Sipping your Starbucks, wearing your denim and listening to the late, great Michael Jackson – American imports seem to sit almost indistinguishably amidst British society. And with no language barrier, and the cosiest of political alliances, the similarities of the British and American cousins are clear for all to see. Even military mishaps are labelled ‘friendly’ fire.
Sitting down to watch England’s very own Hugh Laurie as the maverick diagnostician Dr. House in a humdrum American hospital is hardly radically different from the British equivalents of Casualty and Holby City. Maybe it’s a bit slicker, maybe the actors are all more beautiful and have nicer teeth, but essentially, nothing is lost in translation, except for the nonsensically rare diseases which puzzle Stephen Fry’s sidekick. And even the high emotion of US television can just about be reconciled with British reserve.
However, these outward similarities deceptively mask massive cultural differences behind the ‘Special Relationship’. The debate that has erupted in America over President Obama’s proposed healthcare reforms – essentially helping America’s 47 million uninsured citizens have access to potentially life-saving medical treatment which they would otherwise not qualify for – illustrates these differences explicitly.
The scale of the American debate is huge, and is itself a foreign concept to twenty-first century British politics. Nationally, town hall meetings are taking place where ordinary people on either side of the debate meet to argue their case with the high passions that we’re familiar with from Hollywood. Everyday Sarah Palins across America are espousing their values, while ordinary Bill Clintons rebut with theirs.
To British ears, these arguments are strangely alien. Our NHS sits as a cornerstone of the British establishment – questioning its existence would seem as futile as debating gravity. Only very few individuals on the right-wing of our politics dare to do such a thing—Daniel Hannan, a Conservative MEP is at the forefront of the British arguments against the NHS.
On America’s FOX News, he labelled the NHS a “60 year mistake”, an opinion which has led politicians of every allegiance back in Britain to hastily distance themselves from his view and pledge their support for Nye Bevan’s brainchild. But it would be wrong to dismiss all scepticism out of hand. Neither American sceptics nor Hannan are uncaring people, wishing to cheat the poorest out of healthcare for some outdated class-based discrimination. They argue that the ‘socialized’ system leads to systemic waste, to abuse from every part within, and results in a generally lower quality of care for all. The recurring ‘postcode lottery’ issues of the NHS are evidence of the reality of their concerns – bodies such as NICE have a tough job to do in deciding which medicines are financially viable given the benefits that they provide, and different people with different conditions in different areas may be left worse off. In America – you just pay for what you need.
On the whole, however, these arguments fail to convince British minds. Though the waste that pervades in the NHS presents a stick to beat governments of every stripe with – and attempts to deal with it have involved part-privatisation of some of the NHS’s activities – the benefits of the system outweigh the costs. That healthcare is absolutely free at the point of use in this country, no matter who you are, ought to be a source of pride for each and every British person. The system has flaws, but on the whole, people do seem to recognise the greatness of the institution – its unquestionable presence is quiet testament to this.
This then, is not the blind spot that we have. We recognise the value of the NHS; it is the huge difference in approach that exists between Britain and the USA that we can often fail to acknowledge. It is easy, with this particular debate more than others, to paint Obama as the ‘good guy’ in the British press, but we must remind ourselves that American debates begin with entirely different premises. Though we wear the same clothes and sip the same drinks and watch the same television, our individuality lurks beneath this outward appearance. Americans (to date, at least) have viewed healthcare as a privilege, as fitting within their over-arching commitment to the free market and the value of the private sector; Britain has instead seen healthcare as a fundamental right for its citizens, similar to the services provided by the Police or the Fire Service.
It may seem odd to us that in the wealthiest nation on earth, 47 million individuals are without the provisions that western medicine can provide; but it is our perception of this oddity that it is crucial to recognise and celebrate. We are still Bevan’s children, and his legacy looks after us well. It may not be House, but, as long as every single man, woman and child in Britain can claim medical care free at the point of use, we’ll be happy enough to check into Holby City.