Regular readers will know that in the past year, I embarked on a genuinely life-altering journey. I emigrated to the United States, got married, and now make my home in North Carolina. I love this country – its culture, its people, its landscape (you need examples? Let’s start with big city music performances and small town farmers’ markets, Martin Scorsese and Stephen Colbert, the Ojai Valley and the Eno River State Park. Just as American as industrial wastelands, George Bush and Grand Theft Auto ) It is a privilege to have been accepted here; I want to honor my adopted home by giving something back. Part of that includes the desire to do whatever I can contribute to the discussion about a universal healthcare provision, free at the point of the use, to anyone in the United States.
The first time I had to pay for healthcare at the point of use, ironically enough, was when I was applying for permission to emigrate here. The US immigration authorities in London apparently don’t trust the UK National Health Service. The medical exam I was required to take for immigration purposes could only be done by a private doctor, who charged almost $300 for a 20 minute consultation. (It’s important to note that this included an HIV test; because at the time, the United States would not admit as an immigrant anyone who is HIV positive. I presume this means that the ranks of ‘huddled masses, tired and poor’ still stands as the Statue of Liberty’s invitation, but just didn’t include people with AIDs.) Thankfully, the vaccinations the immigration authorities insisted I receive (the incidence of tuberculosis among white middle class professionals being particularly fast-rising, I suppose) could be given by my own doctor at home. For free.
The fact that the US doesn’t provide a similar system of free healthcare to its own citizens is not just a tragedy for those who fall through the cracks. It is not just a harbinger of inefficiency – given the vast costs in terms of labor and other expenses that accrue when a population is disincentivised to invest in preventive healthcare. It is not just the biggest reason I feel a chill factor in my adopted home.
It is an issue that goes to the heart of the question of what kind of society we want to be, how we want to treat other people, and what kind of ethics we want to guide our lives.
And people who insist on calling such a free system ‘communism’, ‘socialism’, or ‘oppressive’ may either know nothing of communism, socialism and oppression, or might just be distorting the truth to satisfy a vision of individualism. A harsh way to put this would be to ask if the current debates about healthcare are really just skirmishes about human greed and selfishness, rather than serious discussions about how to ensure that no one goes without.
The good news is that the free UK healthcare system even has room for greed and selfishness! Or, at the very least, enlightened self interest. I’ll post why later this week.