There’s a great article today talking about the uninsured’s perceived lack of political power. Much of what the article
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says feels true – I can certainly attest that people who lack health insurance often see it as a shameful thing – a statement about their own failures instead of something they could demand from government or society at large. Even the fact that coverage for their family would cost more than their mortgage doesn’t change the emotional response of personal failure. Unfortunately, this type of reaction lends itself to a world of silent suffering, instead of political action. And the article is absolutely right when it talks about how those most affected are often unable to be politically active – Certainly here in California, even among the affluent, the moment when many people discover the failures of their private insurance is exactly when they are too overwhelmed by illness to do anything about it.
But I do think that one “conventional wisdom” the article asserts might be dead wrong – that a politician who gets health coverage for the 50+ million uninsured is not going to reap any political benefits from doing so. If someone pulls it off, I think the political benefits would be staggering. Even China announced plans to have basic health coverage for all citizens by 2011. My in-laws are all British and the accepted wisdom from people of different political stripes is that Maggie Thatcher got tossed out because she attempted to dismantle nationalized health. Now that’s political power…
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Doc Gurley is a Board-certified Internist physician and the only Harvard Medical School graduate to have been awarded a Shoney’s Ten-Step Pin for documented excellence in waitressing. 
The exact same thing applies to the NHS, except that here in the UK there is only one “insurer”. The way that you fund your medical care is unlikely to solve this problem – it’s much more an issue of needing to be realistic about what’s possible, what’s affordable and what’s sensible.
Ah, dear Paul, the naivete of those who have a true health system is so…heart-warming and also somewhat angry-making in terms of what we live without here in this country. By “failures of their private insurance” I don’t mean asking for the unreasonable. I mean true, actual examples, such as 1) discovering no doctor will see you, 2) discovering you are “disallowed” for that entire, lethal disease, 3) discovering that you have coverage, sort-of, but only so much coverage (despite what they promised) that you will either live bankrupt (and possibly homeless) or forgo treatment altogether. You can imagine that if you have children, the idea of driving your family into bankruptcy/homelessness (75% of bankruptcies in America are secondary to medical costs) so that you can get non-emergency treatment (even for a disease that will, eventually, kill you) is not an easy decision to make. Oh Paul, it’s so much worse than you’re thinking…
Well Doc Gurley, if it’s so good over here why won’t the NHS treat me? It’s not as though I have something that can’t be treated, because my private doctor seems to be doing a reasonable job. And it’s not as though I’m alone, because I know of other people in a similar situation.
The NHS even went so far as to ban me from seeing any further specialists – and that was after just 3 specialist consultations.
I know how bad things can be in the US, but don’t you dare go telling me that the NHS works unless you’re prepared to make sure that I can get the treatment that I’ve paid for. You can get your in-laws on it. Until then, I’ll be telling the world that the NHS is a failure.
As for the situation in the US, it’s hardly my fault if people are careless about the type of health insurance that they buy. It’s not as though there’s been a sudden change in the way that healthcare is provided in the US and people are learning how it works. I stand by my comment – the way that you fund your medical care is unlikely to solve this problem – it’s much more an issue of needing to be realistic about what’s possible, what’s affordable and what’s sensible. However, given that many healthcare decisions are made emotionally, I don’t see that happening any time soon either here or in the US.