I haven’t had that much to say about health care, but I’ve also made no secret of my views: the fact that the richest country in the history of the world allows a cruel and shockingly wasteful system to remain in place while every other developed country has long since addressed this problem makes me furious.
Not as furious, though, as hearing the fantastical and preposterous lies politicians and lobbyists are willing to tell in order to protect the insurance company monopoly over American health care. Can anyone possibly believe, in his or her heart, that it’s a good idea to let impersonal, profit-driven corporations and the bureaucrats who staff them have power over when or if we can see a doctor, which doctors we can or can’t see, and which treatments or medicines we’ll be allowed to have? And that’s only for those of us fortunate enough to have insurance; those unable to afford or to qualify for health insurance are frozen out of the system entirely until or unless they get sick enough to justify lining up for treatment at one of our hideously overcrowded emergency rooms.
And for this inhumane and inhuman mess, we pay, on average, twice what other countries spend on providing health care for all their citizens. So despite the many ridiculous things we’ve heard from those who favor continued corporate control of health care – pulling the plug on Grandma, death panels, etc. – the lie that gets me the most outraged is the one repeated by Georgia’s Senator Johnny Isakson on today’s Republican response to President Obama: Americans don’t want health care reform, he lies, because it’s just a code word for a government takeover. And, he further lies, “Government-run health care doesn’t work in Canada, doesn’t work in England, and it won’t work in America.”
In the first place, the extremely mild reforms being considered in the bills now being discussed in Congress have virtually nothing to do with the way health care is run in Canada or England. If anything, they would give us a system a bit more like Germany’s or Australia’s, both of which seem to be working just fine. But what I really resent is the Senator’s not entirely unfounded assumption that Americans, who don’t travel abroad nearly as much as citizens of most other modern countries, can be lied to so blatantly about health care in Canada and/or England.
It doesn’t work, he says? In what way? How? Unlike the Americans Senator Isakson is hoping to hoodwink, I have spent a good deal of time in Canada (most of my mother’s family lives there) and lived for ten years in the UK. In neither country did I ever hear of anyone who’d been denied medical care because of a lack of money, or denied coverage because they weren’t healthy enough. One of my mother’s Canadian cousins spent the last several years of her life in a nursing home that compared favorably to a three-star hotel, and neither she nor her family were bankrupted as a result. Another cousin has had two kidney transplants, prolonging his life by several decades; neither the operations nor the drugs he requires – which in America would cost a couple thousand dollars a month – has ever cost him a penny.
Oh, but he’s paying it in a different form, you say, in taxes. Yes, Canadians pay slightly higher taxes, but the difference is nowhere near the several thousand dollars a year the average American family spends, directly or indirectly, on insurance and on subsidizing the extortionate costs of emergency room care for the millions of citizens who fall through the cracks.
With respect to Canada I have to rely on anecdotal evidence, i.e., the fact that every Canadian relative but one claims to be very happy with the medical care they get and thinks America is completely insane, not to mention heartless, to go about things the way it does. But with the UK, I have a good deal of personal experience: not only was I treated – and treated very well – by the National Health Service, but I also had an elderly relative who before she died of natural causes at the age of 88, was treated for a variety of illnesses, both major and minor, of the sort that you’d expect a woman her age to be grappling with.
She was hospitalized twice; in both cases, she got care that put American hospitals to shame. Yes, the facilities were older and shabbier than their American counterparts, but the people who staffed them more than made up for any cosmetic deficiencies. Americans: when’s the last time you called your doctor and asked him or her to come see you at home because you didn’t feel well enough to come to the office? Without expecting to get laughed at, that is? Yet we had regular visits by doctors and nurses when required, along with social workers who made sure her flat was safe for someone of declining health, who installed handrails in the bathtub and even came round to cut her toe nails when she was no longer able to handle that task herself.
My own experiences with the NHS, though far less serious, were equally salubrious. I never had to wait more than two or three days for an appointment, and if it had been urgent, could have been seen the same day. On occasions when I needed medicines, they were often just handed to me there on the spot at the office or clinic. The one time I came in with something that seemed like it might be serious – chest pains – I was upstairs getting wired up for an EKG within 20 minutes and in the hospital down the road for further tests almost immediately (it turned out to be a false alarm).
When you visit an American doctor’s office, who are you likely to spend the most time talking to? Most likely it will be the receptionist and/or the person who sorts through all the fine print to find out what your insurance does or doesn’t cover, and your doctor will typically give you a five-minute once-over before passing you on to an assistant who hands you your prescriptions, paperwork, and advice. In London, I could come in and have a leisurely half hour chat with my doctor about every aspect of my health and life factors that might influence it, and even get chastised by him for not coming in often enough. “You know, we don’t want you feeling you have to wait until something’s wrong to come in and see us.”
When Americans who know I’ve lived in England ask me what health care there is like, the best description I can offer is that it’s like being part of a really good HMO, only without bills and without claim forms. During the years I was treated by the NHS, I could count on the fingers of one hand the pieces of paper that I had to fill out. Contrast that with the whole forests that must die to allow the American insurance industry and its medical adjuncts to function. And instead of paying for doctors and nurses and medicines, we’re paying for an army of bureaucrats to shuffle and process those forms.
Is the English (or the Canadian, though the two systems really are different and shouldn’t be lumped together) health care system perfect? Not by a long shot, and they have impassioned arguments there as well over how to improve or reform it. But no serious politician – i.e., none that hopes to be elected and stay in office – questions the fundamental premise that all citizens are entitled to health care and that it should be free or almost free at the point of delivery (there is a segment of public opinion that would like to institute nominal co-pays to attack the problem of people who cost the system millions of pounds by not showing up for appointments, but that view never seems to gain much traction). Although, as in Canada, British taxes are slightly higher than in America, again, the difference is more than made up for by not having to pay for insurance.
I don’t necessarily advocate an English or a Canadian-style system for the United States. I think there are other systems involving a private insurance/government hybrid that might work better for us. But the fact remains that any flaws in the English or Canadian models are minuscule compared with the egregious abuses now institutionalized in America to which Republican zealots (and some Democrats) cling so tenaciously. I’m here to tell you that the English and Canadian systems work just fine, especially when compared with the monstrosity we’re saddled with here in America. And anyone who tells you different is a big fat lying liar. What’s up, Johnny Isakson?