Last week, the Mayor of New York, Bill De Blasio, announced free access to health care for all New Yorkers. For British citizens a universal right to free health care might not sound radical – it is something those of us under the age of seventy have enjoyed our entire lives. But in the USA it is a big deal and even in a progressive city like New York 600,000 citizens currently don’t have access to professional healthcare if they fall ill, because they can’t afford, or don’t have the right documents, to access health insurance. Medical bills are the single biggest cause of bankruptcy in the USA.
Having witnessed some of those closest to me requiring urgent access to our free British National Health Service over three successive New Year periods, I am in full agreement with the Mayor when he says that “[h]ealthcare is a right not a privilege reserved for those who can afford it”, but also reminded that it is a “right” that most global citizens do not actually enjoy.
Those of us who are lucky enough to know that when we get ill we can get immediate medical support, without having to worry how much it is going to cost, also need to remember the immense struggle and courageous leadership that went into enshrining that right into law in our jurisdictions.
Indeed, just as 600,000 New Yorkers are about to gain new services, millions of other Americans face reductions in their healthcare provision if President Trump delivers on his promise to undermine Obamacare.
That process has been more stealthy in Britain, but it is sadly no longer the case our National Health Service (NHS) is entirely free. Successive Tory and, more reprehensibly in my mind, Labour governments*, have foisted upon the NHS the wasteful ‘internal market’ that forces hospitals to compete with each other; required ‘contracting out’ to the private sector of everything from cleaning to ambulance services; saddled health services with enormous debts under the rip-off Private Finance Initiative; and gradually introduced charges for increasingly less marginal services, from hospital car parking places, to dental check-ups and prescriptions.
Or at least that is the case in England. In Wales, to which responsibility for health has been devolved from Westminster, successive Welsh (Labour) governments have resisted the privatising pressure from across the border. Even as a visitor to Wales, the antibiotics that Ms Markontour needed last week were provided free of charge and I didn’t have to pay for the privilege of visting my loved one in hospital, unlike last year when I had to get out a bank card when parking at the hospital where my Dad was being so well looked after in England.
The creeping privatisation and atomisation of a supposedly national health service is a serious departure from the principles laid down at the founding the NHS, the human impact of which was brilliantly dramatised in Owen Sheers’ poem for television, ‘To Provide All People‘, which I raved about in a blog last summer. Both mine and Ms Markontour’s spirits were raised recently when we realised that not only was she being treated in the Neville Hall hospital where the poem was filmed (by another wonderful, innovative public service, the BBC), but that down the corridor was a room named after the author (see photo above).
We are privileged enough that we could have afforded the prescription and parking charges without worry, but that’s not true for the vast majority of the world’s citizens. Charges for health service are not just iniquitous, they are also self-defeating if one’s aim is genuinely to achieve the best possible health for all citizens. Stress is a major cause of all kinds of illnesses and exacerbates many more ailments. What greater stress can their be than the fear, or awful reality, of falling ill and not being able to afford treatment?
Similarly, reading back about the founding of the National Health Service last week, it is notable how clearly Aneurin Bevan, the minister who drove through the legislation, made the link between poverty, pollution and ill-health. Seventy years later it is sobering to note that 400,000 more children are being brought up in officially-defined poverty in Britain than a decade ago, and eight per cent of deaths in London are attributed to polluted air.
Britains’ health service is in serious need of a government that really cares about it and it has been inspiring to hear opposition leader, Jeremy Corbyn, promise a £30bn injection funded by higher taxes on the top 5% of earners, along with the poetic justice of scrapping hospital parking charges in England through a levy on private health care.
Even without that, and despite Mayor De Blasio’s reforms, there remain major differences between the versions of free healthcare in New York and Britain, some of which go back to Aneurin Bevan’s original rejection of the option of an insurance-based scheme, like in the US today, because he didn’t want for-profit healthcare provision paid for by public funds.
Similarly, while New York’s progressive mayor has chosen to go considerably beyond the federal provisions put in place by President Obama, Bevan ignored his own maxim that “the purpose of winning power is to give it away”, and nationalised local health boards because he didn’t trust Conservative local councils to deliver a free, universal health service.
Bevan, however, were he still alive, would have been the first to applaud New York’s progress. Indeed, while celebrating what is being instituted in one of the world’s greatest cities, markontour is also reminded of Bevan’s observation during the passage of the National Health Service Bill that “No country can call itself a civilised society if a sick person is denied medical aid because of lack of money.” Mayor De Blasio clearly agrees.
*The Conservatives under Winston Churchill opposed the creation of the NHS at every turn and voted against it in Parliament more than 20 times, so one can’t expect their successors to truly protect it.