A middle-aged man is sitting, head drooped, on a portable stool in the middle of the pavement, with a makeshift cardboard sign on a string around his neck. Since my arrival in the US, it's been such a common sight to see people – or "bums", as they are dismissively called here – begging that I almost didn't read the sign. But this one stopped me in my tracks.
Scrawled in crayon, it read: "Please Help. Colon cancer. Lost my job. Can't afford the rest of my treatment." The message was as simple as it was brutal. Here was a man, it turns out, who had until recently worked at a job that came with health insurance, but when the job went, his access to life-saving treatment went with it.
The fact is that it would be hard to swing the proverbial cat here without hitting someone with a tale to tell about healthcare. It's ubiquitous. From dinner party conversations to the young campaigners in the street asking for a donation to help counteract the insurance company lobbyists in Washington, everyone wants to have their say.
Peter works in my local independent bookshop in Berkeley, California, and is keen to learn more about the NHS, and to explain why getting sick in America can be so perilous. Peter works part-time and earns a modest income. He has been without employer-based health insurance – something tens of millions of Americans rely on to pay for medical bills – since he became disabled, and is visibly perplexed by people who want to retain a system that means millions of people like him are denied basic treatment."It has to work, it just has to," he says of President Obama's plans to reform healthcare so that the 40 million Americans currently without health insurance have access to some, and so that those depending on employers to provide it don't end up denied life-saving treatment should they be unlucky enough to lose their job. "The status quo is simply unacceptable. But whether we get the reform we desperately need . . . well, that's another thing altogether."
As we talk, other people browsing in the shop join in. It's as if they are desperate to talk about it, to get their concerns off their chest. "It's a terrible situation this country is in and it can't go on," a slight, middle-aged woman proffers. "It shouldn't be the case that a whole family ends up in dire straits because someone gets ill, but that's what happens here."
While still a teenager, the woman's mother, who was the primary breadwinner, was suddenly seriously disabled and the family's meagre insurance cover quickly ran out. Their limited savings were swallowed up, as was any chance the children had of going to college, because the money set aside to pay for education was also consumed by healthcare costs.
"That's what I don't understand about the people who object to [state] healthcare provision," the woman says. "Don't they understand that anyone can get sick? Don't they understand that it's not that person's fault? If someone gets ill, it can mean a whole family going under. What kind of society are we that we can let that happen?"
At times, it feels as if healthcare reform here is being steered, and possibly even derailed, by those who have the most money and lobby for insurance firms, or by those who shout the loudest.
As the general election approaches, we can expect to see healthcare in the UK deployed, as ever, as a political football. There will be plenty of to-ing and fro-ing about quality of care, waiting lists, targets, privatisation by the back door, and curbing public expenditure.
What we won't see, however, is politicians suggesting that we shouldn't have a National Health Service.
What we won't see is anyone seriously suggesting that if you don't have money, then tough luck, the cancer will just have to get on with the business of killing you.
What we won't see is the man or woman who lost their job in this recession sitting in the street asking for a few pennies to help pay for their cancer treatment.
• This is the first in a new series of columns from Mary O'Hara in the US, who is the Alistair Cooke Fulbright Scholar 2009/10
So what do you all think? U.S. needs to step up and take a good look at what it DOESNT have!
(and dont tell me I dont understand!) I certainly DO!
