(Extract from debate on 'socialised' healthcare on US website)
This debate has become shrill enough to be heard across the Atlantic. It seems that many Americans fear that Mr Obama’s healthcare reforms equate to socialised medicine, on a par with the worst excesses of Stalin or Mao. The less hysterical opposition believes the state isn’t competent to meddle in such a fundamentally important service.
As a 39-year old, lifelong citizen of the UK, I’m so appalled by how our National Health System (NHS) is being misrepresented in the US media that I feel compelled to jump into this debate with a native corrective.
First, around 8% of UK GDP is spent on healthcare, principally through taxes paid to central government. By contrast, around 16% of US GDP is spent on healthcare, principally through premiums paid to profit-making intermediaries. While questions remain over the NHS’s efficiency, the plain fact is that the vast majority of the funding it receives is spent on delivering healthcare. In the eyes of Brits and other nationalities with similar systems, a preposterous and distasteful proportion of US health dollars is sucked up by corporate intermediaries for no other reason than to turn a profit.
Second, the term ‘socialised’ is bandied around with a gleeful and fear-mongering abandon reminiscent of Joe McCarthy. The fact that I benefit from a state healthcare system doesn’t mean I wear overalls, work 16-hour days in a tractor factory and attend a daily realignment where I chant the wisdoms of Chairman Brown. I believe that such fundamental public services as the armed forces, the police force, the fire service and the NHS should derive their funding and authority, and be answerable to, central or local government. It is possible and desirable to have a free market economy where essential services aren’t subject to the exploitative whims of big business. After all, does anyone complain about getting arrested by ‘socialised’ state troopers or having their wars fought by ‘socialised’ marines? It has also been claimed that state healthcare is undemocratic, but it’s hard to see how unless you’re a board member for a medical insurance provider.
Third, the NHS does creak in places – it is after all a product of the late forties when the nation was still on a war footing – but it offers every citizen of the UK a comprehensive system of care free of charge and regardless of status or earning power. There is absolutely no prospect of my being denied care because I haven’t been with a given employer for long enough or I hadn’t read the special exemption clause about water-skiing over 30mph. I may pay more tax for this privilege, but I pay far less than many Americans are obliged to hand over to profiteering middle-men who would otherwise deny them what I would consider an essential service.
Over the last three years, I’ve had three operations to stabilise a spinal fracture following a road accident, and one to remove broken knee cartilage following a skiing accident. A bill for those procedures would have easily got into six figures. I have paid nothing, nor will I ever be expected to. It is enough that as a hard-working taxpayer, I contribute to a mutually beneficial, cooperative system which would protect me even if I fell on harder times.
I certainly have my gripes. After my road accident, I was stabilised and left welded to a spinal board by my own blood for twelve hours because A&E (ER) staff were overwhelmed by drunks and hypochondriacs. There are too many managers and not enough clinicians. It is well nigh impossible to get someone to answer a phone to get an appointment changed. But when it comes to the fundamentals of clinical care, any UK citizen knows the NHS will save their life and give them the care they need with no discussion of cost. And for those who can afford it, and are prepared to pay for a little more speed and a bigger room, private healthcare is freely available.
If the political will were there, Americans could learn from other countries’ experiences and build a great, cost-effective, universal healthcare system from the floorboards up, having swept aside the profiteering middle-men. It is galling to see so many millions of people willingly perpetuating a healthcare system so preoccupied with profit that it doesn’t deserve the name, and doing so because of an unthinking fear of government and foreign ways.
