Ambition vs. Will

Ambition vs. Will

A friend recently shared this graphic obviously advocating single-payer healthcare for USA and I agree with that ambition but seriously wonder if America truly knows what would be required and, once all is revealed, do we have the will to realize that ambition?

I do appreciate the concept of single-payer healthcare but, having personally and directly drank from the single-payer healthcare well on offer in Canada and UK, speak from a viewpoint based on experience and not speculation.

My local clinic in London where I consulted with any GP available and not the known GP I now enjoy here in Americashire was but a 5-block walk from our home. This clinic and its admirable doctors, nurses and staff looked after our basic needs but our needs required them to refer my family to other facilities for diagnostics and then specialized consultation.

Given the nature and severity of issues requiring these referrals and the unfathomable wait time for next available appointments, we decided to further invest in private insurance to ensure timely access to required diagnostics and specialists. Had we not been in the fortunate position to afford this additional insurance and access provided, I am not confident my wife would be here with me today.

I sincerely do not mean to be smug but viewing this graph quickly reminded me of the Sesame Street song, “One of These Things Is Not Like the Other”. And that was the obvious intent of this graph. All listed countries save for USA have single-payer healthcare. However, I do urge anyone who might read this note to read beyond the headlines, look beyond the immediate shadow this graph casts over this country whilst remembering that I am not opposed to single-payer healthcare.

And now allow me to set the table preceding the question of whether we as Americans have the will to realize this admirable ambition.

There is in this equation a very large, in fact ginormous issue of scale, and the time and money to achieve scale required here in America. Germany is in some ways a reasonable comparison with respect to its economic development although Australia and Canada would provide a reasonable comparison based solely on land mass.

Germany’s land mass could be placed inside the State of Montana and we’d have room left over for fast-food diners, roadside vendors of carbonated sugar drinks, all-you-can-eat restaurants and all those calorie dispensers that wouldn’t, in and of themselves, be condemnable were we the people to simply frequent them in moderation. Germany’s population is just a tad in excess of 25% of USA population. Yes, one of these countries is most assuredly not like the others.

In order for USA to move to a single-payer healthcare system I’ve attempted to list at least a couple of the things I believe would have to be true.

We would require: patience to re-orientate existing infrastructure (physical infrastructure like hospitals, clinics, etc.) to provide hub-and-spoke access; money (and lots of it) to either buy, rent or build required physical infrastructure; more money to invest in technology not unlike that provided by Cisco in China and witnessed by this author where a very remote yak farmer is able to consult with a regional specialist and thereby serve far-flung communities; more qualified doctors and nurses, and take a more pragmatic and realistic view as to which service should attract those professionals’ time and energy; and finally, the promise of a savage and unpleasant end of days in this life to any politician or bureaucrat who does not partake in this system themselves and is ever caught putting anything above delivering great medical outcomes in return for our hard-earned treasure.

I am not qualified to calculate the sums required to fulfill my small list of things I believe need to be true in order to provide the very large and populous country that is America with single-payer healthcare but I do hope you might at least look in the mirror and ask if you have the will to achieve this more-than-admirable ambition?

In the end, and more realistically from my point of view, single-payer healthcare in America would have to be decided and provided on a state-by-state basis whilst noting that my list of conditions that must be true to achieve this ambition would not be eliminated or diminished.

I’m willing to take the plunge but want to ensure that as we all run toward cliff’s edge on the other side of which is a gleaming example of single-payer healthcare, some do not pull up at last minute having suddenly realized the gap is deep and fraught with danger should we not make it to the other side.

Ambition vs. Will

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