The Right Answer

A few years before I hit the beach, my wife and I made our first trip to Great Britain. When we were in London and unsure of how to navigate the many historic sites, we did what many tourists did—we took the hop on, hop off bus to get to places. While that was not the most efficient way to get to a given site, we knew sooner or later the bus would reach our desired destination. Sometimes that meant a ninety minute ride to get to a place which was only five miles or so from our hotel.

By our third day, we were getting brave so we decided to try one of the famous black cabs of London. They were expensive as compared to a one day hop on, hop off pass but time is money too. We hailed a cab and with a $8o fare we arrived thirty minutes later at the Tower of London which was actually a combined fortress, royal palace and prison. Centuries ago unfortunates received a haircut of a non-financial sort there. Just a little off the top. Permanently.

That steep $80 dollar cab fare was, though, instructive in another way. The cab driver seemed very sad and I asked him if he was OK. He said that he would not normally be driving that day but his adult daughter had just died from breast cancer and he needed to raise money for her funeral. I felt awful for him.

The cabbie said that at least the family did not have to worry about her medical bills since she had been a patient of the national health service. I asked him how he viewed that health care provider for most citizens and he said it was satisfactory. Most people knew it was not “posh” as he put it, but what it had in long wait times and lack of amenties was more than made up by removing financial worries when one got sick. Still, he recognized that more citizens with means were availing themselves of a private healthcare system which has developed in order to avoid the inconveniences of the public service.

Later on that vacation, we found ourselves on a walking tour of the sites of Glasgow in Scotland. We came upon a particularly large, old and ugly building which our guide said was the Glasgow Royal Infirmary where Dr. Joseph Lister first promoted the idea of techniques to insure sterile surgery. It was located uncomfortably within easy walking distance of the famous Glasgow Necropolis, final resting place of posh Scottish Victorians who may not have had the advantages of sterile surgery.

I asked our Scottish guide what he thought about the public National Health Service. Being Scottish and therefore obstinate, he quickly pointed out that the public Scottish Health Service was somewhat different and definitely better than the English version. He too acknowledged that there were deficiencies in the public service but that was more than made up by not having to worry about the financial aspects of being ill. He also liked haggis, a Scottish dish primarily made of lamb entrails, so his judgement may need to be discounted.

I thought about the cabbie and the haggis loving guide as the Democratic candidates for President have been discussing their various health care schemes. In Great Britain, polls both formal and in my case very informal indicate that the public likes the National Health Service, warts and all. So at most, politicians nibble around the edges. No one wants to disrupt that service.

Here in the the United States polls consistently show that while citizens would like to see health care be more affordable, they do not want to lose their private health plans. Yet many of the Democratic candidates seemed to want to replace the private plans with a public scheme, contrary to voters’ desires.

How do you make health care more affordable without replacing existing private health plans? That is a question someone needs to ask. The right answer might make someone President.