The suggestion by a ‘think tank’ that more well-off patients should be charged £20 when they see their NHS GP has been greeted with howls of disapproval here in the UK. I’m informed however that people in America are totally bemused by this news item. For them £20 to see a doctor must seem like winning lotto! Allow me to explain:

Citizens’ rights in the USA are enshrined in the Bill of Rights of 1689.The bill is essentially the first 10 amendments to the Constitution and comprises:

Freedom of religion
Freedom of speech
Freedom of the press
Freedom of assembly
The right to bear arms
The protection against unreasonable searches and seizures
The right to refuse to witness against ones self * (aka ‘taking the 5th’)
The right to a speedy trial
The right to trial by jury
The protection against cruel and unusual punishment

Now you have to admit this is good stuff; I’m not that keen on cruel and unusual punishment myself. But note one important ‘right’ that is not there – the right to medical treatment. You have the right to bear arms and if you aren’t rich you have the right to bear illness and suffering too. Of course if you’ve got money you can buy yourself a lot including a new face and other parts of the body, drug cocktails for your kid with ADHD, organs from people in other countries and so on.

A lot of people run out of money when they get ill in the USA. More than 60% of bankruptcies filed in the last 2 years in the USA were caused by high medical bills. No wonder Americans are always muttering something about ‘health insurance’ in voices laden with fear and anxiety.

So why is medicine so expensive in the USA? After all it’s just a service industry where you buy a service from a medically trained person called a ‘doctor’ – isn’t it? Afraid not. My art, the art of medicine, has become a commodity to be bought and sold by creatures made of very different stuff from simple patients and doctors. Other animals need to make a very good living out of health care: The insurance salesman, the ambulance chasing lawyer, the vexatiously litigious patient and the executives of Big Pharma all have fancy cars, houses and at least one family each to feed. Doctors need to pay huge insurance premiums in case they are sued – which they inevitably are. So the price of seeing a doctor goes up and up and up…  Drug companies spend fortunes on developing drugs so they must make a decent profit for their shareholders!  And there’s a lot of shareholders who need to make money out of sick Americans. Yes, the shareholders are mainly Americans too. Oh forget about it – it’s too complicated to explain but I’m thinking of selling out myself. Any drug company want to offer me a 7 figure salaried job? No, no, not pounds! Dollars will be fine. USA! USA!