Higher taxes or death to poor people: America decides.

In America at the moment the big news is still the progress of Obama’s Healthcare Bill. It has, finally, passed in the House of Representatives, albeit with a majority of only five votes. 215 out of 435 Congressmen voted against the bill, with the Democrats only securing the slim majority by conceding some rights on abortion – pretty noteworthy in itself. However, this is far from the end for this particular battle: the Bill now has to pass in the Senate, which by all accounts will be even trickier.

I was in America this summer, at the height of the healthcare controversy, and was amazed at the pure vitirol aimed at anyone who dared to defend free healthcare. Fighting for space on the TV, alongside seemingly endless Bible channels where earnest men in shirtsleeves spout evangelist nonsense in English, Spanish and Cantonese, footage of tempestuous town-hall meetings with Democratic Senators were all over the news.

In the papers, alongside seemingly endless adverts for POM-X Pomegranate Antioxidant Superpills™ (strapline: “Antioxidants are a necessity – not a luxury. Recession-proof your health with POM-X”), stories of Obama’s plummeting approval ratings and death threats aimed at these same Democratic Senators abounded.

What was the cause of this public disgust? Had these politicians finally gone one indiscretion too far, and drowned a bag of puppies in the Pacific? Worse than that: they had proposed that if a poor person has, for example, a brain tumour, he should be able to have it removed without losing his home.

Like many people in the UK, I find it difficult to understand why the idea that medical decisions should be made on the basis of a person’s medical need, rather than on a person’s ability to pay, should be so controversial. Considering what a hard time the performance of the NHS gets from the public and politicians in the UK, it’s worth remembering how lucky we are it exists at all. It is such a British institution that we can pretty much guarantee that whatever horrible things the Tories do in power, scrapping the NHS will not be one of them. It’s likely that whatever Obama’ administration is able to introduce, it won’t be anything approaching the NHS in its current incarnation: even with the growing raft of privatised services (dentists, opticians, etc), we still have it pretty good.

The main argument from the right against Obama’s plans is that they would amount to a government takeover of healthcare. Here’s a classic soundbite from Candice Miller, a Republican from Michigan, after the vote : “We are going to have a complete government takeover of our healthcare system faster than you can say, ‘this is making me sick’”. The fact that government involvement in public health is seen as a bad thing is instructive: in the USA, general distrust of government – and the possibility of government-run social projects impinging on personal freedom – is enough to win most arguments at the national level.

Of course, it all comes down to money: how much of it you have to pay for yourself and those you care about; and how much you are willing put in the common pot, towards the common good. Whatever the answer to these questions, I am certain of one thing: I would much rather be poor and ill in the UK than the USA.