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(CNN Business) —  

When President Donald Trump arrived in the United Kingdom this week, he landed bang in the middle of a huge political fight about the country’s National Health Service.

One of the biggest issues in the UK election slated for December 12 is what a trade deal with the United States after Brexit might look like, and whether or not it would allow American pharmaceutical companies to charge the NHS more for their drugs.

There’s a huge amount at stake. The United Kingdom is a wealthy nation with an aging population and a state-funded health care system. The King’s Fund, a health policy think tank, estimates that the NHS spent $22.7 billion on medicines in England alone in 2017. Billions more would have been spent in Scotland, Wales and Northern Ireland.