Health care should be a privilege

Call me a socialist — and certainly someone will — but in light of President Barack Obama’s diminishing insistence on a public option in the health care reform package that is developing in Congress, it’s worth noting that, despite the noisy support for the status quo arising from the right, many Americans would welcome significant change in our health care system, which even some Republicans admit is broken.

And why not real reform? When every other nation in the industrialized Western world — that is, the nations most like us — has recognized the mutual value of a healthy populace and made a commitment to ensuring universal health care coverage for all of its citizens, one wonders why the United States, whose Constitution obligates its government to "promote the general Welfare," cannot do the same or better.

The right insists that these "socialized" systems are disasters, maligning the British National Health Service vigorously enough to provoke a defensive reaction in the British press and elsewhere. We’re told, often by those who have a stake in keeping things here just the way they are, that these systems provide inferior, rationed care and long waiting lists for even the most critical surgeries. Sometimes the criticism becomes disingenuously sensational ("Death panels!")

But the fact is, many Americans have no idea how well or poorly these systems actually work or how satisfied their users are, any more than they appreciate the speed and efficiency of public transportation in Western Europe. I don’t claim to be an expert on European health care, but the anecdotal evidence certainly counterbalances the anecdotal evidence usually offered by its critics.

For example, the last time I wrote about health care, a reader said that his son had been living in France for 30 years. The son’s verdict on French health care: "Excellent!" A friend became seriously ill on the flight between Dallas and London and spent four days on the National Health Service. A PhD-degreed family nurse practitioner, she knows something about health care. Her verdict on the medical care she received: "More than adequate." And on the nursing care: "Excellent!"

If you’re calling me a socialist right now, you probably don’t have much regard for Michael Moore. But in his movie "Sicko," he grounds part of his argument for health care reform in the testimony of participants in the national systems of Canada, Britain, and France, doctors, nurses, and patients who expressed a great deal of satisfaction with their countries’ health care systems.

Moore has never made a secret of the agendas that his movies mean to convey. But were the testimonials of the satisfied participants simply put into the mouths of trained actors? I doubt it. If they had been, I suspect we would know about it.

No one would claim that the socialized systems of Western Europe are perfect, but the criticism of those who stand to lose if our country moves in that direction ring hollow in the context of our own system, which is unconcerned with our many millions of completely uninsured citizens, millions more who are underinsured, our disproportionately high health care expenditures, and our no better than middle-of-the-pack results.

Arguments along these lines usually result in several invitations for me to move to France. But many other Americans are not ready to abandon their faith in our ability to build a healthy society on a foundation of good, affordable health care for all citizens.

Doctors, nurses, and other health care providers deserve to be well rewarded for their services. Hospitals need to break even. But the profit motive will never move us toward a generous and just society where access to good health care is, if not a right, then at least a privilege of American citizenship.

(John M. Crisp teaches in the English Department at Del Mar College in Corpus Christi, Texas. E-mail him at jcrisp(at)