British Reaction to American Health Care Debate

A couple of friends living in London have made me aware of the reaction there to our current Health Care debate. Many Brits are appalled at the reluctance of Americans to adopt health care reform, and even more so at the falsified information that is being touted about their own system.

I was directed to a discussion on yelp.com, and decided to add my two cents. Thought I'd throw it up here, since I've mostly avoided the discussion up til now.

My post:

I'm approaching this conversation as a fiscally conservative and socially liberal American with decent medical insurance.

What's happening in the town halls and across the middle and rural areas of our country in regards to the health care debate is the result of American pride, a bit of cognitive dissonance, and a big dose of fear. For years we were told we had the best doctors, the best specialists, the best hospitals, the best research, etc. We took pride in having beautiful teeth and state of the art treatments, and told ourselves that we paid so much because it was worth it. We had to justify the cost, and we've spent years cultivating a sense of pride to validate the outrageous costs. We were told (and told ourselves) that if we didn't pay so much, we'd all have bad doctors and long waits and inferior treatment (and the worst of all things...bad teeth!)

It is only as blogging has become accessible to those for whom this system is not working that we've started to become aware of just how bad it really is. We are now faced with daily (hourly?) reminders of how the American healthcare system has failed the people, and we are reacting to this information with the stage-appropriate denial and fear that you are all seeing. It will take time for the middle of America and rural America to understand what is going on and why this needs to change. The coasts and the cities are starting to understand better, but the reluctance of the more conservative people should not be seen as stupidity or unwillingness to change - it is simply the result of learning that what we thought we were good at really wasn't all that great.

A number of republicans are using fear tactics and distorting the truth to compound this fear. But the democrats aren't helping much, either, by just trying to pull heartstrings rather than offer tangible, balanced solutions that can work in a capitalist society. The fact that there are so many possibilities further confuses the issue and adds to the fear you are seeing from our people.I think if someone could really highlight for people how our system works (because believe me, none of us really understand how it all works in our country, let alone anyone else's), we'd find that we could come to a new system through relatively minor overhauls, and that the new the system wouldn't be so different as to be socialist (which is a bad word here).

I don't know what the new system should look like. I don't know if the NHS is the perfect example of the right answer (although it does seem like a great step in the right direction, and one that could work here). I do, however, know a few things about the fears people have and how are current system addresses those:

1. We are scared of the QUALITY of public systems because we've only seen bad examples. In our cities, community health clinics are supported by the government and private donations, and they are utilized by the poor, the homeless, and those other people who are NOT US. We have an image that they are dirty and inferior and that they cannot attract good doctors. And many of them are, but we do have good community health clinics that are totally supported by the public and by government grants. Clinic Ole, in the San Francisco Bay Area, for example, has become so well known as an excellent provider of health care that the demand from insured patients required them to start accepting insurance when available. The clinic itself serves the entire community on a sliding scale based on your ability to pay, with many free services. If the public could see more examples like this, rather than the images being strewn about by those against reform, they might believe we could adopt something like the NHS and make it work.

2. We are scared of LONG WAIT times and not being able to get the services we need when we need them. But we already have those. How long do people have to wait to get approval from an insurance company to have a procedure? I would much rather wait because the doctor is not yet available to perform the surgery, than be waiting when the doctor says I need it now because an insurance company wants to approve the necessity of the cost first. I had a fairly urgent, but not emergency, surgery 2 years ago. Once diagnosed, I had to wait over a month to have the surgery. Not because the doctor wasn't available, or because there were no operating rooms - but because my insurance company made all of us jump through hoops to prove that it was necessary. However, I was fortunate enough to work for a private funder who happened to be a major donor to the hospital where the surgery was to be performed. Somehow, once that became known, I was immediately booked for surgery within 2 days. The hospital insurance liaison worked with the insurance company to get me approved right away because I was suddenly a VIP. Meanwhile, millions of other Americans were waiting for their insurance companies to approve their treatments. Although thankful for the bump, I find this incredibly depressing.

3. We are scared of bad teeth. I kid, a bit, but seriously...too many people in this country think all Brits have bad teeth because of public health care. Ridiculous, but it is a common perception. But here's the thing...I have pretty good insurance with good dental coverage, and I still can't afford to care for my teeth. Cleanings are covered, sure, but anything else is so expensive that many people can't take care of it. Even root canals that are deemed medically necessary are usually only covered at half cost, if that. A root canal in a city like San Francisco costs a well insured patient about $600 at a mid-range dentist. That doesn't included xrays, diagnoses, and follow-up. So many people forgo them all together. There's a reason we have images of hillbillies with no teeth. We are scared of not being able to access the best doctors and the best treatments, but honestly, most Americans can't do that even here, because the cost is so prohibitive.

4. We are scared of not being able to get treated well when we need specialists, but we don't get the preventative healthcare that would keep us from ever needing it. I currently am working on funding for obesity clinics for children. They need private funding because insurance companies won't insure a child who has been diagnosed as obese. We know that obese children turn into adults with diabetes, high blood pressure, heart disease, etc. Yet we don't fix it when we can? There are countless examples of how the American system represents sick care rather than healthcare.

Just throwing out what I know. I have a great deal of respect for the pride you take in your system, and am looking forward to our government offering a system that might work for us.

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