Rant In A-Minor

Nation’s Healthcare Sodomised

This week, one of America’s most deserving candidates for urgent attention from a mental health professional, Rick “Frothy Mix” Santorum, decided to make a stale start to the new year by doing pretty much the exact same thing he’s been doing for all the previous ones; opening his mouth and squeezing out words that remind one of the now commonly accepted, and rather unpleasant, alternate meaning of his surname. As is so often the case with his fellow patients in the rubber room of American politics that is the Republican party, Rick sprayed the airwaves with a hail of dung bullets in a drive-by shitting that consisted of blaming the collapse of the British empire on the National Health Service (among other social programmes). Other than exposing his ignorance of history, and a blatant agenda of protecting the US healthcare industry by slamming “Obamacare”, it demonstrated, once again, that American politicians (who no doubt have private health coverage out the arse) really need to shut the fuck up about the NHS.

I couldn’t say for certain whether it’s a testament to the quality of the public education system here in the UK, or simply a reflection of how pig-shit ignorant (perhaps even wilfully) Santorum is, but the rampant muppetry of the former senator from Pennsylvania is laid bare by the fact that there is an entire nation of 12 year olds here with their hands in the air right now (many of whom nearly pulled muscles in their torsos while thrusting the eager limb skywards in a desperate effort to be the first to answer), and they’re practically wetting themselves with excitement at the thought of being the one to tell the teacher exactly why Santorum is a complete spack-head. As anyone who bothered to pay a Higgs-Boson’s worth of attention in school can tell you, the British empire came to end because, at the end of World War 2, America bravely stepped up, bent us over a barrel, and ordered us to dismantle it … or else.

Okay, maybe that’s not entirely accurate. To be fair to America, we were already over a barrel (having spent 6 years fighting a war that left us completely fucked financially); they simply pulled our kecks down and assumed the position behind us. “Sure, we’ll help you with money to rebuild yourselves”, they said, “we’ve got loads of it!” (spending, as they had, the first two years of the war doing fuck all but sitting back and watching, as if the inexorable rise of global fascism was somehow a problem for other people to deal with). “The only thing is”, they said, “we kind of want to have an empire of our own, and be in charge of everything in the world and stuff, but we can’t really do that if you’re still running the show”. While it was more than fair to ask that Britain hand back the various countries it was in charge of to the people who actually lived in them, it was a colossal dick move for the US to lube up and give us a 60-year economic butt-fucking (the money was a loan, and we had to pay it back) when we were already in the “head down, arse up” position. That, my friends, is the “special relationship” you keep hearing about.

To compound Santorum’s ignorance, there’s the small matter of how the British empire largely came to an end before the NHS and the welfare state even really existed. The National Health Service Act of 1946 (which established the structure of the NHS) was, when you think about it, an incredible achievement given that it came barely a year after the country was decimated by war. Some of our major cities lay in ruins, the economy was coasting on fumes, and half a million men, women, and children had been killed (either actively fighting the Nazis or as a result of civilian bombing), and yet they still managed to lay the foundations for one of the most important social changes in Britain’s history. In 1948, the NHS finally became a practical reality and everyone in the country, even temporary residents or those simply visiting, became eligible for free (at the point of use) treatment. Never again would anyone be forced to check the contents of their wallets and ask the question, “can I afford to see a doctor?”

The idea that one should have to hand over cold, hard cash in order to see a doctor is a concept so alien, and so repellent, to us here in the UK that we cannot fathom how Americans would tolerate it. Think about it for a minute. The notion that health, the state of well-being or, at least, of not being dead significantly before your time, should in any way depend on your ability to pay for it is beyond disgusting. This is the 21st century, for fuck’s sake, how do we still have the soi-disant “greatest nation in the world” putting around 50 million of its people into situations where they are forced to choose between paying for their grandma’s cancer treatment or keeping their house? No-one in Britain has had to make that decision, and no-one here goes bankrupt due to medical expenses … no-one. The fact that people in a first-world country like America routinely do is beyond comprehension to the rest of us who were always under the, apparently mistaken, impression that access to healthcare was a basic human right.

Our National Health Service is government run, and funded by tax payers in the form of “national insurance” contributions. Unless you’re self-employed, these are automatically deducted by your employer, so you pretty much don’t have to do anything (NI also pays towards your state pension). Our per capita expenditure on health care is approximately half that of the US, yet we ultimately have better health care statistics; we live longer, have a lower infant mortality rate, and have an overall higher standard of general health since we’re less reluctant to visit our GP when we’re feeling a bit poorly (largely because we don’t have to worry about coughing up for it – pun intended). In terms of preventative medicine, the UK is a world leader; GPs are encouraged to promote primary health care (and there are many incentive schemes for doing so), with the emphasis very much on doing what they can to stop you getting sick in the first place. Prescriptions (which cost far less than in the US due to the massive buying power of the NHS) are free for children, pensioners, and those on certain benefits (sight tests are also free, and come with a significant reduction on the cost of glasses).

This is not to say, however, that our system is awesome – after all, nothing is perfect (with the possible exception of “The Shawshank Redemption”); there can be long waiting lists for non-essential (or elective) surgery, and you can’t see a specialist without a referral from your GP, but neither of these are a particularly big deal. For a start, waiting lists have shortened drastically over the past decade, and having the GP act as a kind of “gatekeeper” can help reduce the number of unnecessary cases being dealt with by specialists. Despite this, and the claims of the US politicians who are bought and paid for by the healthcare industry to act in their interests by scaring the living shit out of decent Americans, we do get a choice in this evil, soviet-style system of death-panels and communism. We do get to choose our GP, we do get to choose the hospital we want to be treated in, and we do get to choose the surgeon we want to carry out our urgently needed haemorrhoid surgery.

As readers may be aware, my partner, Raven, is transgender, so naturally this has involved heavy interaction with the NHS; from the original referral by his GP to the Gender Identity Clinic, to consultations and surgery, he has always had a choice. Granted, he has had to go out of his way somewhat – the clinic, for example, is based in London (approx. 250 miles away) – and, with an institution as large as the NHS, we can spend a lot of time chasing paperwork, making phone calls, arranging appointments etc. Despite this, however, we’ve never had to pay for anything – he even gets his travelling expenses refunded whenever we visit the clinic in London (in truth we do have to pay for one thing: a night’s stay in a hotel, and that’s just because we don’t want to have to do a 500 mile round trip in one day). And, when it came to surgery, he was asked who he wanted to do it, which hospital, and what procedure he preferred, etc. During the consult, he was recommended a different surgeon and procedure than the one he originally wanted (and was given good reasons why it would be a better choice), but at no point was he ever pressured in to picking one over the other.

It’s not just the issue of his gender dysphoria for which he has benefited hugely from the existence of the NHS; he is also an asthmatic, and so requires ventolin inhalers (given his benefits status, he gets these free); he often suffers from bouts of sinusitis, which usually bring on chronic headaches and require relief from a beclometasone nasal spray (also free). The hormone treatment for his gender dysphoria, nebido (again, free), results in the kind of hormone levels that can sometimes lead to the infamous spotty teenager look – benzoyl peroxide (once again, free) takes care of that. If that wasn’t enough, Raves has also been diagnosed with Aspergers, making it hard for him to socially engage with people without suffering high levels of anxiety (it’s made it thus far impossible for him to work) – the NHS stepped up again, and he’s now receiving cognitive behavioural therapy (yep, you guessed it, it’s free) to help him develop coping mechanisms for dealing with his social anxieties and become a more functional human being.

By now, one of two thoughts are likely to be occurring in your mind; the first, is that this post hasn’t been particularly heavy on the funny – I haven’t, for example, made as many sarcastic or acerbic comments about some of the more potentially ludicrous aspects of socialised healthcare. “Come on, Kris”, you may be thinking, “I want to giggle a bit more while being compelled to think about this particular issue!” Well, don’t worry, good people, because there is something here for you to get your laughing shoes on for; namely that there will be people who are choosing to occupy their minds with the second thought I mentioned at the start of this paragraph that, because they happen to work for a living and pay taxes, they shouldn’t have to fund the healthcare needs of other people, especially the kind of people who they feel are little more than a bunch of work-shy, lazy, responsibility-dodging ne’er-do-wells who sit on their arses eating crisps and sponging off of the rest of us.

Don’t you find it both hilarious and depressing that there are actually people who give so little of a fuck for their fellow human beings that they can’t stand the thought that they’re helping to support people who, for whatever reason, wouldn’t be able to enjoy the benefits of decent healthcare under a free market system? What horrible, small-minded, selfish bastards they must be that they’d rather some unfortunate child go without life-saving vaccinations because their parents had found themselves unemployed? How despicably self-centred can a person be that they would condemn a house-bound invalid to a painful and short existence, simply because they’re unable to work and cover the cost of the treatment and care they so desperately need? Isn’t it a fundamental human right to expect that, no matter who you are, where you live, or what you do, your basic right to a life as free from disease and infirmity as possible is going to be taken care of? What the fuck is wrong with you people, seriously?

No-one in their right mind will deny that, in any social system, there will always be people who get more out of it than they put in (and that, by definition, the reverse is also true). Yes, your taxes are paying for the healthcare of someone else, but there will likely come a day when their taxes pay for yours. Yes, you may be helping towards the cost of treating a forty-a-day smoker for lung cancer while you’ve been tobacco-free your whole life. Yes, you may be forking out for an obese, burger-chomping alcoholic who doesn’t give two shits about their health while you’ve been doing yoga and eating salad since you were fired out of your mother’s uterus. So what? Even if you ignore the discrepancy that exists with such individual comparisons, the truth is that, long-term, healthy people cost the NHS more because they live longer. Most of the hospital admissions, doctor visits, and prescription charges you rack up in your lifetime occur at the end of it, when you’re more likely to suffer ill health due to old age. Smokers contribute more to the NHS than non-smokers because of the huge amount of extra duty they pay on their drug of choice.

In any socialised system like the NHS it is inevitable that, sooner or later, you will be a drain on others. When you find yourself requiring all sorts of medicine and trips to your local GP in your twilight years (nothing to do with sparkly vampires, I promise, it’s just an expression), I guarantee there will be another, younger generation of people making the same complaints about you sponging off their hard work that you yourself made only decades earlier. That, whether you like it or not, is the essence of socialism; things might not balance out when you make highly selective comparisons between disparate cases, but they do balance out in the context of society. We all benefit; we are all raised up as one to a higher standard, a better quality of life, higher life expectancies, lower mortality rates, and a demonstrably happier and more well-adjusted society that doesn’t have to fill its trousers in terror at the thought of being sent to the poor house every time an elderly relative starts looking a bit pasty.

“Ah ha!” cry the right-wing, conservative “Fuck you, I’m alright, Jack!” crowd whose ears pricked up the moment they heard the word “socialism”. For as long as there has been a healthcare “industry”, those who stand to gain the most from a world in which health is seen as a profit-making business (rather than a basic human right) have sought to equate “socialised” with “socialism”, as if looking after one another were somehow a bad thing. This is particularly true in America, where successive governments have managed to scare the population into thinking that the communists were coming to their towns to force them to eat gruel, queue for bread, and take away all their televisions as symbols of a “decadent capitalist west”. Sarah Palin is one of the more recent examples of these fearmongering arseholes, with her disgustingly transparent attempt to lobby for the insurance industry by claiming that a socialised health system would result in “death panels” that would tell you that your granny should go home and die because her treatment is too costly (despite the fact that the insurance companies themselves act as death panels by refusing to cover millions of people based on huge lists of pre-existing conditions).

If you’ve ever gotten into a froth about socialism, and how it’s ruinous to a stable society, let me point out the following; without socialist ideals, you wouldn’t have education, public safety regulations, state pensions, unemployment benefits, food stamps, disability benefits, child support, or any of the thousand and one other safety nets put in place to protect the vulnerable. You wouldn’t even have public roads, a rail network, other transport systems, or any of the infrastructure that underpins the country you live in and enables it to survive. If capitalist ideals had sufficient dominance when any of these projects were in their inception, every road would be private, and you would have to pay to use them (in fact, you’d probably pay many times per journey as every road could, in theory, have a different owner). If your house caught fire, and you weren’t contributing towards your local, private-run fire department, tough shit; if you were beaten half-to-death by a mugger in the street, the police wouldn’t give a flying fuck until you paid them to investigate.

Speaking of getting in a froth, we return to Rick Santorum, a man who once linked same-sex marriage to 9/11 (seriously). Santorum is just one of many conservative politicians who want you to believe that the free market is ultimately the way to go for everything; that the health of a nation is best served by companies whose primary goal is to make money (and, let’s face it, the most reliable way for a health insurance company to make money is by collecting premiums and never paying out). People like Santorum, who only have their own interests, and those who help maintain their comfortable lifestyles, at heart, want you to believe that socialised health care, or the welfare system, will bring about the end of society and will have us all fighting the grey drudgery of a poverty-stricken, Orwellian dystopia, when the truth could not be more different. The only thing that social programmes can ever bring to an end is the stranglehold that the 1% have over the 99%; a society where a super-rich minority control every aspect of the lives of the majority is the only society under threat.

The fact is that, as George Carlin put it, “it’s a big club … and you ain’t in it”. More for us means less for them, so they will do whatever it takes to protect their disproportionate share and, where possible, increase it further. If that means depriving us of access to free healthcare so that we can lead comfortable lives, safe in the knowledge that we will be taken care of when we’re sick or old, then so be it … they don’t care, because they’re covered. Fuck you, 99%! If you don’t like it then you should have been born in the 1%, shouldn’t you?

So, remember: every time you hear some smooth-talking politician slickly spewing bullshit to get you to vote against the evils of socialised health care, think of Santorum – a frothy mixture of lubricant and faecal matter that you often get after being fucked in the arse.