March 16, 2014 — As Others See Us

“O wad some Power the giftie gie us 
To see oursels as ithers see us!”

Robbie Burns was right. We can indeed learn a lot by considering what others see as they look at us.

Case in point: this column from the German magazine Der Spiegel. The author makes several points, from a European perspective, about the stubborn resistance in these United States to taxpayer-funded, single-payer healthcare.

This viewpoint is noteworthy because the leading European countries have long had such a healthcare-funding system. As have the Japanese. And the Canadians.

Sure, there are murmurings and complaints among citizens of those countries — as is true of any large governmental program. But nobody’s suggesting their nations turn the clock back, get out of the healthcare business and start allowing privateers to provide healthcare according to a for-profit business model, as we do in this country. I also know — from talking to my brother who lives in Canada and to friends who live in Britain, not to mention my own experience of two years living under the British National Health system — that the people of those nations do not, by and large, consider their government-provided healthcare to be a disaster. They may complain about some aspects of it, just as everyone complains about hospital food, but that doesn’t mean they wish someone would come in and whisk it away.

The other fact that’s seldom mentioned in our acrimonious healthcare debate is that, in most of these countries, there are still private, for-profit healthcare providers who cheerfully treat people who possess sufficient funds. Anyone who concludes the government health system isn’t doing right by them, or who desires to bypass a waiting list for a particular procedure, has that option.

I know that, at least in Britain, the cost of these for-profit services is a fraction of the sticker price of comparable medical procedures here in the States — which really isn’t saying much, because American healthcare providers’ sticker prices are artificial creations of their accountants’ fertile imaginations, crafted so as to inflate the amount they can ask insurance companies to pay. It’s like a middle-eastern rug merchant’s first asking-price, down at the bazaar. The truth is, we know very little about the actual cost of healthcare in the United States, because all the players are engaged in this sort of haggling, so the sticker prices have little relation to reality. There are also so many middle-people involved in the transaction — accountants, attorneys, data-entry people, negotiators, various middle-managers — standing there with their hands out, it’s getting increasingly hard to make the argument that government couldn’t do that aspect of the job more economically (as, in fact, it already does, with Medicare).

So, what does this German observer have to say, as she looks on the Obamacare scrum from afar?

1. The ever-practical Germans are baffled that American business is resisting a government program that would give them a competitive advantage. Part of the reason why some of Detroit’s blighted neighborhoods look like a war zone is that so many segments of our once-mighty automobile industry have been transplanted to other countries (in Detroit’s case, just across the river to Canada). Few people seem to realize that a major reason for the economic hemorrhage of outsourcing is that artificially-inflated American health-insurance costs have become such a drag on corporate budgets. Astute corporate executives long ago concluded that moving their operations to another country, where their workers’ healthcare coverage is provided by the government, is good for their bottom line.

2. The Germans are also baffled by “the continued portrayal of U.S. President Barack Obama and his health reform backers as socialists and communists.” This seems especially strange to them because their own national healthcare system was first introduced by Otto von Bismarck in the 19th century — and he was anything but a leftist. None of the Western European nations, Canada nor Japan are communist, nor are they in any danger of flying the hammer-and-sickle flag. On the contrary, their well-capitalized private corporations provide American industry with some of its stiffest competition.

3. Our first-world neighbors also find it strange that we Americans clamor for the right to radical individual choice in matters related to healthcare — as we have seen, in recent months, in the agita over the President’s ill-considered remark, “If you like your health insurance, you can keep it” (while failing to mention that he wasn’t talking about junk policies). Insurance companies have long recognized that the larger the risk pool, the more secure the coverage they can provide. That’s why even they — despite their professed opposition to the Affordable Care Act — quietly insisted that the Act include a required-coverage mandate.

4. Looking at the biggest of big pictures, the Germans also wonder how it is we fail to recognize how the health of every member of a society has an impact on the overall well-being of that society. An expatriate American who owns a couple of Berlin cafés puts it concisely: “The basis for everything is people’s health, not just your own health but the health of your neighbor.” It’s like the oft-quoted words of the Christian preacher and poet, John Donne:

No man is an island,
Entire of itself,
Every man is a piece of the continent,
A part of the main.
If a clod be washed away by the sea,
Europe is the less.
As well as if a promontory were.
As well as if a manor of thy friend’s
Or of thine own were:
Any man’s death diminishes me,
Because I am involved in mankind,
And therefore never send to know for whom the bell tolls; 
It tolls for thee.

Much of Donne’s written work was produced amidst a protracted public-health crisis, a series of plagues that decimated London’s population. What these gruesome plagues taught him is that, regardless of whether or not he or his family personally fell ill, the quality of their own lives was reduced as a result. We Americans love our individualist philosophy, by which we imagine we can withdraw into a gated community and hold the world at bay, but in matters of health this is simply impossible. We are all connected in community. If a neighbor suspects she has breast cancer, but delays going to the doctor because she doesn’t want to get diagnosed before she is insured, and dies as a result — as happened to one of my parishioners — it is a blot on all of us that we allowed such a travesty to happen. Actually, it wouldn’t happen today, because the Affordable Care Act has eliminated pre-existing-condition exclusions, but those who would love to simply trash Obamacare are — whether they realize it or not — advocating a return to those bad old days.

5. Finally — and surprising to some, no doubt — the residents of these highly secularized European countries detect a reek of hypocrisy among us Americans, who claim to be so religious but who callously ignore the mandate of “love your neighbor” that is foundational to nearly every religion. A conservative German politician puts it this way: “The question of health insurance is a humane question. I want every person — independent of age, independent of income or pre-existing conditions — to have the possibility to be helped when he is sick.” Any serious student of the earthly ministry of Jesus Christ must admit he spent a large portion of his time healing the sick. How is it that so many of us, who so proudly claim to follow him, turn in disgust from the most effective means of healing the greatest number of people: taxpayer-provided, single-payer healthcare? Yes, it would cause everyone’s taxes to go up. But please show me how it is possible to claim, based on the scriptures, that Jesus cares more about low taxes than he does about sick people. That’s the hypocrisy even secular Europeans can see, but which we ourselves so often miss. By no stretch of the imagination are we American Christians taking Jesus seriously if we value low taxes higher than the lives of our neighbors.

If we Americans are truly a Christian nation, even the most overtly Christian nation on earth (as so many conservatives are quick to claim), then how is it possible that “the U.S. ranks last out of 16 industrialized countries on a measure of deaths that might have been prevented with timely and effective care”? Can we in any way call ourselves Christians, and let such an obscenity continue?

The simple truth is that these secular Europeans, Canadians and Japanese see healthcare as a moral issue, while we Americans — who so fondly gaze upon stained-glass images of Jesus the healer — do not. It’s time we changed that.

Healthcare for all is not a political issue. Even these single-payer secularists know it is a moral issue. How can we fail to see it?