Wednesday, August 01, 2012

The USPS and the NHS

In the discussion of the Olympic opening ceremonies, Dubbahdee mentioned that Brits are quite fond of the NHS – something we don’t often appreciate here.  I couldn’t think of a good equivalence at first, but I wonder if it is similar to how Americans used to look at the postal service, before competing services came in.  We knew and liked our letter-carrier.  More of the mail we received was from relatives, girlfriends, friends traveling to far places.  We sometimes waited anxiously for the mail to come, and knew the appointed time.  There were bills, sure, but those weren’t Mr. Cohen’s fault.  There was a charm to small-town post-offices, especially the older ones, which suggested something quintessentially American. They got used as movie sets or in still photos to evoke a place or an era.  And the big city post-offices – whew – they were impressive marble edifices, which included other rich-people services such as passports, and long rows of PO Boxes with secret codes for locks.

We rather marveled that they could get cards and letters such great distances so quickly – most of the time, anyway.  We complained about them losing things or mashing them up, dropping them in the wrong box occasionally or returning them for teeny postage due, but we liked them.  They mostly got it right, after all.  We heard from time to time how much money they lost and groused about the rate increases. We laughed that some cranks thought it could all be handled privately.  We knew that was crazy!

Until it started to happen - with some specialised, larger business mail at first, and then with personal shipping and packages. Then we got angrier with the USPS, even as they improved, because we discovered that someone else can do the job – it’s not magic – and there’s no need to lose money on it.  Especially now, as our mailboxes have more catalogues and fliers, and less actual personal mail, we see the USPS as rather hollow.  An irony, that we loved them when they were far less efficient and dislike them now.

European health services came in at about the same time as actual improvements in medicine came in, especially pharmaceuticals and medical devices.  In England, the contrast is between the bad old pre-NHS days, when doctors couldn’t do much for you -  and bright, shiny modern times, with antibiotics and valiums and cancer treatments that actually worked.  Look at the era that they costumed the NHS to evoke:  not only the childhood of all but the oldest Brits, but just as national care came into being in the 1950’s.  They rode the wave of the great successes of the evil pharmaceutical companies and corporate manufacturers of medical devices and diagnostic equipment.  But the association remains.  Avant moi, le deluge.

So no wonder they love their systems and think we are crazy not to have them.  Without realising it, they have no standard for comparison.


Dubbahdee said...

It was pretty clear the Peter Boyle feels deeply sentimental about the NHS. Presumably he was implying that that feeling is not merely his own but is part of the national zeitgeist.

I hear you on the Post Office thing. How about this -- imagine what we would be without Interstate Highways (Route 66 notwithstanding)? National Parks evoke the sentiment of certain populations -- but that's nowhere near the universality of the NHS.

I would suggest that the closest thing we have to bringing out the tears and warm fuzzies is our armed forces. That's the service our government provides that we back like no other.

That's got to mean something, eh?

Texan99 said...

Just imagine if the Post Office, highway system, and national parks were eating up half the budget.

Retriever said...

I hate the Post Office here. We knocked down our mailbox in NH after one too many local yokels baseball batted it to pulp. Now we get zero mail there at all. We get all the important stuff online, and packages by Fedex and UPS. Unfortunately we have to get snail mail at our southern Retriever den, like the tax stuff, and for proof of residency etc. 95% of the mail is junk mail. We can't opt out of all the garbage. The political crap. The advertising crap. The flyers. The free non-newspapers. The trees dying for nothing. Because the Post Office would have collapsed years ago if it hadn't sold all this advertising crap. Grrrrr.

On the NHS? I think it used to be quite wonderful actually. Chiefly because most people in Great Britain earned so much less than in this country, so the safety net factor was a far bigger issue there than it is here. In this country people are always going bankrupt with medical expenses, but more people would have done there without the NHS. Also, historically, the working classes in GB got much worse health care than the upper classes (because of money) and had far worse health as a result, and the NHS somewhat helped to improve the health of poorer people. The problems have come in recent years with explosive immigration of people from countries with endemic health problems, and where cultural differences make communication difficult. Also, British health has worsened as the poor there have succumbed to many of the same ills as our poor.

When I was growing up there, people were all pretty skinny, active, and healthy, and didn't eat too much apart from the national passion for sweets as snacks.

I had four family members who had chronic health conditions that were initially treated (badly and expensively) by private Harley St physicians who made no progress in helping them. When they successively got desperately ill and had to go to hospital, they went on the NHS (because private hospitals are obscenely expensive and could only be afforded by Greek shipping magnates,movie stars, millionaires and rich Arabs at the time). There they got good care, good after care, and finally got better. ANd it was free.

My parents were unable to return to the US to retire because they both had serious health conditions that required a great deal of treatment and support that the NHS provided for free. In the US, they could not have afforded to buy it for themselves, and it would not have been covered because it was pre-existing, and Medicare would not have covered enough of it for them to have had enough left to live on. THey literally could not return to their own country because they were sick.

Now I had many complaints that the NHS didn't give them the BEST care, the caliber of care they could have got in the US. But they couldn't afford to buy the US care, and I couldn't afford to buy it for them.

The irony is, had they been Mexican illegals, they would have got it all for free...

33bbhair33 said...