I keep thinking about health care policy, even as it briefly drops out of the top layer of news. It will come back.
Today’s question: What universal benefits do we, in 21st century United States culture, believe should be collectively funded, through taxation?
Answer: education and certain layers of public health and safety.
President Obama almost got us to believe that we should permanently add universal routine health care to that list, but not quite.
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I recently watched the BBC series “Call the Midwife” on Netflix, and it restarted this line of thought. This drama explores the early and palmy days of Britain’s National Health Service, begun in 1948.
Those were the days: as a 1950s baby in England, I got “free” orange juice, Marmite and rosehip syrup. Even glasses and dental care were free. Those were the days, when visitors to Britain were looked after, no questions asked.
Well, things have certainly changed. The dear old NHS is a lot more frugal now. Wonderfully, though, “Call the Midwife” captures the golden dawn of the new system, dramatizing the puzzled, delighted, sometimes suspicious reactions of the working-class poor in London’s old East End docklands.
The midwives and doctors announce the need for hospitalizations, top-notch specialist care, caesarean sections, and daily visits from nurses: and it’s all free! Their patients can’t believe it.
Why would the government indulge in such largesse?
Immediate postwar years in the UK were austere, but after the left-leaning Labour government defeated right-wing Tory Winston Churchill in 1945, some things started to improve. Class divisions, still chasm-like, made the bemusement of the lower classes even sharper. Why would the toffs — that posh lot at the top — hand out these huge benefits?
The National Health Service was not free, of course, but paid for by income tax. Not everyone in the UK approved. The British Medical Association’s members weren’t all happy in 1948, that’s for sure. And, decades later, my working-class Tory father’s scornful version of the welfare state was this: “In 1945, the Labour government said to everyone, here, have some jam; and then the next day they said, here, have some more jam. Jam today and jam tomorrow.”
Like Mr. Bounderby in Charles Dickens’s 1854 novel “Hard Times,” Dad implied that all of us, especially his feather-bedded children, had got used to — and I quote Mr. B. — “being fed on turtle soup and venison, with a gold spoon.” Now the bill was coming due.
Yes, the bill always comes due — nothing is free. But how we pay the bill shows us what our core cultural values are. Some benefits of civil society, we already agree, should be guaranteed to all of us. When education and public safety are obviously weakened, we expect action, partly because our tax dollars are implicated.
Lead and GenX in the water, crumbling bridges, terrible test scores — these things sometimes cause heads to roll. If the police don’t come when you call, that failure is noticed. We need to reach that same norm, or level of expectation, in health care.
When the sick cannot afford care, that failure should attract the same level of disquiet that greets toxic sludge and non-arriving fire engines. Health care for all — without the added prospect of financial ruin — should be a normal part of a culture which already recognizes comparable obligations of public funding drawn from national, state and local coffers.
We should be ashamed that so many families facing illness and injury take to GoFundMe pages and Facebook appeals to avoid bankruptcy. These emergency flares are pathetic signals of our prosperous culture’s illogical understanding of the values and norms which shape — or should shape — a civilized society.
I don’t expect venison and turtle soup with a gold spoon, but a cheese sandwich and a glass of milk for all — no questions asked — would be nice. Taxes would go up, but we already pay for the accepted shared benefits of education and of all sorts of public safety measures. When will we finally make the leap to the communal funding of routine medical care? Perhaps the mid-term elections in 2018 will give us a clue about the answer to that question.
Rosemary Haskell (firstname.lastname@example.org) is a professor of English at Elon University in Elon, N.C.