delivers far better outcomes than in the US, for less money. According to OECD data, the UK spends an average of $4,192 per head of population, for a universal system. Life expectancy in the UK in 2015 was 81.56.
The American healthcare system is the most expensive in the world: $9,892 per head, yet 28 million have no health insurance and life expectancy in 2015 was 78.7.
In the 2017 fall budget, the UK government announced -6.3 billion (about $8.2 billion) of new funding for the NHS in England, including -2.8 billion over the next two years for day-to-day services and -3.5 billion of capital investment by 2022-23.
But some commentators say there needs to be a fuller rethink. A 10-member panel set up by the Liberal Democrats, a centrist political party, has called for a ring-fenced tax to fund the NHS, stating that an extra -4 billion should be spent next year, with an extra -2.5 billion for both 2019 and 2020.
It is not the first time Trump has caused anger in the UK with his tweets.
Last month, Trump said he would apologize for retweeting a series of posts by a UK far-right group, saying he didn't know who they were at the time.
The tweets caused an uproar in late 2017, and sparked a rare rebuke from the British government, with a spokesman for May saying Trump was "wrong" to share the videos.
Trump has also been involved in a number of well documented spats with Mayor of London Sadiq Khan, who has been outspoken in his opposition to the US President being afforded a State Visit.
Last month, Khan said Trump had "got the message" from Londoners after canceling his anticipated working visit to the city.
Any visit to the UK is expected to be met with widespread protests.