MY FUTURE husband being British, I flew to the UK to be married,
in Christ Church, Swindon.
We were poor students; so we flew on a charter flight that
landed somewhere in Continental Europe, and then popped across the
Channel to an airstrip in East Anglia. From there, a bus would take
us to London, where we could get the train to the West.
I had fallen asleep on the plane in my hard contact lenses, and
by the time the bus set off I knew I was in trouble. I had abraded
corneas - painful, but harmless. My future husband told the bus
driver, who veered off his designated route to find a hospital,
cheered by the passengers.
We finally arrived at a hospital somewhere in east London, where
they patched me up, and dispatched me to a ward of elderly ladies
recovering from surgery. My room-mates wanted to know how health
care worked in the US. I said that it was a matter of getting
insurance. What happened if you were not insured, they asked - did
you have to "do for yourself"? I didn't know. And I still
As far as I can see, if you are uninsured, your options in the
US are a patchwork of emergency-room visits, for which you are
billed, and for which you can be in debt for the rest of your life;
self-paid doctors' visits; and charity. They wanted to know why
Americans put up with this system. I could not answer. I thought
the NHS, as I had experienced it, was great.
Now, as we in the US are on the verge of getting a minimal,
privatised national-health system, working-class Americans who
stand to benefit from it are fighting to stop it.
Most Americans are convinced that we cannot afford a national
health-care programme. Working-class Americans who are insured
believe that the programme will send their insurance premiums
sky-high, as they are forced to subsidise the improvident,
uninsured underclass. (For underclass, read "black".) And older
people who have Medicare, a programme for retirees, are convinced
that it will privilege the young at their expense. They worry about
"death panels", and pressure to forgo treatment.
Money has always been the best defence against evolutionary
fitness. Once Eskimos got into a money economy, in which old men
had economic power, they stopped putting their old men out on ice
floes to die. We worry that, in a national health-care system, we
will be put outon the ice floes. We have a sense that a private
system, which we pay for, will give us control over our lives, and
ensure that we will be able to get treatment, even if we are old -
that we will not be bullied into having ourselves "put down".
But, in the US, health care is run by for-profit insurance
firms, which employ cadres of clerical workers to screen claims,
and do what they can to deny them, or to minimise payments. I am
not crazy about government, but, if I have to trust anyone with my
body and my fate, I would rather go with government than for-profit
insurance companies, whose primary aim is to deny me treatment in
order to promote their profitability.
Dear Jesus, give us the National Health!
Dr Harriet Baber is Professor of Philosophy at the
University of San Diego, USA.