I interrupt my regular posts on the foibles of the super-rich to bring you something closer to home. The day Obamacare was upheld, I received a thoughtful email from a young MS sufferer (who, yes, happens to be my sister) describing why she applauded the decision. I asked her to expand on her note, and I've printed it below. Carolyn O'Connor is a writer and freelance academic editor living in London.
I’m 27 and was diagnosed a year ago with Multiple Sclerosis, an autoimmune disease I will have for life. I got it despite my youth, resources, education and mostly healthy lifestyle. It’s a complex disorder, and potentially disabling. But I get to be sanguine about my future: I know that whatever comes, I have a safety net, a growing range of treatment options and the care of a first-class specialist. I have these things because I happen to be a UK national. Constitutional ambiguities aside, Americans should rejoice in a move towards a European healthcare model. Here's why.
Without access to the National Health Service or private insurance, I would be (and was, for a time) spending about $2000 a month on medications alone; along with consultants’ fees, ancillary imaging and testing, the disease could easily cost $40-50,000 a year. My best-case scenario would be a choice between health and a comfortable existence.
At the time of diagnosis, I had just moved from New York to stay with family in Bermuda, a British territory with a US private healthcare model. I was uninsured, and the moment vague symptoms became a blip on an MRI, I became permanently uninsurable. The diagnostic process, conducted in the US, proved stunningly expensive.
I moved to the UK to take advantage of my NHS eligibility, exhausted and angry after months grinding my fingers trying to wrest health out of an engine geared foremost to produce profit. Fragile and afraid, I had banged at the door of a fragmented, incoherent healthcare industrial complex, and – even with ready money – found only the frustrations of bureaucracy, and healthcare providers at every level whose interest in my case evaporated the moment the check cleared.
I came to the NHS steeled for similar challenges, only cheaper. Instead I found a different world. A de-monetized doctor-patient relationship has made a tremendous difference to my experience of care. With no incentive for hasty patient turnover, primary-care physicians learn about you and have time to fight your corner within a system they know intimately. A central data-sharing system obviated my stressful, hyper-vigilant legwork, accounting and record-keeping.
Crucially, the NHS model promotes collaboration between services rather than excessive competition. Out of necessity, it privileges cheaper preventive schemes rather than the high-cost acute interventions more common in unregulated healthcare markets. UK Government mandates for prevention and efficiency targets keep individual contributions low and curtail illness. For myself, timely cancer screening and abundant female reproductive care options are great allies in this awkward business of having a body.
The NHS has problems. It’s an overburdened, lumbering old beast bedeviled by cuts, and often doesn’t move fast enough to provide specialized services when I want them. So I have the option to buy relatively inexpensive supplemental private insurance and avail myself of world-class private care at any time. This imperfect system, despite schism and expenditure squeezes, allows me to live unburdened by fear because it invests in the sustainability of the only system dear to me, the one made of cells into which I breathe. And it will never turn me away.
While a healthy and fully insured person may not take much interest in my atypical healthcare adventures, those with interest in the health of nations might recognize a justifiable investment in human capital. A system that allows me to pursue my potential earns my talent as an asset of the state. An economy cannot gain health by laying waste to latent skill.
A year on, every time my neurologist squeezes in an unscheduled visit or orders an MRI just to appease my curiosity, every time my valuable medication arrives with perfect regularity in temperature-controlled packs, and whenever extra blood tests are foisted on me by a zealously caring and abundantly cautious GP – all for zero outlay - I’m aware that being taxed buys me disproportionate freedoms. I can still scarcely believe my luck.