Health Care Reforms: An Englishman’s Perspective

After months of debate and controversy, President Obama’s landmark Health Reforms have finally passed. I thought  it might be interesting to give you my take on the whole thing, being a foreigner in this part of the world, and in the process hopefully encourage a discussion in the NOURISH community.

Coming from England, I have grown up with the safety net of a national health service (NHS) and fortunately I have never had to directly pay for health care (although I have paid my fair share of National Insurance taxes).

Having lived in California for over a year now, without health insurance, I have been monitoring the development of the health reforms pretty closely. When they were finally signed off and phrases like “landmark deal” and “new day” were thrown around I found it quite amusing… because when you compare the reforms to what has been going on at NOURISH for the last year, they suddenly do not seem so revolutionary.

In a roundabout way, the reforms will, hopefully, make medical care more affordable, and easier to access, for millions more people. While this is certainly a cause for celebration, NOURISH has been doing this since they opened! It is one of Victor and Jocelyn’s core beliefs… that they will make services affordable, because no one should have to choose between their health and their finances.

In lobbying for the reforms, Obama and the White House administration asked us to support them in their commitment to the nation’s health and wellness by getting behind the bill. The fact that the bill will force everyone to sign up for medical insurance, or face a hefty fine, could also be viewed as a commitment to the health and well being of the American people… even if it is forced one. Once again, commitment to clients health has been a cornerstone of NOURISH’s core values since they opened. Check out the website and  you will find a mission statement that states NOURISH will always seek to encourage “students, clients, and customers to join us in our commitment to their health and wellness.”

However, the reforms differ greatly to NOURISH’s approach to health and wellness when it comes the compromises made to get them to the people. Obviously NOURISH and the federal government operate on very different levels, but I cannot but help feel that the repeated concessions Obama and Co. had to make to finally get the bill passed has, for now, tainted the sense of accomplishment.

While to some extent the notion that ‘it is better to have something than nothing at all’ rings true, I know that NOURISH would never accept such terms. While compromises on logistical, administrative or material elements are often considered, they would never compromise the health and wellness elements of the center. This is evident in things like the time Victor puts into organizing his classes, the attention the massage therapists give to each client so that they are not just relaxing them but also healing them, and the notes Jocelyn takes in every consultation so that nothing is overlooked and everything is available for consideration.

I suppose ultimately, while the reforms are not particularly innovative, we have to hope that they represent a first step forward. So the cliche goes, Rome was not built in a day, and similarly America’s health concerns cannot be solved with one new bill… they are too deeply ingrained. But the positive change and momentum this bill brings will hopefully encourage more people and officials to think like NOURISH and make health and wellness and even bigger priority.

At the risk of wedging myself into the middle of the great debate over whether a US national health care service would be un-America (whatever that means), I will say, for it’s worth, that while the English  NHS is far from perfect, it is absolutely worth it! I do not think that a government ensuring that it’s people are safe and healthy crosses any privacy lines. It is a necessary intervention. What’s more, for those people in England who do not want to use the NHS, and are prepared to pay for a premium service, there is also the option of private health care. I see no reason why you could not operate the same system here.



Now, NOURISH member, Susan Stuart, who has a masters in Public Health, has been kind enough to continue the discussion and, for those of you who are still as confused as me about what it all means, provide a summary of the reforms:

“Although I have personally worked for the single payer bill in California, I am happy that congress is about to pass the senate health reform bill. President Obama has called it a middle of the road bill, which it is, but it has many good things in it. Insurance companies will not be able refuse coverage for pre-existing conditions or drop coverage. Young people will be able to stay on their parents insurance until age 26. Small businesses will get tax credits for covering workers and will be able to purchase more reasonable plans through insurance exchanges or pools. Medicare prescription coverage will be improved. More money will be put into prevention and into the Medicaid program. It will provide grants for small employers that establish wellness programs. It will also begin to lower health care costs, which is absolutely necessary given that health care is something like 16% of our GDP.

I’m hopeful that this is a signal that American society is beginning to believe that health care is a right; because I’m certain that a more egalitarian society is a healthier society for everyone. I recommend that people read the new book, “The Spirit Level: Why Greater Equality Makes Societies Stronger” by Richard Wilkinson and Kate Pickett, British social epidemiologists.

I’ll end with a quote from MLK: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

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