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By Brian Johnstone

I offered my support to Health Care for All-Oregon after hearing a talk show on KBOO, and I admit to being a little confused. Most advocates are still trying to imagine what a Universal Health Care system would mean to so many people, as Oregonians first of course, because it looks like the US is going to have to do it state-by-state, so far behind is the national consciousness lagging.

Perhaps I could help by relating what it is like from a British point of view, having been born into the NHS (National Health Service, instigated in 1948). I'll mostly use the Scottish model as my reference point, bein' as how it's my home country, but I've had care in England and the Irish Republic, mostly for rugby injuries.  They pretty much work the same way, at least from a patient's point of view.

So let me begin by saying that access to universal health care very quickly becomes part of the national consciousness. You really appreciate it after being here for any length of time and seeing how scared people are of getting sick, even with insurance. And how every powerful entity from  big-pharma, big-insurance, and corporately-run (although mostly biblically-named) hospitals, as well as what I call the "Owner-Media," are often intertwined with the many other interests who prefer not to see a universal system come to pass in this country.  

To give you a first of many examples from an outsider's viewpoint, i remember, on first visiting a doctor's office and hospital  in this country in the mid-to-late 1970's, at seeing Visa and Master card signs at the reception desk! That was the first confirmation of the horror stories I'd heard about medicine in the USA, and the inspiration for my determination to do what I could to get people to understand just how--yes--criminal this for-profit insurance-driven health lottery is. Maybe my stance is a bit radical, but I intent to contribute what I can by writing articles from both a small-business owner's stance and also as one who has been financially ruined by the non-system firmly in the driver's seat here.

Another example: I have twice traveled back to Scotland for non-emergency but much-needed surgery whilst a US legal resident, the first time without insurance, the second with what would be considered good coverage here. In the first case, on obtaining estimates from three surgeons, I decided to go back home with due notice to my family doctor in Scotland. The cost, including examination and confirmation of the condition, hospitalization and surgery, a ten-day stay in hospital and two weeks out-patient check ups, plus another week to become fully mobile and a round-trip airfare from the US West Coast, came to 1/3 less than it would have cost me had I decided to have the work done here. In the second case, with insurance, the expense in Scotland still came to less than half the cost here after deductibles, after-care and medication were taken into account. The last time here, however, when I was ruined by it all, I was taken to the ER, and then they really had me!

One point  the US talking heads never tell you in their desire to down-grade other nation's Universal or "Single-Payer" systems:  private insurance is available to anybody in the UK who wants to go that way. A friend of mine in Scotland, a small-business owner, decided to give private insurance and care a try. He ditched it after six months, declaring, "Hell, it never got me any better care than the NHS."  And that's the point d'appui; the care is the same for everybody. Any little trimmings are secondary but all are entitled to the same degree of treatment and healing. I don't know if this could ever be achieved in a "winner-take-all" society like the US, but we have to try.

I will never budge from the belief that 'if it's not for everybody, it's not a system!" This intrinsically implies that health care is a basic human right, as your Canadian neighbors realized in 1963, and your Mexican neighbors realized as far back as 1940, more extensively since the 1970's.

One thing that kills me about US doctors is that they, through their for-profit hospital's, administrators and insurance masters, have long denied care to so many, although they have to take the Hippocratic Oath, like their brethren and sisters throughout the "civilized" world. It might be a surprise to those of you who have not been treated elsewhere, that in most civilized countries nobody asks for your insurance, means of payment or anything else when you are taken to hospital or a clinic for attention. They get you right in to the treatment area for vital signs, then to the doctor, no matter what your legal status or skin color.

So what comes first here, exclusionary medical care or this oath? And how often is the oath violated every day in this nation? What it comes down to is that universally available health care and healing is one of the principal and glaring differences between "Industrialized" and "Civilized" countries. Know where you are and face the truth.

My wife's cousin is married to a Getty Oil executive and was stationed in England for a few years, obviously in a very privileged status. The UK system has a "well-baby" clause where a nurse is sent to check on any baby born or brought into the country until a certain age when its overall health is determined to be satisfactory. The well-baby benefit includes a milk allowance. (My daughter was subject to this procedure when we brought her to Scotland from Indonesia, for which we were most grateful).  Cousin Mary-Lou looked on the whole thing as "government interference" in her daily life, implicating a sinister motive which cost her nothing. Her husband, of course, had top-of-the-line US insurance which he didn't really need in the UK. Mary Lou is a dyed-in-the-wool Republican back home in North Carolina, and probably bad-mouths the British system at every opportunity.

So that's the kind of self-centered opposition you might anticipate from the reactionary element here. But so many more are needy (and this number is growing monthly) that the opposition are like rattling, mostly empty tin cans who have never faced the reality of the  need of true and comprehensive care.

Just another little story from my memory vaults.

Brian Johnstone is a Scottish exile. He says “I'm not a U.S. citizen mainly. due to the medical non-system here. I'm a potter, painter, former architect-construction manager, musician, chef and aspiring writer. I’ve studied US history and the Constitution closely, as was my perceived obligation when I chose to live here. 

“I have traveled and lived extensively worldwide, especially in South and Central Americas, S.E. Asia, India, N. Africa and Europe. Now I reside in Nehalem, Oregon, with my soul-mate Kate and our four beloved felines.”

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