When health care is a right

WHILE I was recently visiting England, my country of birth, my 79-year-old mother fell ill. Worried by her worsening condition, my sister and I contacted her health center and were told to call the emergency number, 999, as her symptoms indicated heart failure.

Almost before we put the phone down, we heard the ambulance sirens, and within minutes, two efficient and friendly medics had moved our mother in to the ambulance, where they proceeded to take her vital statistics and make her comfortable.

When we reached the hospital, a bed with her name on it was ready, and a registered nurse performed a physical check-up and took an exhaustive medical history, asking my mother and me, as her next of kin, a myriad questions about her current and past health. Next came an examination from a doctor, a diagnosis and prescribed medications to stabilize her.

For almost two weeks now, she has received constant care from a team of remarkable orderlies, doctors and nurses. Not only the immediate condition, but also an unrelated chronic hip complaint, has been treated.

Having lived in the U.S. for over two decades, this encounter with Britain's National Health Service (NHS) was in stark contrast to my usual experience with health care.

First, never did anyone mention health insurance or bills for service or drugs. Even though I currently have what is considered to be one of the best employer-based Blue Cross/Blue Shield health plans, trips to the hospital or doctor are always circumscribed by time-consuming referrals, paperwork and co-pays. A shocking one-third of all health care spending in the U.S. goes to such bureaucracy.

In the past, when I had an inferior health insurance plan, my diagnosis with multiple sclerosis--which was traumatic enough on its own--was made even worse by constant battles with a hostile insurance company, and then the steady accumulation of debt as I struggled to cover one-third of the costs of MRIs, consultations and treatment.

It is common knowledge that for the almost 50 million uninsured Americans today, getting sick can be an economic catastrophe. But this is also the case for many millions more of the "underinsured."

In England, in contrast, no one referred to the cost of ambulance, X-rays, blood tests, doctors, hospital beds or medications. We were assured that my mother would not be discharged until she was medically fit to cope at home, and that they would provide an assessment and a care package--including such services as a visiting home aide, physical and occupational therapy, meals-on-wheels, etc.--to enable this.

The doctors didn't restrict themselves to the particular health problem that led to the hospitalization, but rather were interested in the overall picture, including mental and social well-being--again, in stark contrast to the hyper-specialization that defines health care in the U.S.

SO IT was surreal to follow the right-wing propaganda against "socialized medicine" in the U.S. while experiencing the benefits of a government-run national health care system.

The lunatic right-wingers stacking town meetings and monopolizing the airwaves warn that a government-run system would mean death panels to decide whose Granny gets to live or die, inefficient and substandard care, no choice, long waits, cumbersome bureaucracy and soaring costs.

In reality, it is the U.S. for-profit system, dominated by the big pharmaceuticals and insurance companies, that produces the kind of horrors conjured by right-wingers.

Countless studies have confirmed that while the U.S. far outspends other industrialized nations that have national health plans, including the UK, it ranks at or near the bottom in terms of access, quality, equity and public health. While death panels do not exist here any more than they do in the UK, whether or not someone gets necessary treatment in the U.S. is determined by ability to pay, unlike in the UK where provision of medical care is universal.

The NHS is not perfect. One of my criticisms of Michael Moore's otherwise brilliant critique of for-profit health care, Sicko, is that the documentary fails to mention the cuts and creeping privatization that have eroded health care in the UK and elsewhere. As underfunding has created long waiting lists for routine procedures, those with the money, or workplace-provided plans, have turned to the growing private health care system.

There is also some regional unevenness in health care provision (both within and between the separate health authorities in Wales, England, Scotland and Ireland). And fees have been introduced for some prescriptions and dental care.

But even so, the NHS provides health care that is vastly superior to, and far less expensive than, that in the U.S. This is why it has retained immense public support, to the degree that none of the major political parties dare to attack it, and neither Margaret Thatcher nor New Labour under Tony Blair succeeded in privatizing it.

The overwhelming majority of Britons believe that health care is a fundamental right that should be guaranteed by government, not something that corporations should control and make money from.

The right-wing slander in the U.S. produced an outpouring of support for the NHS in England, with local and national news outlets running stories about the difference in care in the two countries, and glowing personal testimony from countless individuals.

But there was also a lot of misinformation about the debate. Many people are under the illusion that the "Obama plan" offers universal government-provided health care, and that the American people "just aren't ready" for such radical reform.

In reality, U.S. public opinion polls for years have consistently found that around two-thirds of Americans do favor a national health plan akin to Medicare, run by the government and supported with tax money. As David Sirota writes in a recent Salon.com article, Obama in the past publicly favored a single-payer system--for example, in a speech in 2003, at which time "ABC's 2003 poll showed almost two-thirds of Americans desiring a single-payer system 'run by the government and financed by taxpayers,' just as CBS's 2009 poll shows roughly the same percentage today," Sirota wrote.

It is certainly true that support for Obama's health care reform has dropped precipitously, but this has happened as the debate in Washington has moved further and further away from the proposal for a single-payer system--and as it has become increasingly evident that the pharmaceuticals and insurance industry are overrepresented in the Baucus committee. (For a good overview of this, see Chad Terhune and Keith Epstein's August 6 Business Week cover story, "The Health Insurers Have Already Won.")

We desperately need fundamental health care reform in this country, but for that to happen, the terms of the debate need a drastic reorientation. As Physicians for a National Health Program wrote in an open letter to the president:

Only single-payer, by redirecting the vast sums wasted annually on bureaucracy and paperwork back into care, can assure high-quality coverage for everyone with no net increase in U.S. health spending. Only single-payer can rein in costs. Lesser reforms, with or without a "public option," won't fix our broken system.