President-elect Barack Obama recently named Tom Daschle as his secretary of health and human services. The decision is sure to upset conservatives and some mainstream Americans since a few of Daschle's ideas, like the creation of both a government healthcare programme that would compete with privates ones and a federal health board to determine coverage, carry with them overtones of socialism, that politically dangerous word so often hurled at Obama during the campaign.
As a proud liberal, you may be surprised to learn that I know how these detractors feel. When my husband, daughter and I moved to London a year ago, I knew I would have to sacrifice a few things – like the sun – but letting go of my healthcare scared me most of all. Like many Americans, we had been insured through my husband's employer, but in England we planned to switch to the National Health Service, in effect a socialist programme that is tax-based and ensures healthcare to all, but is run by the government. It wasn't that I loved my former health plan – I didn't – but it was familiar and felt safe. I did, however, value the idea of universal healthcare. I was just sceptical that it could actually work. I was used to hearing it equated with long lines, shoddy care and lawmakers with stethoscopes. Just two months before we moved, Rudy Giuliani made headlines when he thanked God that he was cured of prostate cancer in the US: "My chance of surviving [it] in England? Only 44% under socialised medicine."
My fears, however, quickly dissipated during my first encounter with the NHS. Three months after moving, I picked up my two-year-old daughter from the babysitter and was told she went to the bathroom 25 times that day. Not exactly the strong type, I called our local clinic in a panic. I'd yet to register with their office, and of course it was late Friday afternoon. No worries, the receptionist said. "You may have to wait awhile, but bring her in." Expecting the worse, I packed a bag with enough activities and treats to last the weekend. But 30 minutes later we were done. On our way out, the doctor reminded me that children get free prescriptions, and adult prescriptions are capped at around $11. "Now," I wanted to say, "you're just showing off." Eleven months later – over five of them spent pregnant – I'm still a convert. The sheer ease with which the NHS works is its strongest selling point. You are assigned to a clinic close to your house (mine is a 10 minute walk away). Once registered, you often have a choice of doctors (we're on a first name basis). And because it is so hassle-free (in a recent survey, 74% of Britons waited 15 minutes or less on the day of their appointment), you feel less anxiety about using it. In the last week alone, our family has had contact with our clinic six times relating to matters from vaccinations to pregnancy to constipation. (The girl who couldn't stop peeing now can't poop. Go figure.)
Gone are the hours spent debating whether to make an appointment. Will it be worth the time and the cost of the co-pay, the prescription? Gone are the days of arguing with insurance companies over deductibles and coverage. Most importantly, gone is the immeasurable amount of stress spent worrying that one day you'll lose your job and have to choose between your children's health and putting food on their plate.
I'm not claiming the NHS is perfect. Madonna once quipped that British hospitals were "old and Victorian", and sometimes they appear that way. Unlike in the US, my antenatal care doesn't include regular visits with an OB-GYN, but with my GP or midwife instead. And they only hand out flu shots to the very neediest; the rest have to pay. Despite this, I have never once felt that my health was compromised. In fact, despite Giuliani, my husband has about the same chance of surviving prostate cancer in England as he did in America.
As Daschle and Obama move forward on the latter's campaign promise to provide "affordable, accessible healthcare for all", it's important that Americans think outside the box. We need to envision healthcare as a right, not a privilege, and to do this we have to stop making coverage contingent on work. In this economic climate – with unemployment at 6.7% – that's not a practical or ethical option.
Daschle's ideas are steps in the right direction, though many will try to scare the public into believing that more government means less freedom. Obviously, compromises will be made. In England, there is constant controversy, for instance, over the government's refusal to pay for extremely expensive drugs with limited effectiveness. These are tough issues, no doubt. But every child in England is still covered, unlike nearly nine million American kids. Our system is hardly without its moral failures.
And in the end, a healthcare programme that is not profit-driven actually creates more choices than it prohibits. In Britain, you can quit your job and go back to school without worrying about accidents and illnesses. You can even write that novel. You can also stay home with young children. And if you want to leave an unhappy or abusive marriage, you can do that too without the fear of putting your own health and the health of your children in jeopardy. These options are unavailable to most Americans, but they can be if we keep an open mind as this debate progresses.
