Thursday, 13 August 2009

We love the NHS! Sort of.

This article has also been published at The Huffington Post, with thanks to my boyfriend, Andy, for letting me pillage his life story for cheap points. I love you, baby.

My partner suffers from a bone disorder which requires regular operations, paid for by the British NHS. His most recent procedure was performed without anaesthetic by a drunken surgeon wielding a rusty hacksaw. As I forced a mouldy rag between his teeth to stifle his screams, an official wearing Nazi insignia burst in and informed us that limbs were not considered an NHS spending priority, so dirty chisels were employed to remove both his legs and one of his arms for good measure. My partner is now a triple amputee, and I am forced to prostitute myself for heroin to numb the pain of living in an Orwellian super-state. God save the queen.

This decidedly made-up story is hardly more ridiculous than the lies that Republicans have been peddling about the NHS all week. To set a few spluttering records straight: patients over 59 are not denied heart surgery; Professor Sir Stephen Hawking has personally come forward to say that he would not be alive without the NHS; and Republican hysteria over ‘death panels’ reflects more accurately the situation in the United States than in Britain. On both sides of the Atlantic, lofty officials get to choose how best to allocate a finite amount of healthcare funding – the difference is that the NHS bases decisions on its analysis of how best to deliver equitable healthcare for all, rather than basing decisions on the interests of its shareholders.

Brits all over the world have been stepping forward to defend the NHS, with ‘welovethenhs’ becoming a trending topic on Twitter this week, surely the ultimate signifier of public passion. The British are proud of our healthcare system, and even members of the Conservative party have pledged to defend it, knowing that without promising to uphold socialised healthcare their chances of election success would vanish.

What Obama is proposing is not a simple transposition of the NHS, although it will make for a fairer system if it passes Congress. He is right not to base his plan on the British setup: the NHS has its flaws. It’s not a simple case of NHS good, medicare bad.The reality, as ever, is much more complex, and is being obscured by half-truths, frothing right-wing paranoia and outright lies.

My partner’s illness, however, is real – so let me tell you what really happens.

Whenever he needs an operation, my partner receives top-quality care from our local hospital – eventually. Because his debilitating, agonising condition is not life-threatening, he normally has to wait many months for the free operations, and the process of consultation and aftercare varies on a sliding scale from risible to non-existent.

On the other hand, his disability makes him unfit for most work, and were we US citizens my meagre half-salary would doubtless put us amongst the 43 million Americans with no healthcare cover at all. We can and do complain about the NHS – being British, it’s one of our favourite hobbies – but the specialist painkillers he needs to get through his worst days are free, and they will remain free for the rest of his life.

It isn’t easy for my partner, being 25 years old and facing a lifetime of pain and limited mobility. He worries about his future; I worry, among other things, that any children we decide to have will inherit his condition. But one thing we never have to worry about is being able to afford those vital operations, or the medication that keeps him stable.

Moreover, if I were to fall pregnant tomorrow, even on my low-income I would be treated to regular check-ups, help to quit smoking with free NHS classes, ante-and-post natal care, and food vouchers so that I could afford to drink milk, eat vegetables and take supplements to safeguard my health and the health of the fetus. By contrast, staggering inequalities in the US healthcare system mean that the United States has the highest infant mortality rate in the developed world.

I’m proud to live in a country with ‘socialised’ healthcare. For all its faults, its shoddy waiting lists and its dreadful dental care, the NHS system erases health inequalities and relieves millions of people, rich and poor, from the burden of constant anxiety about medical bills and sudden sickness. Even more importantly, it creates the progressive impression that the physical and mental health of the nation is the collective responsibility of all its citizens. In the process, without making a fuss about it, the British NHS truly upholds the principles of life, liberty and the pursuit of happiness for all. If that’s socialism, then sign me up.

27 comments:

  1. One of the Few times i will agree with you penny , it's sickening to see the cartoonish soundbites the Republican critics are vomiting up and the glee at which some of the MSM are gulping them down.

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  2. Hear hear!

    I think it's interesting also (if not ironic) that a lot of the shoddiness in the NHS is Thatcher's legacy, due to her vicious spending-cuts in the 80's and the installation of "managers" with little or no clinical experience, understanding or respect.

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  3. Well said. though I think you overstate the problems in the interests of balance - which is a shame at a time when politicians of bth mawin parties, despite their cuddly rhetori are trying to soften public opinion up for the introduction of 'oo-payments' - i.e. a switch to thekind of system that has decimated social care and 'NHS' dentistry (which is being privatised through the back door).

    So don't take the tabloids at face value. They recognise that dismantling the NHS is unpopular - but it's already happening.

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  4. We're quickly heading to 49 million uninsured.

    The problem isn't health care reform, per se. It's more about a continuing backlash against "liberalism". Which could be thought of as similar to "socialism" but is actually nothing like it. :-)

    One of the more interesting points about the protestors is that many are white, conservative and elderly. Which means they're on Medicare, and receiving government funded health care, already. Which might explain why so many are saying they don't want the government involved in their Medicare program...

    The protests, to date, have been rather incoherent, "death panels" notwithstanding. (The provision that provided funding for end-of-life counseling has, apparently, been dropped from the Senate bill. So now people will face difficult end-of-life decisions with absolutely no help whatsoever. Nice going, Republicans and Fox News.) The fact that the protestors seem to have a plentiful supply of guns is not especially helping them, nor is the link to the idiotic "birther" conspiracists.

    Anyway, back to "liberalism". A couple of people on Fox News summed it all up: they complained about the banning of school prayer, about the fact that abortion is still allowed and now sees the fascist Obama [sic] as introducing a socialist state. In other words: don't look for sense, logic or even anything you can actually argue against. (The protestors are also notably lacking in alternative ideas.)

    In other words: it's not about health care reform. It's about a Reagan-esque ideal versus a society that seems to be getting freer with each passing year. Leary's "do your own thing" versus what is perceived as "public responsibility".

    With a bit of luck, and a bit of political courage, America will end up with a health care system that might just help it, instead of hindering it. It's the "political courage" bit that's the problem...

    Carolyn Ann

    *School prayer was banned in the 1960's when a Christian objected to the public recitation of prayer. Roe v Wade remains the 3rd rail of American politics. And I'm still trying to figure out the whole fascism/socialism thing. It's a common theme, but no less inexplicable despite its popularity.

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  5. Isn't the reason for shoddy NHS dental care that dentists are no longer required to give a certain amount of NHS time in their clinics (i.e. they can just do private work)?

    The NHS is probably the greatest achievement of the British state and society. It is irritating to hear that, according to the Guardian, embassy officials in Washington are only 'quietly' correcting the Republican's outlandish claims. Instead, setting the record straight is left to individuals like Prof Hawking.

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  6. Republican Party in "wrong" shock.

    Visitors to woods warned that bear-shitting is "not unheard of".

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  7. Penny, if the physical and mental health of citizens is the collective responsibility of the nation, then why don`t we institute a national sex service? I`m sure there are lots of people (not me) for whom the knowledge of a guarenteed weekly shag would mean alot more than the relief found in the knowledge that they`ll be allowed to die a bit more slowly.
    How about people without anyone to cuddle? Fuck... if I was in my home all alone with no one to talk to or have the occasional bit of physical/sexual contact with, that`d be far more of a priority for my happiness and well being than putting off my inevitable demise for a few extra years.
    Basically, the basis on which NHS care is provided - to prevent death - is deeply flawed. Socialism is an effective way to distribute those things which market based motivations have already provided us with an abundance of. I see no abundance of immortality and we`re running out of space for all the heads in jars.

    Also, I have to say... I don`t know exactly why, but in my experience the NHS is alot less effective than the healthcare systems in other countries (all of the other systems were also at least partially socialised though). Maybe it is the emphasis on managerialism?

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  8. Basically, the basis on which NHS care is provided - to prevent death

    Whut?

    So, er, Pennys story about her partners non life threatening condition which is treated on the NHS passed you by altogether?

    Socialism is an effective way to distribute those things which market based motivations have already provided us with an abundance of

    Also silly. Centrally planned economies have been running out of the most abundant of materials since they were created.

    Socialism is a good alternative when innate market failures make a less authoritarian structure.. weak. In the case of healthcare- it's an information asymmetry. See "Akerlofs Lemons" for more details.

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  9. Some of those Americans are definitely off their heads.

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  10. Plus, the posters of Obama as Hitler are offensive to anyone supporting the NHS who is Jewish or of Jewish descent.

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  11. Hmmmm... an authoritarian structure doesn`t do anything to solve the underlying weakness - chances are good that the system will still fail to function correctly.

    Surely in that case regulation rather than socialism is the order of the day?

    And if you have a non-life threatening condition, the NHS doesn`t view you as a priority - I know. They won`t treat you at the early stages of something - often you have to wait until you`re at deaths door before they`ll do anything for you.

    It`s stupid.

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  12. Thank you, Penny. Well said.

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  13. Many people are mistaken in their belief that there is no support for people in the US without any health insurance. There is a minimum level of care that must be adhered to every American be it private or public. Hospitals must help people in certain life threatening situations regardless of their insurance status. There are also public hospitals.

    Indeed for the ordinary Joe Blow who can afford health insurance they will receive better health care on average than people treated through the British NHS. The US medical facilities are far superior than those in Britain.

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  14. unfortunately penny, if you were to become pregnant, youd realise that the nhs is far from supportive, and actually leans very much the other way, causing far more problems than it solves. but how else can it generate money for nothing?

    i believe a national health service is much more desirable and humane than the other way. however i dont believe that our NHS does what it says on the tin. there are more beaurocrats than there are health practitioners, and any serious health condition is made to wait for months and months before even the slightest attention is given to it. and even then itll likely be fobbed off with a 'maximum of three sessions' of 'pain management' without even the most basic investigation, then shoved back to the back of the queue. this is my experience, as well as the experience of my partner, and countless others of our friends and family.

    the NHS is just a way to exchange a whole lot of money for a bunch of empty promises. we need a real health service, not this sham, and no amount of National Pride twittering can hide the problem. from my perspective, the NHS looks more like a religion than a service. it runs on the faith of the healthy, and doesnt give much of a shit about the rest of us.

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  15. Mr Divine - there is no real support for people without health insurance. Really - there isn't. There's a theoretical minimum, but it doesn't work for most.

    If you're destitute, and need basic care - there's nothing. If you're suddenly in a life-threatening situation, and able to access a hospital, you'll get some minimal care. If you're like so many these days, and have a house, but no job or insurance - you may have to choose between care, or your house. I forget how many go bankrupt trying to pay medical bills, but I do recall it's a staggering number.

    Your claim is not supportable, not even in theory. It's all controlled by State (not Federal) regulation, and who knows what is possible, and what is not, in each state of the Union?

    Carolyn Ann

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  16. Mr Divine: I suggest you check out the excellent "30 Days: on Minimum Wage" episode by Morgan Spurlock. A spin-off series from the movie Supersize Me, Morgan attempted to live life for 30 days as something that was outside his normal experience. Living on minimum wage, his medical bills (due to injury received while doing minimum wage jobs, and due to illness caused by the deficiencies of the lifestyle he was able to afford) at the end of the month totalled around $1,000 dollars, that he had to meet himself from the wages earned.

    The NHS is a huge amount better than that level of care, since that was clearly not a sustainable way of life.

    @ v. - the problems you cite are a part of the Tory and New Labour attempts to get rid of/privatise the NHS. Yes, we need a proper health service. The way to get it is to support the NHS now, and campaign vociferously for a return to the principles on which the NHS was founded, as opposed to the quasi-market driven sham we currently have.

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  17. "Many people are mistaken in their belief that there is no support for people in the US without any health insurance. There is a minimum level of care that must be adhered to every American be it private or public. Hospitals must help people in certain life threatening situations regardless of their insurance status. There are also public hospitals."

    True, but the system in the US lands people with large medical bills when they are at their most vulnerable. That is undeniable.

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  18. Fucking ay, Penny. Fucking Republicans, they suck. I am so sick of their shit. Too many people have a vested interest in keeping our system status quo at everyone's expense. I'm pissed and so is the majority of the country.

    And Vanilla Rose, you are full of shit and there are very FEW public hospitals and when you do go, they take all your income info, want to see your tax returns, etc, by the time you give them all of your shit, you're already dead, so give us all a break.

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  19. @Lisa

    If you look at Vanilla Rose's comment you will notice that there are quotation marks. These are referring to a comment further up the page. It is not Vanilla Rose that is full of shit but the person who originally made those comments.

    I think you owe Vanilla an apology. She is a very sensitive soul and possesses a great ability to decipher the real meaning of our words and the issues of today. She also has a mean pair of B-cups.

    Now Lisa go up and yonder and find the dirty rascal who wrote those words and give them shit .. if you dare.

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  20. Lisa: I think you owe Vanilla Rose an apology. I've read, and reread every single comment she's made here, and I can't see what would have you so incensed.

    VR made a statement that is not entirely accurate, but it's not slanderously so. What did annoy so?

    Carolyn Ann

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  21. Thank you to Mr Divine and to Carolyn Ann. Cyber-hugs to both of you. Mr D, this is a platonic cyber-hug, so I hope you're not fiddling with my bra strap. Carolyn Ann, how would you amend my comment or comments to make them more accurate? I don't want to get my facts wrong.

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  22. Rereading your statements, Vanilla Rose, I can see I was wrong. Your generalization is reasonably accurate! :-)

    I do quibble when you say "Plus, the posters of Obama as Hitler are offensive to anyone supporting the NHS who is Jewish or of Jewish descent."

    Those images are offensive no matter what!

    (I do find it interesting that Eric Cantor, the Republican, has not seen fit to denounce those images.)

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  23. Good point, Carolyn Ann, the posters are indeed offensive no matter what.

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  24. Congratulations and thanks for your comment, Penny Red. Althought I'm writting from Spain, I do agree.
    We are lucky for having a system to complain of as much as we like... BUT that will help us in the bad moments of illness no matter (almost)our social status.
    Doubtless it could be improved, that's the challenge, as almost anything in the world, but let the medical companies to do this task will be completely stupid.
    As we say: let the fox to take care of the chicken...
    Fpadrino (Alicante)

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  25. I hear the bit about the US having the highest rate of infant mortality is a bit of a myth. (The US has different conditions for infant death at birth - some cases that europe would report as a stillbirth count as a death in the US) What do you think?

    Other than that, great article.

    - Halo Jones

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  26. We are lucky for having a system to complain of as much as we like... BUT that will help us in the bad moments of illness no matter (almost)our social status.Doubtless it could be improved, that's the challenge, as almost anything in the world, but let the medical companies to do this task will be completely stupid.As we say: let the fox to take care of the chicken...And Vanilla Rose, you are full of shit and there are very FEW public hospitals and when you do go, they take all your income info, want to see your tax returns, etc, by the time you give them all of your shit, you're already dead, so give us all a break.
    ================================
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