An Open Letter to Americans
16th August 2009
I am just a chemist from Southampton, a town in the United Kingdom, you know, the kind you will meet in your local drug store. So, in the scheme of things, I am relatively unimportant with no political affiliations. All I care about is the welfare of my patients. I wouldn't even have dreamt of writing this letter if my NHS has not been dragged into the important debate you are having across the ocean. I want to speak to you from the heart. Call it a social experiment. I want to explain why I am passionate about my NHS and why you have an important decision to make about your healthcare system. This is a social experiment because I will not spend a penny to publicize this letter but I want it to reach as many lives in America as is feasible using the social media that is Twitter and Facebook. I want people to read this letter and make their minds up about this important healthcare decision you are about to make. This is an opportunity for the marketers and publicists that litter these social media sites to prove their worth. You have my word: I will place no ads on this site, just links to the site's statistics.
I would consider myself a great friend of the United States. You have a great nation that you should be very proud of. You gave meaning to the word 'Liberty'. I knew yours is a great nation but I didn't understand how great until I listened to the book '1776' by David McCullough last year. If you haven't read it, I personally recommend that you do. It was Abraham Lincoln who said: "A friend is one who has the same enemies as you have". Our common enemy is inequality of health and I will explain why you should take this decision you are about to make very seriously.
My NHS is not perfect, but I have experienced a great deal of determined change in the way it is now configured over the last 10 years. Through a combination of strong leadership and determination, I feel the service is moving in the right direction. This is the service I am proud to call my NHS. The only reason why we are all rallying behind the NHS is because of the basic NHS ethos: the concept that healthcare will be available to every citizen that needs it.
America has been involved in a great many battles: The American Revolution led by General Washington between 1775 to 1782 when you Americans facedoff the largest empire in the world, and won. David McCullough described the events better than I could. Then there was the war of 1812 aptly named the Second War of Independence after which your independence was assured. Then you had the Civil War, the deadliest in your history and you came out of it with utmost dignity. In the end you had the Emancipation proclamation. 'A great majority of the 4 million slaves were freed by the Emancipation proclamation' (Wikipedia). You introduced the world to the concept of 'The American Dream' - Anything is possible. You even demonstrated this by electing your first black president. You have given much to the world. It is time for you to give something special to yourselves: The gift of health. Abraham Lincoln said "I am a firm believer in the people. If given the truth, they can be depended upon to meet any national crisis. The great point is to bring them the real facts."
What are the facts about health?
Once you have lost your health nothing else matters! That is why we all take health very seriously and I have no doubt your current system takes this very seriously. Why can't you extend that gift to everyone of your citizens? You have made giant strides on the tough issue of liberty for all. America has always been known as the land of the free people. I read about a survey conducted by the US Census bureau in 2007 that estimated that nearly 46 million Americans, or 18 percent of your population under the age of 65 were without healthcare insurance(NCHC). That is far too many people without cover. What happens to them? Slip away quietly and die! If you now consider that since 2007 your country (and indeed the whole world) is going through the worst recession ever, then you can only imagine how bad the figures are right now.
Worry, you see, is the worst enemy of good health. I know that my health means everything to me. So if I am worried about keeping up with my health insurance premium and have no fall back, then it is likely to have even more detrimental effect on my health. When your citizens can put the healthcare worries to bed, they can start to live. They can start to work even harder for Uncle Sam. The kind of work which, will make your great country emerge even stronger from this recession.
I know some people will argue that you have charitable institutions that look after those that are not fortunate. My answer to them is Bernard Madoff! Surely you have not forgotten what happened! I'll explain: When the country is booming, it doesn't matter. There will always be some rich people (I am happy to say you have a few of those in your great country) with a big hearts to help the down trodden, the uninsured . But when the financial juices dry up, charity will always begin at home. You can't blame them - natural instincts. Then you have people like Mr Madoff and his Ponzi scheme. Whilst running his scheme, he supported a lot of charities. Institutions which affected peoples lives. The Wall Street Journal reported the impact of his actions as 'catastrophic' on the jewish charities (WSJ). 'Programs for Bone-Marrow transplants and Human right campaigns find themselves in peril'. So you cannot put something as fundamental and important as your healthcare in the hands of some charity. The only institution which will be able to guarantee that universal health is the institution you control - your government! As Americans, it is within your gift to extend this to everyone of your citizens. After all, you have just spent billions of dollars bailing out the bankers.
What are you concerned about?
That you will be supporting those who have been irresponsible enough not to have healthcare insurance? That the cost will sky-rocket and you will not be able to afford it? That the pharmaceutical companies will not be able to innovate? Let me try and tackle each question:
Supporting the irresponsible
At least we can agree that there will always be people through no faults of their own, who are disadvantaged as a result of a number of factors; even disability. Does that make them irresponsible? A mark of greatness is the ability to support the society's unfortunates. After Madoff and the global credit crunch, a lot of perfectly responsible people now find themselves in impossible positions. That person you think is irresponsible could have been you (or may have been you!).
Then there are those who are genuinely irresponsible. How do you deal with those? It is your healthcare and you can make it whatever you want it to look like. Please remember that when you describe someone as irresponsible, you are making a judgment on that person. And you may be wrong!
Cost will sky-rocket
The healthcare will be as expensive as you make it. If you are paying for it you will start to scrutinize your therapeutic interventions more closely. You will have to eliminate waste. Ask your healthcare professionals. They know where the wastes are in the system. They will save you money without compromising your quality of health. With strong leadership, you can start to spend your healthcare budget on interventions that makes real difference to people's lives.
The pharmaceutical companies will not innovate
I am personally encouraged by what is coming out of the big pharmaceutical companies. They are beginning to understand that they have a social responsibility. It is not all about profits to shareholders. A number of them are now consolidating their positions. They want to be part of the solution not the problem. They now know what they have to do. And if they want to innovate and they ask you for help, it is within your rights (and power) to develop a system which will provide the pharmaceutical companies with opportunities to innovate. It can be done and it is being done. What will you rather have your pharmaceutical companies doing? Supplying drugs to you on the strength of an effective marketing campaign or on the strength of a great product? It is in everyone's interest for the pharmaceutical companies to develop new innovative drugs. The debate has never been about that in my humble opinion.
Ladies and Gentlemen, the most important decision you have to make is the gift of health to everyone of your citizens. As I understand it, President Obama, has set Congress 8 principles on healthcare. He is asking Congress to do what it is employed to do. The 8 principles are:
- Guarantee Choice
- Make Health Coverage Affordable
- Protect Families' Financial Health
- Invest in Prevention and Wellness
- Provide Portability of Coverage
- Aim for universality
- Improve patient safety and quality care
- Maintain Long-term fiscal sustainability
I am just a pharmacist working in my NHS and helping my patients get the most out of their medications. I am also a good friend of America. Your country has given the world so much. It is time you give your citizens the gift of health. I felt compelled to write this because you brought my NHS into the debate. My NHS is not perfect but I love it. This is a golden opportunity for you to give yourself a healthcare you can call your own. Please don't let it pass. And guess what? I know you wouldn't.
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