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Keep an open mind on national health care

The British model proves it's not as scary as feared.

Ashley Sayeau

is a writer living in London

Many Americans are probably worried that Tom Daschle, Barack Obama's choice for secretary of health and human services, will support more government involvement in health care.

Although I am a proud liberal, I know how they feel. When my husband, my daughter and I moved to London a year ago, I knew I would have to sacrifice a few things - like

the sun

- but letting go of my health care scared me most.

Like many Americans, we had been insured through my husband's employer. But in England, we planned to switch to the National Health Service - the kind of "socialist" program widely reviled in America. The service guarantees government-run, taxpayer-supported health care for all.

I didn't love my old health plan, but it was familiar, and it felt safe. And I liked the idea of universal care, but I was skeptical about whether it could actually work.

I was used to hearing government health care equated with long lines, shoddy care, and politicians bearing stethoscopes. Just two months before we moved, Rudy Giuliani thanked God that he was cured of prostate cancer in the United States, adding, "My chance of surviving [the disease] in England? Only 44 percent under socialized medicine."

My fears, however, quickly dissipated during my first encounter with the National Health Service. Three months after we moved, I picked up my 2-year-old from the babysitter and was told she had gone to the bathroom 25 times that day. I called our local clinic in a panic.

I had not yet registered with their office, and it was late on a Friday afternoon. No worries, the receptionist said. "You may have to wait awhile, but bring her in."

Expecting the worst, I packed a bag with enough activities and treats to last the weekend. But 30 minutes later, we were done. On our way out, the doctor reminded me that children get free prescriptions, and adults' are capped at around the equivalent of $11. I wanted to say, "Now you're just showing off."

Eleven months later - more than five of them spent pregnant - I'm still a convert. The sheer ease with which the National Health Service works is its strongest selling point.

You are assigned to a clinic close to your house (in my case, a 10-minute walk away). Once registered, you often have a choice of doctors. (I'm on a first-name basis with mine.) And because it's so hassle-free - 74 percent of Britons waited 15 minutes or less on the day of an appointment, according to a recent survey - you feel less anxiety about using it. Last week, our family had six contacts with the clinic for a range of services.

Gone are the hours spent debating whether to make an appointment - whether it would be worth the time and cost of the copay or prescription. Gone are the days of arguing with insurance companies over deductibles and coverage. Most important, gone is the immeasurable stress about the possibility of losing your job and having to choose between your children's health and putting food on their plates.

I'm not saying the National Health Service is perfect. Madonna once called British hospitals "old and Victorian," and sometimes they do look that way. Unlike in the States, my prenatal care doesn't include regular visits with an obstetrician-gynecologist; I see my general practitioner or midwife instead. And they hand out flu shots only to the very neediest; the rest have to pay.

Despite this, never once have I felt my health was compromised. And in fact, despite Giuliani's assertion, my husband has about the same chance of surviving prostate cancer in England as he did in America.

As Daschle and Obama move to provide "affordable, accessible health care for all," we need to think about health care more as a right than as a privilege. And we have to stop making coverage contingent upon employment. With unemployment at 6.7 percent, that's not practical or ethical.

Many will try to scare the public into believing that more government will mean less freedom. Obviously, compromises will be made; in Britain, there is constant controversy over the government's refusal to pay for extremely expensive drugs with limited effectiveness. But every child in England is covered, unlike nearly nine million American kids.

In the end, a health-care program that is not profit-driven creates more choices than it eliminates. In Britain, you can quit your job and go back to school without worrying about accidents and illnesses. You can even write that novel.

You can also stay home with your young children. And if you want to leave an unhappy or abusive marriage, you can do that, too - without fear of jeopardizing your health or your kids'.

Such options are unavailable to most Americans. But if we keep an open mind as this debate progresses, they can be.