Learning points from Obama’s bloody nose

Many of us in the UK, although admitting the manifold weaknesses of the NHS, are totally bemused by the violence of the opposition to President Obama’s healthcare reforms.

The good folk of Massachusetts have just delivered him a severe bloody nose by electing a largely unknown (other than for his nude pose in Cosmopolitan) Republican senator. This is sad, but if the majority of Americans chose to have a system which provides phenomenally good healthcare for those who can afford it while providing Third World medicine for those who cannot, then surely that is their issue! After all in the land of the free you should be free to chose, even though your choice effectively deprives millions of others of any choice at all.

Medical bills are the highest cause of bankruptcy in the US. But hey, if they cannot afford to support themselves or their family then they must be the undeserving poor for “The greatest of evils and the worst of crimes is poverty” (G B Shaw, Major Barbara). So why should this bother me?

But in some strange way it does! It is not the ludicrous comments made by the likes of Sarah Palin (pit-bull in lipstick) on the NHS “death panels” that upset me, or the assertion by the Republican right that Prof. Stephen Hawking would long since have died had his care been left to the NHS. We all know that Middle America, fed on a diet of Fox News (an oxymoron if ever there was one), is largely unaware of the world beyond its own back yard (it is said that many Americans only learn world geography through the countries they invade).

However it is too easy to ridicule Palin, and the views she represents. Many millions of Americans regard her as a cross between Princess Diana and Joan of Arc (although thinking about it most of them are unlikely to have heard of St. Joan - she never appeared on Oprah).

What really troubles me is the fact that to some extent I agree with them! The Republicans hate what they term “big government” and they profoundly resent the interference of politicians in healthcare matters. Does this ring a bell?

When Blair came to power, recognising that the NHS was chronically broke, he significantly increased funding (a good thing). But then he could not leave it alone and imposed his top-down, command and control, micro-management culture. Thatcher was almost as bad!

The results are MTAS, MMC, WTD, revalidation, endless standards and regulations, the Care Quality Commission (and its predecessors), process and outcome measures, a legally binding NHS constitution, Lord Darzi and, of course, targets.

Don’t get me wrong. I think the American healthcare system is vile and a disgrace to a supposedly fair and democratic society. But I do wish our politicians would back off the NHS for a bit and let us get on with the job.

Tags: US healthcare