America’s fevered imagination


ONE could be excused for suspecting that Britain’s National Health Service (NHS) is the new Al Qaeda, given the virulence with which is being attacked in the United States – in many cases by people who are unlikely to have been aware of its existence until very recently. Nobody has so far proposed air strikes against NHS facilities, but surely it is only a matter of time.


The ire is not occasioned by anything the NHS has said, done or neglected to do. It has to do with health insurance reforms championed by President Barack Obama. Is he proposing a system of socialized healthcare modelled on the NHS? No, nothing of the kind. The British are somewhat bemused by the fuss, but more or less united in defending the NHS against the fusillade of insults flying across the Atlantic.


One of the pithiest defences I have encountered came from a London-based American, Mitch Glickstein, who wrote in The Guardian at the weekend: "There are difficulties with the British health service, but perhaps the most important fact is that no one I know here is afraid to be sick … The relationship between doctors and their patients at every level is different from the States; here money does not change hands … I became ill when I was briefly back in the US some years ago [and] the first person I saw, and the only one who could admit me for treatment, was the woman in charge of payment. My credit card probably saved my life."


In Sicko, a documentary released a couple of years ago, Michael Moore tried to educate fellow Americans about the effortless superiority of healthcare systems in countries such as Britain and France – not to mention Cuba. In all the countries where patients are not turned away from hospitals for lack of cash or insurance, the per capita cost of healthcare is lower (dramatically so in the case of Cuba) than in the US.


Apart from the 46 million Americans who have no insurance cover, it is reportedly not all that unusual for private health insurers to find an excuse for withdrawing cover as soon as a person falls sick. Which is not particularly surprising, given that profit maximization is the insurance firms’ primary aim.


Unfortunately, the proposed changes do not add up to a radical restructure: if the legislation is passed, it will be tantamount to tinkering at the margins of the existing system. Yet, if they are diligently implemented, there can be little doubt that some improvements would ensue, with health cover extended to most of those who don’t have it, and with insurance companies obliged to restrict their level of callousness and encouraged to lower their premiums. Folks who already have cover and are satisfied with the arrangements would not be affected at all.


Why on earth, one is compelled to wonder, would anyone seriously object to such reforms? There could certainly be cause for complaint on the grounds that they don’t go far enough. But that is hardly among the objections raised by a shrill minority of naysayers, most of whom appear to have little idea of what they are attacking. Or, to put it another way, the objects of their apparent fury bear little resemblance to anything in the proposed legislation.


For instance, there’s been talk of "death panels" – committees that will decide whether the elderly should be allowed to live. This amazing piece of misinformation stems from a clause – suggested by a Republican legislator – that facilitates advance conversations between a patient and health experts about late-life care options, when the patient may no longer be in a position to make decisions. It’s a sensible choice and hardly a step towards euthanasia – which in fact would be an even more sensible choice, but is hardly likely to be introduced first in a country where anti-abortion fanatics are still able to get away with murder.


That hasn’t prevented it from becoming the basis for a disinformation campaign, propelled along by the likes of Sarah Palin and the lunatics let loose on the Fox News channel. The Republicans, who succeeded in jettisoning Hillary Clinton’s health reforms during her husband’s first term as president, are thrilled by the early opportunity to humiliate Obama, and the private health insurers are happy to sponsor the campaign as a means of protecting their profits. But they are playing a dangerous game by allying themselves with fascist fringe groups that feel obliged to oppose everything the president says or does because they don’t like the colour of his skin.


In the past month or two, a great many lies have been told in an attempt to "prove" that Obama was born in Kenya rather than in Hawaii. The fantasy of the Mombasan (rather than Manchurian) candidate feeds into the myth that he is a plant, a part of some clever Muslim conspiracy. In different circumstances such nonsense might be considered mildly entertaining, but the level of ignorance in the US gives it a different dimension.


The Bush-Cheney administration was able to convince the vast majority of Americans that the proposed invasion of Iraq was a perfectly logical consequence of 9/11. recent opinion polls show that little more that 50 percent of Americans accept that Obama was born in the USA – a figure that more or less coincides with his approval rating. He is being accused of harbouring socialist ideals and/or behaving like a Nazi, sometimes by the same people. Calls for his death have acquired an alarming frequency.


The president has thrown himself into the health reform campaign and appealed for the kind of grassroots support that propelled him into the White House. One can only wish him success, not because his plan is particularly enthralling – it can’t be described even as a distorted version of the NHS – but on account of the sheer perversity of his absurd adversaries, whom it may not be entirely inaccurate to categorize as the American Taliban.


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