Don’t get sick
A trans-Atlantic cat fight is underway about just who has the worst health care system.
‘Surely it’s the Canadians?’ you’re no doubt thinking. But no. With handbags at 10 paces, the US Republicans have squared off against the British left and they’re batting each other with soft leather as the prescription papers fly, each claiming the other has a barbaric medical system.
Evil and Orwellian
In the US, Republicans are using the NHS to scare Americans into opposing President Barack Obama’s health care reform plans. Calling the British system ‘evil and Orwellian’, they’ve run advertisements that claim the Obama plan would, like the NHS, ration health care, deny the elderly and the terminally ill life-lengthening drugs, stop people from seeing specialists, create a government barrier between the general public and care.
GOP grassroots groups have run an expensive advertising campaign that shows the union flag and Big Ben as a voice intones ‘$22,750. In England, government health officials have decided that’s how much six months of life is worth. If a medical treatment costs more, you’re out of luck’
#welovetheNHS
The British Medical Association responded in tones of outrage and wounded pride, insisting that life expectancy in the UK is longer than in the US. One anonymous representative of the BMA said, ‘Doctors and the public here are appalled that there are so many people in the US who don’t have proper access to health care. It’s something we would find very, very shocking,’ she said.
The BBC supportively showed scenes of people in Los Angeles waiting to enter a free clinic and the reporter said, breathlessly (and quite wrongly), ‘This is the only place for the unemployed and the poor to get health care.’
On Twitter, so many people in the US were writing posts about being scared of the NHS that ‘NHS’ became a trending topic. Almost immediately Britain responded en masse, making ‘#welovetheNHS’ a trending topic, as thousands of people wrote about how they have the best health care system in the world right here in the UK.
Get a grip
As ever, there is some truth in the words of each side.
The GOP ads might be insulting, but nobody’s saying they’re untrue. They just seemed outraged that it’s being said at all.
And if you look at what is alleged in the ads, well, that is what the NHS does.
It just sounds so negative when they say it like that. All accusing like.
Face it: In England the hospitals are run by the government. Doctors are hired by the government. Doctors are the government. Government officials make awful managers. And bad doctors.
Hospitals are filthy, and people die because of it, and primary health care varies wildly in both quality and thoroughness. Access to specialists is controlled by the government, so if your GP has been told not to make referrals, you won’t get to see a specialist. Waiting lists for everything are absurdly long, medical tests take weeks to complete, and people die because of all of it.
That is insane.
And the American system? Well, the American medical system is outstanding. One of the best in the world. And so well funded. If you have ever been very ill, wherever you live in the world, odds are some element of your survival had something to do with American medical research.
The problem is, not all Americans have access to that high-quality health care. In the US, if you are poor, the government funds a not-very-good free basic health care system for you, much like the NHS. If you are middle class and permanently employed, your health insurance plan probably provides damn good care. Unless you actually do get sick. In which case they just might drop you, and then no insurance company in the country will pick you up again.
The problem with the US system is that it is riddled with holes. The lower middle class, the self-employed, those who work for small companies, and the chronically ill all fall through its cracks. Neither the government nor insurance companies protects those people, and there are millions of them. A huge percentage of the population – between 20% and 30% of the working-age population – is uninsured and does not qualify for government health care. Many parents can’t afford to insure their children, so then young people don’t get the health care they need.
Before this recession hit, the leading cause of homelessness in the US was illness.
That is insane.
Take it from me
I have lived in both countries. And I can say that without a doubt the level of care I received in the US was consistently better. Doctors were more experienced and compassionate. The drugs I was prescribed for illnesses were more varied and better chosen. My care was better monitored. Specialists were routinely suggested if I developed problems.
I had the same GP for 10 years even though I moved constantly. I could see him no matter where I lived if I was willing to make the trip, and I was willing because he was brilliant.
But I did not have health insurance so I saw specialists only as a last resort, and I had to save up for it, or put it on my credit card. When my doctor prescribed drugs he often gave me free samples so I wouldn’t have to pay the outrageous prescription fees.
I never had a catastrophic illness, so I never had to face that awful situation. But a few years ago, I knew somebody whose wife was having a baby, and they had saved up $10,000 in advance of the birth in case there were complications.
By contrast, in the UK I’ve seen probably a dozen different GPs over the years. Every time I move, I must register at a new surgery, be assigned at random a GP who does not know me. Wait months for my records to transfer. Begin again the process of convincing them that my health problems are legitimate. Have the same tests again.
With one exception, all the GPs I’ve seen have lacked compassion, behaved like androids and been slaves to their computers. I’ve found them to be overwhelmingly complacent, insulting, lazy and scary. I found the lack of choice in this system depressing and difficult to accept.
I never once in America thought I could die from illness. In the UK on several occasions I have seriously wondered if I would survive. Each time my GP couldn’t have cared less.
I once sat on the pavement outside my GPs surgery in London, too sick to go home. The doctor I’d spoken with on the phone 30 minutes before had forgotten to tell me the surgery closed every day from noon to 2pm. For paperwork.
A stranger on the street helped me get a cab. The cab driver told me that he thought the health care he received in prison had been better than the care he got from the NHS now that he was out of jail.
But I’ve never had to pay a dime. I do not risk losing everything if I get cancer.
The problem I have is: Everyone’s treatment is free, yes. But that treatment is of such dubious quality that it’s hard for me to say that British people are better off than the Americans who re-mortgage their house to pay for an operation. At least the Americans get the operation, and they can choose their hospital and their surgeon.
An apple a day
What I’m trying to say is this: Both systems are unacceptable.
The British system is authoritarian, grim, unbelievably dirty, dangerous, depressing, badly run and the GPs seem to have either limited medical knowledge or astonishingly poor communications skills.
The American system is unfair, too expensive, results in too many people going to emergency rooms for routine care, leaves people at the mercy of greedy insurance companies, and destroys lives.
Both systems have something to offer. The completeness of the British system – the way it ensures everybody gets some basic health care - and its obsession with the elusive idea of fairness is impressive.
The richness of the American system – the way it values and rewards research and spares no expense or time in trying to save lives – and the compassion shown by its doctors should be the goal of all health care systems.
What the Obama plan is trying to do, I suspect, is bring in more completeness without losing the richness. There’s no guarantee that he will be able to do that, as democracy is ever a study in compromise and there is blood in the water right now. But at least he is trying, and a debate is underway.
In Britain, though, I suspect there will be no debate at all. For the population has been presented with a bogeyman. Sitting right next to France with its outstanding healthcare system, it looks only west, pointing a tremulous finger across the Atlantic and saying ‘We love the NHS! Best health care system in the world! We don’t want to be like America.’
If the discussions in both countries were less hysterical and nationalistic, both could have systems more like the one in France, which offers an interesting combination of the American and UK systems; it costs more than the British system but less than the American and actually seems to work better than either of them.
Please shut up
The thing that gets me is how similar the right-wing Republicans’ scare tactics are to those used by the largely left-wing pro-NHS contingent in Britain. Each creates a simplistic caricature of the other system and uses it to stymie badly needed change.
Each country could learn something from the other, and each could take some caution from the other’s mistakes. But as long as the loudest voices are the most extreme, everybody will suffer.
So please, see that the answer is somewhere in between. Don’t be brainwashed. For your own sake, acknowledge the weaknesses in whichever system you unfortunately have where you are.
And whether you live in America or Britain, until more rational minds prevail, my advice is this – Don’t get sick.
Serious underlying rubbish
So, now seven people have died in the UK from swine flu. And seven times the mainstream media have duly repeated the government’s contention that the dead suffered from ’serious underlying health problems’. The clear implication is, were it not for these serious problems, the dead wouldn’t have died.
Having heard the same thing over and over, though, one could be forgiven for becoming suspicious.
When a government says the same line over and over, they’re trying to influence the way you think. And when the press repeat that line without investigating it, that’s your propaganda machine, right there.
Ministry of Disinformation
Propaganda. Not a word we’re used to seeing in the modern age, but these are interesting times.
Britain is ‘well placed’ to survive the recession. Britain is ‘one of the most prepared countries in the world‘ to handle swine flu. The recession ‘started in America‘.
You heard those over and over and over again, right? Each one repeated by the government and the media blankly. Each one a little piece of propaganda.
The International Monetary Fund later said Britain was the worst positioned in Europe to survive the recession. Britain now has the most cases of swine flu in all of Europe. Among the most egregious sub-prime lenders were European banks including Barclays and Deutsche Bank.
Let’s get serious
The Centrist, no doubt like you, takes the word ’serious’ seriously. If you say a dead person had serious health problems, I tend to think, ‘Hmm, HIV positive? Terminal cancer? Multiple Sclerosis? Parkinsons Disease?’
Nah, how about asthma, diabetes or epilepsy? All rarely fatal, eminently treatable health conditions.
(And can somebody please tell the British press that the word ‘fit’ is as archaic as ’swoon’ and in its own way as wrong as ’spastic’? The modern term is ’seizure’.)
I know people with every single one of those mild health conditions, and I’ll bet you do too. I myself have asthma, which the government, through the National Health Service, has treated with an almost devil-may-care lack of concern, tossing me an inhaler when it first flared up a couple of years ago and telling me to let them know if I was ‘worried’ about it.
Now I know that if I die of swine flu, the government will use my asthma to explain it, as part of its propaganda, so that you can continue to think swine flu is just a bad cold. They’ll put on their sad faces, look moist-eyed at the BBC camera and talk about my serious health problems.
Let me tell you now: my asthma is mild. It should never, ever kill me. I have had flu several times and survived just fine. I’m just a bit of a hypochondriac, really. Not terminal. Not serious. Ought to live.
Here’s the truth
The government’s inability to get a handle on swine flu, it’s failure to take it seriously enough and to properly educate the population about it, it’s failure to encourage self-quarantining as other countries have, the fact that it has not encouraged people to work from home and the fact that it did not ask them to stay out of crowded places, allowed the virus to spread out of control.
Because of all of that, those seven vulnerable people caught the virus through no fault of their own, and now they’re dead.
Rest in peace
Increasingly there are murmurs outside of the mainstream press that this government doesn’t understand how epidemics work.
But I believe it’s more callous and soul-chilling than that. I think the government doesn’t want you to know how serious the situation is, because then you might lose faith in them. You might support the Labour party even less than you already do. You might vote against them in the next election.
And that genuinely appears to be all that matters to them. Or at least, that’s what matters most.
So the propaganda machine swings into motion, and it keeps telling you everything’s Ok. You probably still think swine flu’s not that big of a deal. It’s just a mild flu or a bad cold. The young and healthy will be just fine. Right?
Who told you that?
The government and the press. And you believed them.
Did you know that swine flu disproportionately impacts the young and healthy? It’ll kill you if you’re old or ill, but it almost prefers to kill the young and healthy. The British government doesn’t want you to know that. You need to know that. Everything is not going to be Ok.
Google it
Again I say: Don’t believe this government. It’s scared. And scared, bad governments lie.
And don’t trust the mainstream press: it’s slow on the uptake.
Do your own research. And be careful out there.
Don’t worry: it’s all under control
I love everything about the story in the Times this week about the swine flu epidemic raging so far out of control that the government has given up its outstanding work containing it.
I use the word ‘outstanding’ because I think that’s the word they’d use. And The Centrist is nothing if not supportive.
According to the Times, Health Secretary Andy Burnham says it’s all going to plan. (By the way, did you ever wonder how his background qualifies him for this job? Well, he’s got a degree in English from Cambridge, and he’s a keen cricketer and an MP. What more health experience do you want during a deadly pandemic?)
Mr Burnham said: ‘Our approach has focused on containing the spread and working with the local NHS to identify cases, isolate them as quickly as possible, treat them with antivirals and treat those around them and offer prophylactic treatment to those around them. This is very resource-intensive, but it has been highly successful.’
Yes, the government’s containment plan worked so well that Mr Burnham’s quote was in a news article entitled: ‘Swine flu spreads so rapidly it cannot be contained’.
The same article noted: ‘The number of confirmed cases in Scotland increased by 111 yesterday — the largest one-day rise since the outbreak began.’
If that’s containment working well, I’d hate to see it working badly.
I can see why they’re stopping it.
A personal story
Let’s take a closer look at the government’s containment policy.
I’ll start with a personal example: a friend’s school in north London called for help after the vast majority of its students didn’t show show up last week - all were home with fevers. In my friend’s five-year-old’s class, 20 of the 25 students were ill.
The government swooped in. Those with the highest fevers were tested for swine flu. They tested positive.
The school was closed. Parents were told to pick up Tamiflu at the school, and were given no other advice about what to do. My friend went back to work, her daughter went out to play with friends. The government does not recommend not doing this, by the way. They recommend nothing if you are not personally exhibiting symptoms, even if you have been exposed to the virus in an up-close-and-personal way.
In its early stages, swine flu has such mild symptoms you could mistake it for hay fever or a cold. But during that time you will be spreading the flu to potentially vulnerable people.
This might go some way toward explaining why the government’s containment policy didn’t work. Or rather, why it worked so spectacularly well that swine flu is now raging out of control.
There’s more, though.
My friend wasn’t particularly worried about the whole thing, but she wanted her daughter swabbed just to reassure her that she did not have flu. But the health authorities refused to do it. They told her no further swabbing was happening at her school. Even those whose children had mild symptoms were told they could not be tested.
So out of, say, 100 children at her child’s school who probably contracted swine flu, only a handful were added to the government’s chart of verified cases, because the government refused to test the rest of them.
Now, the government’s numbers show that around 3,000 people have had swine flu in the UK so far.
But if you extrapolate the situation at my friend’s school out to a national level – if the government is only swabbing a fraction of those exposed to the virus country-wide, in other words – it’s possible, even likely, that 10,000 people or more have already had this disease.
Save yourselves
I suggest all readers take a look at how other governments are handling the outbreak, because I’ll tell you what the government won’t: this epidemic is going to knock us all on our arses this autumn. We could be left with empty offices, closed shops, a decimated workforce.
Other governments are urging their populations to stockpile enough food to feed their families for at least two weeks in case stores are closed if the staff become ill, or in case they themselves become ill suddenly. If you contract swine flu and you have to go to the store for bread, you will spread the virus. Just ilke that.
Other governments ask parents to self-quarantine for seven days if their child’s school is closed because of swine flu – in case their child has the flu but has not yet shown symptoms.
Other governments are taking this seriously.
As far as I can tell, the British government’s entire swine flu plan is Tamiflu. Don’t worry, they keep saying, we have Tamiflu.
Tamiflu has a mild palliative effect in some cases if given in the first day or two of the virus.
That’s all we got, people.
And the NHS seems to be hinting that we don’t actually have that much of it.
If you stop and think about it – if you, for example, read the Wikipedia page about the swine flu epidemic of 1918 – that should scare the hell out of you.
But the government, well, it’s got it all under control. You can tell that by way in which the virus is spreading like wildfire.
No need to worry.
