Medical Care Debate in U.S.A.

I travel to the States a great deal (2 or 3 times a month) and have several American friends. I’ve been surprised by the intensity of the health care debate. There are many reasons for this rancor and they have been discussed, but I’d like to add my own perspective.

1) Many republications are seething from their recent loss and are re-trenching on the far right, and oppose almost anything Obama proposes. Their ads, especially the ones depicting British and Canadian health care systems, have been shown to be full of lies. But nothing has stopped them, and the Obama group have been a little slow off the mark in rebutting their vicious attacks. Grandparents forced into euthanasia? Come off it!

2) Choice. This is the word I hear so often in the debates. People are afraid Obama will take away their “choice” of health care provider. This word is a charged signifier because underneath it are a load of other words like “capitalism”, “free market”, “independence” etc. For a Canadian like myself, this word was confusing. I have a choice of doctor (if my area is well-serviced, some are not). I can usually get a second opinion on surgery (been there, done that) and most diagnoses. But then I just go to a hospital and they take care of me.

I believe that the U.S.A, with its mainly “for profit” system, has sold its citizens the myth that paying hundreds of dollars a month for something that most industrialized countries provide for everyone from general tax revenues, is a good thing because they have “choice”. This implies that you can shop around for the best plan. Of course you have to have a pretty good job to do this, and your employer has to contribute. I think the number is 47 million (?) Americans who have no choice at all (actually, they have the choice to wait until they get really sick and then go to emergency where they usually cannot be turned away). My friends in New York had a “choice” when they changed plans so they would only be paying $300 per month each and their new plan was so “cheap” because it had a $10,000 deductible!

So “choice” ignores the working poor and even the working lower-middle-class. But it has become a buzzword for everything that is wrong with Obama’s plan. From a Canadian perspective this just seems a bit crazy, but Americans have been sold this “free-enterprise is good, government is bad” line for so long that it is kind of a religion. Even after banks have collapsed and corporations have poisoned the environment, government can still be portrayed as the “bad option”.

But if we took away the illusion of choice, then what would be left? Only the realization that the USA is out of step with other capitalist countries like Canada, Britain, Germany, France, etc. in not providing basic health care for its citizens. It’s really a “rouge state” in regards to this element of human necessities.The American Dream is to prosper in a land of opportunities, just don’t get sick before you’ve achieved your goals or you could be out on the street.

I don’t mean to imply that everything is great in Canada and elsewhere regarding health care. We have doctor shortages which will probably become worse with the aging population. We have long waits for some elective surgery (although things that are important, like CAT scans after an accident, or cancer surgery, can happen very quickly). We have increasing debt and some people believe costs cannot continue to rise and we need to have a “two-tiered” system where you would be able to purchase some services. In fact, anyone who has enough money to jump the queue can, for example, go to the MAYO clinic in the USA or even travel to India which offers excellent value in medical tourism.

So anyway, the viciousness of the debate does surprise me, as well as all the hidden meanings. In this blog post I’ve talked about “choice”, perhaps in a future post I’ll get into the “socialism” word!

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