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America has no right to speak ill of our NHS
Free healthcare is the mark of a civilised society. It is the one principle that unites British politicians across the spectrum
Janice Turner
Dear America, for some time now we’ve realised that far from being your special pal, you’re not that into us. We know the love — like the extradition treaty between us — flows mostly one way. For his military loyalty, our previous Prime Minister got yo-Blaired. For his exquisite hand-wrought presidential gifts, our present PM got White House gift shop tat. America, we sucked it up.
You can diss our food, recoil at our personal hygiene, cast our RSC grandees as 2D villains, send Gwynnie and Madonna to patronise us, fingerprint us like criminals at your airports, mow down our sons in “friendly fire”. But as the rage over President Obama’s healthcare reforms descends into attack ads and town-hall gunfire, don’t you dare speak ill of our NHS.
It is the one thing, in our digital, atomised, privatised, multi-ethnic age, that unites us; our irreducible essence, the very best of us. Healthcare free at the point of delivery is the principle upon which every politician across our spectrum — marginal self-publicists such as Daniel Hannan aside — now agrees. The NHS ministered to David Cameron’s brain-damaged son as tenderly as to Gordon Brown’s fatally ill infant girl. It shows that decency, fairness and compassion, the national traits we fear died with nobler generations, live on. That America does not have universal health-care, that 47 million of your citizens live in fear of getting ill, appals and, frankly, baffles us.
The Republican National Committee can condemn the NHS as Orwellian or evil or “socialised”, but what it is, at root, is Christian.
Perhaps not the kind of noisy, nosy, puffed-up Christianity that Senator Chuck Grassley, of Iowa, or Congressman Paul Broun of Georgia are most familiar with, one that applies its energies chiefly to shutting abortion clinics and preventing gay couples from sanctifying their love. It is the simple, quiet, industrious Christianity of chapel and kirk that, woven into the Labour movement, strived to do God’s work on Earth. I’m no Bible-basher, but I’m struggling to recall the verses in which the Good Samaritan asks for insurance details or Jesus bills Lazarus for “co-payments”.
I happened to read Senator Grassley’s statement that in Britain the 77-year-old Ted Kennedy would not have received treatment for his brain tumour, at the bedside of my 86-year-old father. Mr Grassley’s view that “when you get to be 77, your life is considered less valuable under these [NHS] systems” seemed rather surreal, as my old pa, who collapsed at home, was brain- scanned until it was discovered that he had suffered a minor stroke. As a consultant attended him, physios assessed him and he was found a place in a rehabilitation unit, where he will spend a month recovering, I thought how the life of this elderly man — no high-born statesman but a person of modest means — was treated as immensely precious.
Throughout this difficult week, in which I was plunged abruptly into the dark labyrinth that is geriatric care, I gave thanks that the least of my worries — and more importantly my father’s — was money.
To be old, sick and poor is a ghastly fate, and worst among the Republicans’ disgraces is the alarm caused among America’s elderly, that Mr Obama will slash the Medicare system, which is their saviour. It is, as David Frum pointed out in these pages yesterday, a misconception that America has no state provision for its poor and elderly. Indeed, Medicare and Medicaid (for the poor) is so expensive that it is bankrupting your nation, America.
But unlike the lean NHS, there’s a spare tyre of fat on the system and any Briton who has been treated in America can tell you where it lies: around the bellies of physicians grown corpulent on prescribing unnecessary treatment.
To us it is unimaginable that a doctor would order a scan, pills, an invasive test, an operation even, not based on whether it will make us well but on how much he can charge. (We are revolted too by the drug company adverts nagging the sick to “ask your doctor to prescribe” some profitable new gimmick.) And if you are covered by Medicare or Medicaid, the doctor can pass this egregious fee on not to the insurance company but the taxpayer. Some even demand kickbacks from hospitals for referring patients. The scandal of unscrupulous US doctors milking state medicine makes our MPs’ expenses debacle seem like a minor dishonour. Yet why the uproar, the shots fired, when President Obama seeks to redirect tax dollars from doctors’ condos in Palm Beach to sick children?
As with so many facets of US life, healthcare seems a mix of wasteful overconsumption and appalling need. In America a doctor delivers a baby with a battery of beeping machines and a bill that goes “ker-ching!”. Here a regular birth is attended only by a midwife. Once home, a British mother is visited for the first ten days by the same midwife, and a health visitor, has a free weekly drop-in clinic to answer her questions: a new American mom must muddle along alone. Which system works best? US infant mortality is a dreadful 6.3 per 1,000 births, Britain’s 4.8.
When a British friend living in Los Angeles watched his wife give birth he prayed that she wouldn’t need a Caesarean section: they had funds only for a normal delivery. That your citizens are born into this unneeded stress ill befits the richest country in the world. My friend’s health insurance for a family of four costs £800 ($1,300) a month. Yet when his elder daughter had a developmental disorder requiring tests and therapy, the insurers balked. Every clinic visit was followed by a call haggling about what percentage they would cover. It is, he says, like arguing over your sick child’s body with a firm of car clampers. He and his wife paid $50,000, their entire life savings — 70 per cent of bankruptcies in America are caused by medical bills.
In Britain the bureaucracy you fight is the hospital, in America it is in the insurance companies. Dealing with the NHS is like wrestling a Leviathan. The system is trying, rigid, oblique: the endless wait to see a doctor if there is no emergency, the senseless way everything stops at weekends, the noise in the wards, the defining mode of grace under pressure.
But the NHS has one thing about it that is perfect — its underlying principle. Only when you can say that about your own health system, when no American suffers through lack of funds, will we permit you to point a damning finger at ours.
