Honking Big Government

This week we take a look at what "government" means on either side of the Pond.

Toni:

There’s a lot of Americans upset about the government at the moment. Apparently, President Obama, and his supposed love of BIG government is pushing the USA towards socialism, communism or fascism, depending on who they’ve been listening to. (Rather sadly, most of these opponents probably couldn’t differentiate between the three but seem happy to bandy the terms around.) Apart from being mildly insulted that the UK’s health system is seen as the absolute worst thing that could happen to this country, the protests got me thinking about how government is viewed on each side of the Pond.

Having grown up with unlimited access to excellent, free healthcare it shocks me that some in this country go without routine medical check ups because they have no health insurance and others can be bankrupted by health care bills. Even though everyone agrees there’s a huge problem with healthcare in the US, Obama opponents see the status quo as preferable to government involvement. What is conveniently overlooked is that Medicaid (for some low income families) and Medicare (for the over 65’s) take care of millions of Americans and both are tax funded and government run. Sound familiar?

And I have more questions- Don’t people realize that law enforcement services are also tax funded and government run? And why isn’t state education such an outrage? Why is there no outcry against federal or state funded interstate highways? I understand that this country is made up of individual, autonomous states, but within that structure there is still government, and it’s often less efficient and more corrupt than the Federal government. (I live in Chicago - I know what goes on!)

I also get that this is a collection of very different states, and that’s the way people want it to stay. What I don’t understand however, is why it’s okay to have government involvement in some things, yet it’s seen as an attack on civil liberties (or a partnership with Satan) in other areas.

Makes no sense to me and I’ve yet to hear a decent explanation.


Mike:

Probably the best argument for limited centralized government is that was what the founding fathers had in mind. But this isn’t what people are reacting against; at least I don’t believe so. Although I no longer live in the US, I did grow up there and I think I understand where this resistance comes from.

As a flag-pledging, God-fearing, Boy-Scouting American, I knew—just as I knew that if Jesus came back to earth he would, by God, be an American—that communism was bad. Well, “bad” doesn’t quite cut it. “Better Dead Than Red” seems to sum it up nicely, though.

Big government is simply the government seeking to control all aspects of your life. And that—especially if you are talking about health care—is communism, pure and simple.

If you take Big Government to its logical extreme, you are talking about a totalitarian state, so there is a basis, however small, for the current vociferous opposition. Why the health care system seems to be regarded as the Maginot Line I can’t say, but possibly is it because it represents a large entity moving from capable private hands into the slimy embrace of the Nanny State.

I have to admit, if I were still in the US, I would be firmly in the “you can take my health care when you pry it out of my cold, dead fingers” camp, but after living under a national health service for seven years without developing an unhealthy interest in Karl Marx, checking The Communist Manifesto out of the local library or referring to people I meet in the street as “Comrade,” I think the American public may be over reacting just a bit here.

The founding fathers could not have conceived of anything as abstract as “health care” in an era where medicine could be described as primitive, at best. I like to think, however, that if they could have looked into the future and understood that providing adequate heath services for the entire population was to become a possibility, they might look upon that, not as governmental interference, but as something any compassionate country would do for its citizens. Like seeing to it every child is offered an education.

The Health Care Debate

Mike:

I welcome the chance to talk about health care because it is so rarely discussed. Whenever the subject is debated, the argument always centers on access to health care, and not the care itself.

As far as access to health care goes, the US has some problems, but I don't think the system should be thrown out in favor of socialism. How to fix it? I can't tell you; ask someone smarter. But I lived there for 46 years and never knew anyone without some sort of health coverage; the rich could afford good, private medical insurance, the rest of us took what our jobs handed out, and some people (check the Internet: estimates range from 74% to 2% depending on your agenda) slip through the cracks. In Britain, however, we have universal health coverage provided by the State, which means the rich can afford good, private medical insurance, the rest of us take what the government hands out, and some people slip through the cracks.

Before I go on, I do want to stress that I like Britain's access to health care better than what I had to deal with in the States. There, I had to review policies every year and choose what I hoped was the best one, go to only certain doctors, etc. And you could never think about quitting your job and taking a little time off because your coverage would stop, so, yeah, universal health care has its perks. But the advantages stop once you actually get into a hospital; so if we're talking about health care and who is better at it, the US wins hands down.

I am told the NHS was once the flagship of Britain’s Social Engineering Armada. That may be so, but it's now a drifting wreck, foundering in a morass of governmental meddling. And I do blame the government for the state it's in, not the people who actually provide care. The rank-and-file NHS employees are dedicated people who sacrifice a great deal to remain on that sinking ship, grimly determined to keep it afloat even as the red tape pours in faster than they can bail it out.

Bloated bureaucracy, mindless management and legislative lunacy have made British hospitals dangerous places to be, especially if you are sick. Budget cuts mean losing a lot of useless managerial layers, um, I mean, scaling back on cleaning staff, orderlies, nurses and lower level clerks to the point that the hospitals are dirty, in disrepair and generally disagreeable places to be.

That's if you can find one. So many local hospitals are closing that if I break my leg in Horsham, West Sussex, I have to be trucked all the way to Redhill in Surrey to have it tended to. Soon, all the local hospitals in Britain will be closed and we'll all be sent to a central processing facility in Leeds.

In the hospitals I have visited I have seen dirty floors, ceilings with broken tiles and wires hanging down, a single, novice doctor having to cover an entire ward and ambulances queuing up outside the emergency room entrance.

When I asked about the latter curiosity, I was given this explanation:

The government, to track NHS efficiency, instituted a quota system. Any patient admitted to the hospital must be seen within a certain number of minutes. If the hospital falls outside the limits imposed by the government, they fall in the rankings and receive less funding. So, to stay within their quotas, they leave patients languishing in the ambulances outside the emergency room. When they feel they can see them in a reasonable amount of time, they admit them.

This way, the government gets to see nice, jolly figures, the hospital stays on target, the money (which is not enough to begin with) keeps trickling in, and everyone is happy. Right?

So, if in America, the perceived answer to their health care ills is to get the government involved, you can come take ours. Please.


Toni:

Ah the “S” word - "socialism". President Obama asked recently, since when is taking care of your fellow countrymen "socialism"? When people call for radical change in the system, they are simply asking that everyone be given "access" to health care. (I’m sorry but to ignore the access problem over here is simply copping out.) At present it is proposed that, for example, self employed people be allowed to join together as one big insurance pool instead of having to pay over the odds for individual insurance. No one’s talking about free or socialist anything.

Times have changed in the USA. Because of the rising costs of insurance, the trend is for employers to pay less (eg. 60% as opposed to 100%) of an employee's health insurance, which can lead to hefty bills for workers. Many smaller companies are simply not able to offer employees any health benefits at all. As a result, there are more than 47 million uninsured people here, 37 million of whom are actually employed, which makes them ineligible for any kind of government assistance. And while I'm talking about Medicaid, the government program, it takes care of only 40% of America's poor.

So where do the uninsured go? Well, most of them don't go for any kind of preventative care, so by the time they are really sick/ill they are forced to use a hospital Emergency Room. If, as I did a year ago, you turn up with a kid and a badly broken arm, you get to sit in line with ear infections, snotty noses and conjunctivitis because these people have no primary care doctors. And guess who gets to pay for their care? No, not everyone else, (that would be socialism) but me. My hospital bill is approximately 45% higher than it should be because the hospitals lose about that amount caring for patients who can't pay. (In most states, hospitals must treat anyone who walks into the ER regardless of their ability to pay.) Even if it were being proposed that taxes pay for health coverage it would be a damn sight cheaper all round. Those of us who are lucky enough to have health insurance get to pay for everyone else who doesn't. What's the difference?

Interestingly, although the US spends more per capita on healthcare than any other country, (WHO stats) its use of health care services falls far below the OECD median. In other words, a small percentage of Americans are spending most of money. A family member last year, who was admitted to the hospital for tests, was so adamant about being tested for what he thought was wrong, that the doctors caved and ran all the tests. Hey, they weren’t paying. Because of rampant malpractice litigation, many GPs refer you on to a specialist anyway. I rarely bother with my GP as he’ll charge about $200 to tell me that I need to see an orthopedic doctor/allergy specialist etc. As I said, I’m lucky enough to have family health insurance, but I pay $12,000 per year for it, I have a $5,000 deductible before anything kicks in, AND I pay 20% of bills thereafter. Bargain. For that, I can choose pretty much any doctor I want. If you go for the cheaper premiums, you are told which doctors you can use, but in an emergency, there’s a high chance that someone outside of your plan will be involved in your care, and your insurance company won’t pay for that. It’s hard to ask everyone in a hospital whether they are in your plan – especially if you’re bleeding from the head.

Some people, even with health insurance, find themselves facing bankruptcy.

No one should be in this position.