Quite contrary to what John McCain's campaign manager, Rick Davis thinks, this election is most definitely about the issues. Sure, you can argue it's more about energy policy, more about wider economic policy or primarily about education - but healthcare policy is doubtless an important voter issue in this Presidential election. And when making the cross-Atlantic contrast on the issues, there are a plethora of different issues that we might choose to focus on. Be it, taxes, education or anything else, there are obvious and glaring differences between the politics of the United Kingdom and The United States of America. Healthcare, however, is perhaps the greatest contrast we have available today.
Healthcare is a major issue in this election and the difference between party lines couldn't be starker. Both of the major Democratic frontrunners in the primary season, Hillary Clinton and Barack Obama, supported a vision of universal healthcare. We can argue about the means, be it mandated or otherwise, but their end goal was ultimately the same. This was, and still is a stark contrast with the Republicans, a party who - rightly or wrongly - have opposed the policy from a much earlier point in history (See: The defeat of Hillarycare).
Truth be told, we know something about universal healthcare here in the United Kingdom, because since the creation of the National Healthcare System in 1948, we've had one! So what do we think about it? And more importantly in this election, how do we think it weighs up against the current private-based system in America?
Let's start by touching on a few, bi-partisan facts. John McCain and his fellow Republicans constantly attempt to remind us that America 'has the best healthcare system in the world'- and they're right! America does have the best healthcare system in the world - for a chosen few. In 2006, 47 million Americans did not have any form of healthcare and unfortunately, that number continues to grow in 2008. Here in the UK, we struggle to understand how a healthcare system that doesn't cover over 15% of the population can be anything like a good healthcare system, let alone the best in the world. Take for example, Antony Allen. This 21yr old British music student who was treated in an NHS hospital for a non-emergency operation last year, recently told me "I think it's the most viable system we have available to give quality healthcare to everyone. As a student, I simply couldn't have afforded the operation I had without the NHS". It has to be said that this view is more or less indicative of the wider views of most people here in the UK. Moreover, we arguably see this less about government handouts than about sensible, pragmatic government and as Mr. Allen adds, "I think that the health of the inhabitants of this country is critical for economic growth, not just social reasons. Because clearly, the more people who are healthy, fit and able to contribute to the economy the better".
But let's not confuse pragmatism with blind optimism. We also know we have managerial problems with our system, where government targets have sometimes overtaken the skill and knowledge of trained doctors, waiting lists have become troublesome and budgets have spiraled out of control. GPs and medical staff across the country often echo this warning and Dr. David Spackman, a General Practitioner in Oxfordshire, England is one of those Doctors: "To provide the perfect, golden service for the whole population for the UK is just not affordable...We need to be prepared to make tough choices about our healthcare priorities and the areas we want to invest in the most".
Yet throughout this debate, we've acknowledged these kinds of teething problems for exactly what they are: examples of mismanagement and not an overriding problem with the theory or the philosophy of universal healthcare. "We actually do have a fantastic healthcare system in this country" Dr. Spackman insists, adding "I think the level of NHS healthcare is pretty fantastic for the money that's available; the waiting lists and services on offer are very good. I'd far rather work under this healthcare system with all its failings than the American one, because I never have to worry about my patient's ability to pay - because I know it's covered and I can just get on with my job". In many ways and for all of our existing problems, this only encourages us further. We're not so foolish as to think that we have the perfect system and we know there are things that we can do better. What we rarely doubt, however, is the very idea of quality healthcare for everyone. Never will a citizen of the UK find themselves unable to pay for cancer treatment and left to suffer - it just wouldn't be allowed. So whilst we know we may never have that golden system, we also know that we find ourselves in a much better position than most Americans right now - where fantastic healthcare may be available for the fortunate few, but everyone else is out on their own and struggling with their premiums.
This brings us to the most definable contrast between the healthcare systems of these two great countries - between two different faces of Conservatism. In late 2005, David Cameron burst onto the British political scene as the new, fresh face of the Conservative Party and in his first major speech at the national party convention in 2006, he told the faces in the audience "When your family relies on the NHS all the time - day after day, night after night - you really know just how precious it is...For me, it's not a question of saying the NHS is 'safe in my hands'. Of course it will be. My family is so often in the hands of the NHS. And I want them to be safe there". To the population of the UK, this came as no great shock; no leader of any of the major parties would dare to suggest the abolishment of universal healthcare in this country - there would be riots in the streets (think Poll Tax).
Consequently, in the United Kingdom we view this election and the issue of healthcare through the prism of our own political climate and therefore with at least a degree of confusion. In the US, this argument is very much an argument between Liberals and Conservatives - between the left and the right. Yet here in Britain, where British Conservatives from Maggie Thatcher through David Cameron have always stood up for the NHS, universal healthcare as a philosophy has seldom been the subject of cross-party controversy. In contrast, the Conservative ticket in this Presidential election - of McCain-Palin - stands firmly opposed to any kind of meaningful reform of the healthcare system - certainly nothing resembling universal coverage. Indeed, John McCain and his fellow Republicans have consistently cited Great Britain's healthcare system as one of the best examples of how universal coverage almost always fails. We find this even more suspicious, as it seems to suggest that opposition to this specific policy issue is a grander facet of Conservative government. Rather, here in the UK, and regardless of its many shortfalls, Conservatives and Liberals alike consider the NHS an example of our extended freedom, and not our socialist ideals.
This week OffTheBus is publishing a variety of stories that cover the presidential election from an international perspective.