Who has the best health care?

One of the key tactics in the battle of health care reform has been to make certain claims and accusations about the merits or deficiencies of various health delivery systems in the U.S. and abroad. Proponents of the constantly morphing behemoth making its way through the convolutions of the American legislative process are quick to cite the advantages of the European, Cuban and Canadian versions and tout examples of satisfied participants as proof that those systems work since, if they didn't, how could anyone have a good story to tell about their experiences with them?

The opponents have sadly chosen to just be reactionary and claim there is nothing so bad about the current American system that it requires such draconian transformations, and simultaneously denying horror stories from our own shores, while relating the ills of those other nations' health services.

As is often the case, the truth is not strongly on either side.

It's shameful that we always fall for the punditry that extremists of any ilk use to inflame us into following their viewpoints and rejecting any others without so much as hearing them. Here in the land of trying to find tolerance for everything and avoiding stereotypes at all costs, we are still easily tricked into divisive regional, racial, cultural and ideological prejudices that are then used to support that "theirs could never be as good as ours" or "vulgar America needs to aspire to the cultural superiority and enlightenment of other nations" in order to manipulate our emotions before our common sense has a chance to kick in.

Here's a bold statement: You can get excellent health care anywhere in the world that has a system for delivering health care. It's true. You can get great care in England, or Canada, or Australia, or Germany, China or Cuba; heck, even in the United States in a V. A. hospital. There may be better odds of it in some than others, but then that's still pretty subjective to each person's view of great care.

What's more, it's pretty much a certainty that anyone in any of those places that is really in need of medical attention will get it regardless of their ability to pay. None of them are able to do it without lines, or limitations of some sort, and they do generally tend to treat the sickest first, meaning that the rest are not going to get what they want as fast as they want unless they grease a few palms.

No matter how free a system is, there will always be those with affluence that can move ahead in the line or be plucked out of it entirely to get preferential treatment, but due to the inherent ethics of health care workers, this is far less prevalent than in any related industry. One of the issues that have been discussed in the wake of the Haitian earthquakes is whether American citizens who are victims there should get preferential treatment by American aid workers on the ground there.

It's a strictly academic debate, because the reality is that the type of people that are there doing that job are not the type that are going to care what anyone tells them about whom to help first. They are going to focus on who has the greatest immediate need. It is in their training; it is in their character, and it is endemic to the profession as a whole. Profiteers and bigots exist, but they are pushed to the fringes and ostracized wherever they are recognized.

The reason you can get great care anywhere is because that's what care-givers do. They do the best they can for everyone that comes into their care regardless of the resources at their disposal. Obviously, there are factors such as moral judgments; racial, sexual and cultural bigotry; greed, burn-out and elitism that affect the individual health care worker's quality of care, but those are so secondary to the primary imperative of those who choose this work that the desire to ease suffering is the great equalizer, not only between individuals, but between nations and their health care systems.

This is not at all to say that the American system or any other in the world does not need improvement or that access issues can be comparatively better in other nations than in the U. S. There is a definite need for reform, but the reform should not only be made based in the reality that the issue is getting the infirm and the healers together, but that once that is done the care will be delivered as compassionately, efficiently and as fairly as can be done, wherever in the world it happens. Anecdotes of good care anywhere are irrelevant because they are the rule, not the exception.

Critical Mass

It would actually have been a better pun before the election when some of us viewed the outcome as critical to the survival of the republic. Now that Scott Brown is the winner, the Senate election in Massachusetts is not the critical juncture anymore, but the situation is still approaching crisis.

For all the denial of Obama Administration officials and supporters that Senator Brown's victory was in any way a referendum on anything but local politics in the state of Massachusetts, or at worst, a protest vote against the failure of the party in power to accomplish their stated objectives, polling among Brown supporters indicates exactly the message that voters were making a statement to the federal government that they are opposed to the health care reform bill, and more particularly to the tactics being used by the current administration and Congress to push it and other changes through.

The merits of that or any other bit of legislation are no longer important or even worth consideration. The methods of our Congress are so similar to the behavior of the Parliament of Great Britain toward the American colonies that it is unthinkable that revolution of some sort will not take place unless we are not the same sort of people that inhabited this continent in the 1770's. How fitting it is that the first shots in this revolution were fired in the same state as the one that led to the formation of this republic.

One could go back to the fall victories in Virginia and New Jersey and point to them as indicators of the direction of the electorate away from the policies of the Progressives, but it wasn't until the shock of Massachusetts that the will of the people was felt as strongly as the stand of the Minutemen on Lexington Green that resulted in the "shot heard 'round the world."

The comparison is not overly dramatic. The repercussions are likely to be every bit as transformative as those of the American Revolution, particularly if the powers in D.C. react in the same manner to this uprising as the Crown did following Lexington/Concord; not in the sense of an armed put-down, but rather in failing to recognize that the majority of the populace are not content to be meek subjects to their wills- accepting the supposedly benevolent dictates of the Great Fathers in Washington without the checks and balances that the Founders built into the Constitution for this very purpose.

Just as the colonists evolved an awareness that foreign rule was no longer in their best interest, the people of the today's United States are slowly waking up to the recognition that a bloated government serves its own ends first and has become an entity unto itself- separate and alien from the common American and viewing us as indifferently as the Lords of Parliament across a gulf wider than the Atlantic Ocean.

We've had our tea parties and exchanged political salvoes. Right now, the Progressive leaders are holed up in Washington like the redcoats in Boston pondering their next moves, while militia arrive daily to oppose them. They'd better pay attention to the sounds of axes and shovels on "Bunker Hill" as they consider their own critical decisions. To paraphrase Rahm Emmanuel, crisis can sometimes be a useful thing.