BONNIE GREER: Why I fear US will pick bones of NHS
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An friend's experience of the American healthcare system showed BONNIE GREER the horror of a US-style NHS.
A true story... About a decade ago, an old friend of mine from America and her husband Jerry were about to make the trip of a lifetime – a train journey through Europe.
It was their first visit abroad to anywhere, and they decided to come and stay with me and my husband in London as the first leg of their journey. Their plan after that was to fly to Munich and, a day later, catch a train that would take them down eventually to Italy.
On the morning that was to begin their journey to Turin, Jerry fell out of bed and on to the floor. It was about 8am – the most dangerous time of the day for middle-aged men; the heart attack hour. And he was having one.
My friend had the presence of mind to call down to the hotel front desk and within seven minutes Jerry was in an ambulance and stabilised. Luckily for the couple that their hotel was close to one of the premiere heart hospitals in the world: Munich's Deutsches Herzzentrum.
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I caught the first plane out and arrived at a hospital so clean and tidy that you felt like you could eat off the floor.
We sat in the cavernous waiting room outside one of the operating theatres, my friend and I literally holding one another like the two little girls we had reverted to. After what seemed like an eternity, the surgeon came out to tell us that Jerry had come through an operation for which the survival rate was not much above 1%. He had had a burst aorta.
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Above our crying and screams of thanks and gratitude the doctor told us that something had confused him and his team. They could not, for a long time, get Jerry under anaesthetic. He had been concerned with his medical insurance number. All Americans know that if you do not have that, it's a patch–up and out.
Jerry had been so agitated because he could not get the digits in order, that he could not calm down long enough to go under. The doctor, befuddled, asked us what was going on?
What was going on was American medicine, as experienced by most US citizens in real-time. What you have to know, and what you have to have, in order to be seen. To get treatment.
Jerry got back home a month later to be confronted with a mountain of paperwork. Being a military veteran, he was entitled to lifelong relatively free healthcare through the Veterans Health Administration, the closest American equivalent to our NHS. But The VA hospitals, like everything else in the US, are subject to market forces.
The doctor assigned to treat Jerry also shilled for a pharmaceutical company, so he prescribed their wares and that was it. Jerry, now with complete faith in German doctors and no one else, sought out and found, close to his home in LA – a German doctor. This doctor tore up the VA doctor's notes and started Jerry over.
What the doctor knew was that if Jerry had had his heart episode in the US, even in a big city, he could have been rendered quite quickly to the past tense. And Jerry being an African American man, you can double that past tense.
The staple joke in American comedy is the one about the kid who asks his dad the sure-fire way to riches. 'Be a doctor,' the father replies without hesitation, and it always was and still is a way to ensure that you live well. This, despite the utter medical deprivation of some rural white communities, especially in the Deep South, which could merit a visit from Médecins Sans Frontières; while the African American community could be carrying specific medical legacy conditions held over from slavery; while the indigenous population is plagued by alcoholism and the psychological effects of disrespect, and theft.
Europe and the UK understand what social medicine is, its raison d'être and its concept.
Many American doctors do too, but have very little opportunity to practise it. And because most Americans have access to healthcare mainly through their jobs, the unemployed, the marginal, are often in the streets. Literally.
Not long ago, it was possible to see a person in Chicago or New York walking the streets still dressed in a hospital gown. They had been patched up in 'Emergency', as per the law, and turfed out. Sometimes with a drip to hand – if the doctor was kind.
The tragic opioid epidemic in the States, which is decimating the MAGA demographic that supports Donald Trump, is fuelled by the lack of healthcare free at the point of delivery. There are drugstores every few streets in some rust belt towns in the north-east, where the jobs are gone and only the elderly are left.
The Bernie Sanders and Alexandria Ocasio-Cortez cry of 'Medicare for All' is a goal. But how to reach it, particularly within the lifetime of a rapidly ageing society? Therefore, in the matter of Brexit, in terms of what we have to trade, it is the NHS that is this country's premier asset. Nothing comes close.
For most of us, the NHS is the GP's surgery or maybe a stay in hospital. It is where we get service with no payment. But the NHS is much, much more.
When another US friend of mine came over for his university-aged daughter's medical emergency, he discovered that she had a rare genetic condition that was particular to Ashkenazi Jews. The NHS treated her, but also wanted to collect data on her, in order to help other people.
My friend and his daughter consented and now people with her ethnic background may be able to be helped.
This kind of knowledge and research is, of course, a gold mine. An entire lucrative brand of drugs can be created out of what the HNS gathered on my friend's child alone.
Those drugs can then be sold around the world, making the company that owns the patent rich beyond measure. This is called 'Big Pharma', and anyone who has seen the medicine cabinet of the average American knows that the US likes pills. The majority of the commercials on US television are about pills, medical procedures and insurance to pay for the pills and procedures. What is the part that an actor can go for that ensures a kind of longevity? The television doctor.
The NHS as part of a US/UK trade deal could become a spill-over service, say, for the Veterans Administration. It could then be commanded to open its doors to only American products. Veterans, while their own hospitals are overhauled, could be transferred here until that is done. That golden generation: those born in 1948 and who will truly have what the Service was made for – cradle to grave care – are a wealth of information for an ageing and advanced society like America. The opportunity to make money off the National Health Service could be endless.
What can people do about it if a treaty or agreement is signed after Brexit? Nothing. Because the UK is now known as a 'distressed negotiator' – a country with very little quid pro quo and its back against the wall.
I remember back in the day, when I watched Fox News for its entertainment value, that the MEP Daniel Hannan would pop up from time to time to deliver dire screeds concerning the present and future of the NHS.
Hannan made it all sound like something out of Solzhenitsyn. Who knows how many Fox-watchers are rarin' to go? Who knows, too, if the network – which is informally known as 'TrumpTV' – could persuade the president that the NHS would be worth a good old American shake-up.
If the UK truly does become the 51st State post-Brexit, it will be through the National Health Service.
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