My job during my frequent trips to London is to try to explain Americans and American policy to our former cousins.
When I was first there in 2006, I had to explain how it was that W had gotten a second term.
Now they want to know about healthcare. About how people can believe that it’s okay to let your fellow citizens die for lack of it. About how we would resist a single payer system when it would cost less and deliver more. About why we think everyone having health insurance (the way all car owners have car insurance) would somehow make us all commies.
I can’t always give answers. I don’t know why members of my own family believe that if you don’t have insurance, due to its expense or due to pre-existing conditions, you should just be allowed to die. But they do. One told me that it was a shame, but it wasn’t his responsibility to keep anyone else alive–staying alive is a personal responsibility, you see.
It was Christmas, and we were told to stop arguing, so I didn’t say that other people’s tax dollars pay for his children’s school, blah, blah, blah.
I can’t explain these positions because I can’t even begin to follow the logic. My mother is furious right now because her sister is ill. Due to pre-existing conditions, my aunt has not had health insurance in decades. No primary care physician in their area will take her. No specialist will see her. Rather than looking forward to January, when the pre-existing condition problem won’t be a problem, or when Florida finally allows its healthcare program for the poor to be expanded, my mother’s response to this situation is to say:
“This is how it’s going to be for everyone when Obamacare kicks in.”
When asked to explain, she says she doesn’t “believe” that my aunt would be able to get health insurance under the new regulations. Instead, she believes that the new rules will mean that because my aunt doesn’t have insurance, the IRS will take away her house.
No, I can’t explain that to people, who, even though they don’t live here, understand Obamacare better than that.
(By the way, I’m not entirely happy with Obamacare. I would rather have a single-payer option. But I think the changes under Obamacare are better than what my family’s political party wanted to do–to blame my aunt and people like her for not having insurance and to watch while she suffers.)
What I can do is explain that many Americans have myths about the British healthcare system. That people believe Brits have to wait forever for care, that they can’t choose their doctors, that the quality of their care is low, that the government makes their health care decisions, and that they don’t like their own system.
These myths surprise my British friends.
The other thing I can do is challenge the myths they have about our system. Most of these myths are about what life is like for those of us with insurance.
Surely, they think, if my company and I are going to pay WAY more for my healthcare than it costs in tax dollars in the British system, I must have it good.
Then I explain some things:
1. My insurance company makes a lot of my health care decisions. These decision come in the form of them telling me that I’m not allowed to have something the doctor wants me to have. Yes, while the other side is terrified of the government deciding which asthma medicine I can be on, they are fine with a company making that choice–a company who bases that choice on their own profit.
2. I have to wait for care. Every time I need to see a specialist, it takes months. Once, when my son really needed to see an ENT doctor, my GP had to mark “urgent” on the referral to guarantee that he would be seen within two months. Insurance doesn’t guarantee prompt care.
3. Although I have insurance, I could still easily go broke due to medical costs. In 2001, I had insurance. I also had a significant health issue that ended in surgery (although the surgery didn’t completely resolve the issue). I spent over 1/3 of my gross income that year on healthcare. As I was a single mother making less than 20,000, it should come as no surprise that I am still dealing with medical debt from way back then.
In May, I was in an emergency room. A doctor came in and said I needed surgery and that he was going to call an ambulance to transfer me to a hospital that could do it. I am now supposed to pay over $800 for an ambulance that a doctor called for me.
This blows my mind. It blows the minds of the Brits.
After I explain how our system works, our cousins don’t envy us. And they don’t just feel sorry for Americans without insurance. They feel sorry for Americans with it too.