Some time in the making

At a social event a few days ago, I fell into a conversation with an older woman. She related an unfortunate emergency room experience she had while visiting Ireland a few years back. Following the flawed logic that seems to accompany far too much conservative thought, she inferred that this experience was representative of all forms of (wait for it) "socialised medicine."

Watch a few hours of TV this week (a few minutes of Fox News) and you'll be treated to a circa 1993 Republican attack ad along the same lines.

OK, let's cut the shit. Speaking not as an observer, but a participant in the American healthcare circus for the past four years, these hoary chestnuts will get us nowhere. Thoughtful participants in this system differ on details, but they do agree:

--The American healthcare system is broken. Not, probably, beyond repair, but it is too much damaged for Republican platitudes to be anything but a pathetic joke, and more proof that this party is hysterically out of touch with reality.
--It is immaterial whether we have the best research and medical technology in the world when we hardly make the top ten in delivering that research and technology to patients.

There are two kinds of horror stories available for Republicans: the one I listened to is the most common. These stories are not an indictment of nationalised care, so much as they are an indictment of emergency and trauma care everywhere. As things now stand, ED clinicians are on the short end of everything but workload. We work our ED providers to burnout or death, while more and more of the 47 million people without care, and many with inadequate care, pile up on the doorstep.

The other sort of stories most often come from people living with nationalised care who find a level playing field in access offends their sense of entitlement. With a respectable address, they don't see why Junior's scraped knee shouldn't entitle him to more ED attention than that accorded a bystander with a sucking chest wound caused by the local gangs' latest firefight. In the US, one entitled family can suck up an infinite quantity of medical resources. In Canada, the privileged who are politely told to wait their turn get on the phone to the US and sob their stories to the Republican pit bulls.

Republicans like to warn that "socialised medicine is rationed." Take a good look around, pilgrim: it already is, and it's big private healthcare payers who are doing most of the rationing.

In the Republican nightmare, those 47 million uninsured people are all freeloaders who have to be forced to get healthcare. That, of course, is why Romney backed Massachusetts' reform and why it's structured the way it is. Yet what did we find out? The people who had voluntarily opted out of health insurance numbered something in the low four figures. Most of them seem to have been children of privilege, mostly male, who traded on a sense of immortality and Daddy's trust fund to keep them out of trouble. Not quite the stereotype, eh, to have all these little proto-Republicans sponging off the system.

If you want something better, it may be time to vote the wingnuts off this island. See what we can do to fix it, instead of whining about all the reasons that we can't.

There may be other rants on this topic.