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One of the first things I'll do when I return to New Zealand in about, oh, 17 or so hours, God willing, is go and visit the doctor. He's a fine fellow. He'll talk to me like an intelligent person, peer inside my ports, and then instil me with the general sense he knows what he's doing, and is concerned about my well-being.
He doesn't see me, for example, as a revenue stream. At least, I don't think he does.
A visit to a Kiwi sawbones is a treat, a little like eating fish and chips on the beach, or saying the word "munter" and being understood. I've very little confidence in the Yank quack I pay $US20 (reduced from $US50, thanks to the subsidy from the insurance that costs around $US360 per month) to go and visit. He usually doses me up with some medication. Honestly, he's the John Updike of prescriptions, a man who can write faster than you can read.
But he processes patients quickly, and he is cheaper than the last guy I used to see, who was a very nice man, but charged me $US75 to do pretty much the same stuff, and kept me hanging around in his cramped waiting room for hours while he dallied with patients. He was a gas bag, and he drew gas bags to him.
I remember during one stationary hejira, I was obliged to listen to a lecture from a fellow patient detailing the failures of the Canadian health system. The chief failure was a lack of choice, apparently.
Choice is very American, that is, unless you happen to have been born here, which isn't a choice is it?
As some form of healthcare reform seems increasingly likely, it's interesting to look back and catalogue the distractions, the modes of distortion this debate has passed through to get this far.
There were the "death panel" allegations that socialised medicine would have committees pulling the plug on Grandma if she sucked up too many resources while dying. President Obama had to go and say, on telly, "No-one's going to pull the plug on Grandma."
Sometimes democracy looks and sounds like a rabble.
There was the patriotism argument, advanced by my friend, an immigrant to the US, and very pleased with its values, the freedom and choice. This boiled down to: Canada = Bad; USA = Awesome.
Okay, every country feels patriotic, and Americans do so with a particular spiritedness, but this seemed a rather paint-flecked lever that was being manipulated in lieu of discussions about the legislation itself.
Finally, there was the "It's too costly" argument. Some merit must be attached to this. Common sense suggests you can't insure 17 million or so hitherto uninsured people, many of whom are likely unhealthy (you tend to think seriously about performing your own operations if not insured in the US), and not have costs rise.
Many consumers agree the US health system sucks. Many observers, including the President, believe that if untended, medical costs will bankrupt the Federal in a matter of decades.
But to get this reform through takes horsetrading. A new report by the Associated Press details just how Capitol Hill is doing this piece of pre-Christmas business.
The list includes gun rights lobbyists agitating successfully for language to ban collection of data on gun ownership in the bill. And the American Medical Association endorsed the bill, but only after Democrat Senate Majority leader Harry Reid removed a 5% tax that was in there on plastic surgery procedures, and whacked a 10% tax on tanning. Obviously their lobbyists, unlike the plastic surgery industry guys, aren't much chop.
I also note that insurance stocks were up today, on anticipation of this bill. Surely if insurers, the guardians of the status quo here are happy, then I, as a consumer, should be worried about this "reform"?
Read more of Tim Wilson's blogs.
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