Watching the US health care debate from 10,000 miles away in Australia has been fascinating as well as frustrating.
I have friends in the US, UK and Canada and when we all compare our lives one thing that stands out about the US experience is the stress levels that come from worries about health insurance and health care.
I wish very much to see my US friends relieved of this stress. I guess our experience here with universal coverage and single payer might be useful but at this point in the debate seems a bit like walking into a tank battle with a cheery message printed on a ballon. Anyhoo..
We've had universal coverage since 1973 when a Labour government, lit by reformist zeal, introduced comprehensive reform on the back of a handsome electoral victory and a compelling mandate. That landmark acheivement happened in the context of the comparative simplicity of a nation of (back then) only 16 million and a now unrecognisably straight forward landscape of health costs and technologies. All of which means that it is disingenuous at the very least, and in some cases just plain dishonest, of some on the Australian left to say self righteously to our American friends "We did it, so can you".
The monumental gordian knot now facing Obama and the US legislators is in no way comparable to the logistically simpler challenge that faced Gough Whitlam in '73. To say nothing of the fact that our system has only about 2.05 branches of government and no executive veto. None of which is to diminish for a second the importance of what Whitlam acheived.
Nonetheless, even though the paths to the end result are very different, the more I think about it the more I'm convinced that you need to end up where we are. Which is also, plus or minus, where Canada, Japan and Germany are too.
And, yes, I know all those systems have differences that can be debated endlessly but, the fundementals are the same. Especially this, universal coverage.
That signature difference between American experience and that of those us in other parts of the west seems to me to be mostly about unversal coverage. The peace of mind that every Australian has had over the last generations that comes from knowing that no matter what life throws at us, no matter what our status, we are covered. You need that. Trust me on this.
How to get there from where you are is really hard and scary and involves letting go of a bunch of shiboleths that have been around for decades. Politically, this is Everest the hard way, in bad weather. No wonder so many Members and Senators are acting scared. They're not acting. They really are terrified. And no doubt those that know Australian political history will point to Gough Whitlam's ultimate electoral fate and say "look what happened that guy". But I think if you were to ask Gough (he's still with us in his mid 90s) he would say it was worth it.
Good luck to you and I really hope it works out so that next time we see our American friends they'll be less stressed and scared about their health.