Being a naturalized United States citizen, I don’t pretend to understand everything about the Americans. That said, I’ve never really thought of Americans as being particularly inscrutable except when it came to two issues: universal healthcare coverage and the unfettered availability to any Tom, Dick or Harry of guns, about which I confess I have been completely stumped for some 33 years.

When I left the United Kingdom I left behind what many ignorant Americans on the right refer to pejoratively as socialized medicine. In fact, that system provides universal health coverage to all residents; primary and emergency care is first-rate, and while there may be waiting times for non-emergency surgeries these have decreased in the last several years with extra funding. No Brit pays out-of-pocket expenses for medical care (dentistry is a different matter) and statistically health outcomes compare favourably with this country. And all of this is achieved with an expenditure of a bit less than 9% of GDP compared to more than 16% in the US. And among industrialized countries, the UK represents the rule not the exception.

By way of contrast, at any given moment between 40 and 50 million residents of the US are without health care insurance. Thousands die every year of treatable conditions for which they did not seek timely treatment because they lacked insurance. Out-of-pocket medical expenses are the leading cause of personal bankruptcy in America. Under the current system insurance companies can refuse to cover people with pre-existing conditions; many are so underinsured that limits on coverage can be reached quickly in the event of expensive and long-term treatments for conditions such as cancer.

A delightful illustration of why Americans should be ashamed of this state of affairs comes with the news that some of the wounded victims of the Aurora movie theatre shooting lack insurance and will have to depend on the charity of friends and relatives, and perhaps a national whip-round to pay their hospital and rehabilitation bills.

Yet, inexplicably, a plurality of Americans appears to prefer this awful status quo to the first meaningful reform effort to be signed into law: the Patient Care and Affordable Care Act or “Obamacare” as the preferred pejorative label this time from the ignoramuses on the right. While far from perfect (a public option would have been nice) the ACA promises to bring real and substantive benefits to both the insured and uninsured to address the flaws in the current system; but to most Americans it’s the policy equivalent of being forced to take castor oil.

And on the subject of guns, America again has taken a different path from other advanced nations. Unless one is to believe (which I do not) that Americans are inherently more violent than Europeans or Canadians, it is virtually impossible to escape the conclusion that America’s weak gun laws account for its murderously high homicide rate. And I’ve never understood why Americans on the one hand express shock and outrage at events such as the Aurora movie theater shooting-spree when, on the other, they have made such incidents inevitable by their refusal to vote for stronger controls and restrictions on the sale and possession of firearms.

The result, as with the lack of universal healthcare reform, is that thousands more Americans die or suffer grievously every year than would otherwise be the case if ordinary Americans and their political leaders made a different choice.

So is it Americans’ ignorance of the rest of the world which feeds their delusions that no matter their own travails they are better off than everyone else? Or are Americans simply a nation of masochists who suffer to be free or simply want to be free to suffer?

For me it continues to be a mystery and more than a little sad.

About N J Barnes

Retired sixty-something originally from England now a U.S. citizen living in Seattle. Married with a wife and two children. I love Seattle and consider it to have been a wonderful place to live and help raise my daughters. I worked in government my whole life. Whilst I see its flaws I also understand that government can be a strong force for good in democratic societies. My interests are current affairs and military history. I consider myself to be a centrist politically by any reasonable standard but probably left of centre in today's USA.

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