How Six Year Old British Me Learned About American Healthcare
When I was a kid I didn’t know about the United States of America. I just knew about a place on the TV where the cars and houses were bigger, and everything was a bit more glamorous, and they spoke in a way that was sort of, but not quite, like us.
One night I was watching an American, family-friendly type TV drama with my mum. I can’t remember what it was. There was a family in this episode, guest stars, not regular characters, and there were two main themes to the episode.
They were poor, but they hadn’t always been poor. They’d become poor.
The little girl was suffering from some form of continuing illness.
And it seemed to me that the story was saying that these two facts were very strongly connected in some way, with them being poor because the little girl had got ill. Problem was, I couldn’t see how on Earth her being ill could have caused them to become poor.
See, I knew that my daddy was the one who earned the money in our family. My stay-at-home mummy would tell us that our daddy had to work very hard to put food on our table and a roof over our heads and toys in our bedroom. So I understood that if my daddy got ill and couldn’t work, that would make us poor. But I knew that if I got ill, that wouldn’t make us poor, because I was a kid.
I didn’t have a job.
Eventually, I asked my mum what was going on, and she explained to me that in America, if you got ill, doctors wouldn’t treat you unless you gave them money, so the family had had to give all their money to the doctors to treat the little girl, and that was why they were now poor.
That blew my tiny mind.
So if you ask me what was my first, founding impression of America, it wasn’t as a land of freedom, or a land of opportunity, it was as a dystopian hellhole.
(I have since become aware of America’s place in history, its constitution, its culture, and its overall ethos, but hey, in geopolitics as in life, a bad first impression will salt the earth for any better impressions attempting to set the story straight).
The point is that I grew up in a society where it was just accepted that the state would just do certain things for you. It would teach you to read and write. It would send a fire engine if your house was burning down, a policeman if you were being mugged, and an ambulance if you collapsed in the street. And if you were ill, it would provide doctors and nurses to treat you.
It still baffles me that in America, the first three things in that list are seen as required services for a Developed World nation to provide to its citizens while the last two are seen as “socialist”. Over here, if you phone 999, which is the number for the emergency services, you’ll get an operator asking you which emergency service you require: fire, police, or ambulance. There literally is no odd one out in that list of three. They’re all emergency services. It’s bizarre to say that the state has a moral duty to help you if you’re trapped in a burning building but not if you’ve had a heart attack in the street.
Over the years, I’ve mentioned the anecdote about the TV show in various online forums and had Americans tell me that my mum was talking shit. They told me that everyone in America will always get medical care if they need it. They talked about Medicare and Medicaid and some law that Reagan passed, before moving onto massive bouts of goal-post shifting and no-true-scotsmaning to try and deny the essential point that my mum had made.
But in a week in which the apparently calculated and targeted assassination of a health-insurance CEO triggered an outpouring not of grief or even sympathy but gleeful schadenfreude, I have ask…
Was my mum’s explanation not a reasonable if simplified summary for confused and bewildered six year old me?
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