The US vs. The NHS

N.B. Originally written for my A-Level politics groups

You may have been aware of a furore over health care that has taken place in America over the summer. The political battles have been very insightful for students of AS and A2 politics. Below, I will try to outline some of the main points.

At the moment, healthcare in America is funded mainly by private insurance companies. In other words, it is not free. In order to cover the costs of a stay in hospital Americans need to purchase insurance with one of the many big insurance conglomerates such as AETNA or AmeriHealth - see http://www.amerihealth.com/. Insurance, however, is not cheap and 47 million Americans go without, leaving them at risk if they develop health problems. In the 1960s the American government stepped in, creating "Medicare" and "Medicaid" - to help retirees and the destitute (you'll have to check which is which). However, these by no means provide the kind of universal health care that the likes of Clinton and Obama have campaigned for.

When Bill Clinton became President in 1992 he tried to pass a bill guaranteeing "Universal Health Care". It failed, and now Obama is trying for a second time. Basically what it means is that a "National" Health Service along the lines of the British and Canadian model will be created. This will guarantee health care for those currently too poor to pay for insurance. Ideologically it recognises that health care is a right, not a privilege of the rich. Also, by covering ALL Americans, it carries rather a lot of moral clout. In the world's richest country, the only superpower left, many people are dying needlessly. Charities originally set up to help third world patients treat Americans in converted sports stadiums. The system at present seems wholly unworkable and unethical. Why, then, is it coming up against so much opposition?

There are three reasons for this:

1. Money. The Health Insurance Companies make a lot of money. It the government suddenly dipped its hands in its (deep) pockets and guaranteed health insurance for all Americans these companies would face a serious drop in profits. They therefore use their influence to flood Washington with lobbyists who get politicians to block healthcare reform in return for financial help at election time. It's a neat situation which keeps everyone happy - the incumbents are re-elected due to well financed campaigns; health reform stays off the statute book. Given this state of affairs, the White House appears incredibly isolated.

2. Ideology. This is perhaps even more important; Americans are incredibly fearful of the growing influence of the state on ordinary people's lives. They see government intervention as the preserve of the failed social democratic countries of C20th Europe. Some right wingers even go as far as to say that universal health care is one small step on the slippery slope towards communism. Amercians are fiercely conservative, they don't like change and they don't like the idea that the government is interfering in their lives - which, as they see it is a waste of money and personnel.

3. Fear. Unfortunately, this is the ugly side of American politics. In order to stop this so-called 'communist' system being passed, some Republicans and opponents have said that:

-National Health Care is a breeding ground for terrorism - they cite the failed Glasgow airport terrorist attack (perpetrated by two NHS doctors) as an example.
-Elderly or sick patients would face government "death boards" where bureaucrats decide whether you should live or die (assuming than continued care would be at too great a cost to the state)
-Obama and his supporters are socialists (a dirty word in America ever since the days of Cold War hysteria), a communist, a fascist, a Hitler-lover etc...

Worryingly, some even say that health care is not a fundamental privilege for anyone but can be used a tool of "social cleansing" - the worthless sections of society can be allowed to die off, thus improving the collective 'lot' of the 'good' sections of society.

Conservatives have also cited the NHS as symbol of everything that is wrong with government controlled health care. It is claimed that death boards exist, hospitals are dirty, primitive and if you get cancer "then you're a gonner". American news networks have interviewed British conservatives who support their views, most notably the MEP Daniel Hannan who has said that he 'wouldn't wish the NHS on anybody': http://www.youtube.com/watch?v=FiSPRkq28iU

This has let to an almost patriotic outpouring of support for the NHS in the UK this summer. The Labour Party has jumped on Hannan's remarks as symptomatic of the ambivalence felt by the Opposition for Britain's most cherished national institution. David Cameron has dismissed Hannan's remarks as "eccentric" and pledged his party's support behind the NHS. Nevertheless, the Labour Party are bound to claim again and again before next year's election that the NHS will not be safe under a Conservative government: http://www.liberalconspiracy.org/2009/08/18/labour-keep-up-nhs-attacks-on-tories/. This is quite clearly a piece of political opportunism by Labour. Everyone knows that the NHS is safe with either party - as Tony Benn puts it, if it were disbanded "there would be a revolution". The bigger problem is how to reform a system which, no matter how much you love it (as Brown's twitter on 'welovethenhs' contends), still provides a number of challenges to a government no matter its colours. This is where the real dividing lines will be drawn before the next election.

In the meantime, American Universal Healthcare seems to be stalling. Town Hall meetings are descending into shouting matches, Democratic congressmen are hiring bodyguards to protect themselves during the heated exchanges and Obama has had to go on TV telling Americans that the government will not kill the extremely ill (as Hitler's euthenasia programme of the late 30s did...this was suggested by one woman at a meeting here http://www.youtube.com/watch?v=nYlZiWK2Iy8). In short, this is a battle for the very soul of America and it reflects the divided nature of this young democracy. If healthcare passes, and I doubt it, this will mean more than the extension of insurance to the needy - it will be a sea-change in American politcs. But then again, this country elected a black man less than a year ago. Anything is possible...