It's been a while since something got me so riled as the debates going on the in US about healthcare. So while the old political Dave is back I thought i would put my thoughts down.
In Europe, the arguments over universal healthcare were over decades ago: all that remains is a polite discussion of how best to fund them. But in the US, the idea that government should have any place in the relationship between doctor and patient remains controversial to many, and a red rag to a few. Less than 20% of Amerians believe their healthcare system is in crisis - a proportion that has not changed in 15 years. Based on healthcare insurance, supplemented for the over 65s, and Medicare for the poor, at best the system is good. So where is the problem? Well premiums are rising fast. We call it an excess, I believe you call it deductables. For almost 20% of those insured, deductables exceed $1000. A lot of fat cats are getting fatter on the backs of many who can ill afford to spend as much on insurance. At best healthcare in the US is outstanding. But as a sytem judged on quality, access, equity and healthy lives, US medicine lags behind the UK, Australia, Canada, Germany and New Zealand, according to the Commonwealth Fund. The US scores well on rapid access (second only to Germany). Americans however do not put equity, access and efficiency as high on their list and are seemingly unaware that their expensive system doesn't, on the whole, deliver good results. In 2007 the US spent 16.2% ($2.2trn) of GDP on healthcare, against the UK's 8.4%.
I think it is important that we both realise the reasons for the radically different national consciousness both our nations have. To do this we need a little history lesson. Britons, along with their neighbours in Europe, were for centuries forced to live under a system of government that abused their power, it's citizens and it's wealth. At a time when Britain enjoyed the largest modern Empire the world has ever seen along with the wealthiest economy it has ever had the majority of it's people IN Britain were left to starve. The Empire was built on the backs of the poor yet none of the wealth filtered down to them, they were in essence slaves of the Empire not subjects of the of the ruling nation. Consequently resentment showed itself in many ways, one of them being socialism and the other a want, even need, to free ones self from the ruling elite. The 'American' war of independence happened because those Europeans living in the new land had chose the second option. Centuries of maltreatment errupted when opportunity for a new nation presented itself. In wasn't infact a war of independence but a civil war, a revolution against the ruling elite and only happened because of centuries of social evolution. It was a chance that Europeans living in the mother nations didn't have. So you now have two sets of Europeans. On one side of the Atlantic the very same Europeans have now become Americans with a distrust at best and resentment at worst to socialist values. The reason for this resentment and mistrust is because they never needed the help of a socialist system, for they were already free from the shackles they once had. On the other side of the Atlantic however the struggle continued as did the resentment. Socialist movements grew and a shift in thinking eventually followed.
Now there are two events that changed things forever, the First and Second World Wars. A shift in thinking had now taken place. Europeans needed to be looked after and their nations needed to be nurtured and re-built. It is because of this that Europe has a different view of the role of government than America. The government is there to serve the people, but it is also there to look after its citizens. People were living in broken countries and were destitute. The vast majority of people simply could not afford medical costs and quite simply a welfare state wasn't an option it was a necessity. The state of the nations health had to become a politcal idea and it must remain that way.
You talk about equal opportunities in a way that makes it sound like a uniquely American idea, i assure you it is not. The most important word is not that off opportunity but that of equal - equality. All of us are equal, from the very rich to the very poor. We are all the same and as a result should all be treated in the same way. Most in Europe have had the opportunity to develop and they have been enjoying it on a national level for far longer than America. In 1955 a black man in London would have the same freedom and opportunity as a white man sitting next to him, i don't think the same can be said for the US. Freedom and equality for all or only if your face fits and you have the money?
An insurance system by way of private companies promotes resentment towards those who, for whatever reason, do not pay their way. You will always get free loaders and like you I have a deep distain for them. Believe me we have many of them in this country but i don't think we should let them ruin it for the majority of people who simply cannot afford to pay their way. Should we go back to the days of Oliver Twist and adopt a laissez farie attitude towards social care because of the few that abuse the system or should we maintain a level of national care that will continue to see increasing living standards for the masses? I pay 11% of my wage for National Insurance. That 11% will pay the bills if i lose my job; fix my arm if it is broken; provide money should i become too sick to work; give me a pension in my old age and provide me with a payment to help me cope with loss should my partner die. It also ensures that those same benefits apply to those who do not work but do I resent that? The answer is no. Should little Jonny down the road suffer in poverty because his mum is a drug addict and sponges of the state or should the state be there to provide cradle to grave care for him? What is the point in having equal opportunities if you can not reach them? If you begin life in the gutter it is almost impossible to benefit from such opportunities without a helping hand from the government.
In America there is simply a lack of consensus around the idea that universal healthcare is an ideal worth striving for. In Europe it was made part of our 'new start' after WW2 and we cannot imagine a world without it. Individualism brought us two world wars and saw millions dead. Those who weren't dead were forced to live in poverty. The US however saw no reason to abandon individualism, and now it is much harder to do so. While the protests have been orchestrated, they would not have occured at all unless they chimed with deep and strongly-felt sentiments.
I believe that by the strength of our common endeavor we achieve more than we achieve alone, so as to create for each of us the means to realize our true potential and for all of us a community in which power, wealth and opportunity are in the hands of the many, not the few, where the rights we enjoy reflect the duties we owe, and where we live together, freely, in a spirit of solidarity, tolerance and respect.
You see for us it is more than healthcare. Our National Health Service (NHS) is a reminder that the days of the lives described in Dickens novels are gone forever and while the NHS exists they will not return. For that reason we love our NHS and it should be the envy of the world.
Geek - probably, boring - certainly not....
