Three days in a US hospital convinced me that America needs ObamaCare

The bare-faced callousness of the American healthcare system is obvious. This isn’t a hospital; it’s the Wild West.

But is it really? Image: Getty

 

“Yeah, you’re going to need to go to the emergency room with that.”

In a healthcare drop-in centre in Brooklyn, I’m paying a man in a white coat $130 to prod my puffy red hand.

I last set foot in an A&E when I swallowed a piece of Lego, aged three. An emergency room, though? It has that “let’s not fuck about with unnecessary words” sense of American urgency to it. An emergency room is where you go when you’ve been shot seven times in the spleen. It’s where humans reduced to bloody slabs of gristle are careered about on trollies, and doctors need amounts of things, “stat”.

It started with a mosquito. For unknown reasons, a small bite on my finger ballooned and left me with a buoyant ham where my left hand used to be. Despite having been told by a dead-eyed pharmacist, “It’s fine. Take Benadryl”, there was no way (as a formidable hypochondriac) I wasn’t going to get it checked out.

My sister lives in New York, so I’ve spent a lot of time in the States, visiting her. But this is my first time navigating my way through the USA’s Kafkaesque healthcare system. First comes the paperwork, a War And Peace-thick pile of it, on which I write my name so many times that the words “Eleanor” and “Margolis” become hilariously absurd. Good thing I’m right-handed. I’ve been an American patient for fifteen minutes and I’m already starting to sweat. I bought health insurance at home, but I’m convinced that the company will play dirty; trying every trick in their sputum-dripping book not to cover me. While my hand is getting bigger and redder right before my eyes, I envisage a bill for a mighty stack of dollars. This is met with a peel of laughter by my insurance company, because I forgot to specify on their forms that I have one tit bigger than the other. “I’m sorry,” they’ll say, “We only cover the evenly-breasted. Enjoy prison.”

As the US government shutdown draws to some kind of close, maybe, I find myself lost within the system that started the whole thing.

I’m in a hospital bed, on an antibiotic drip. Some kick-ass painkillers have started to take effect, and I feel like human cheese on toast. I’m sharing my room with an elderly Hispanic lady called Carmen. Carmen is motherly and flatulent. Worried that I might catch a chill, she covers me in a blanket, then retreats behind her curtain and loudly farts.

My attempts to get to sleep are intermittently interrupted by the nearby calls of a nurse with a thick Brooklyn accent.

“Mary!” she says, again and again. I hazard a guess at Mary being a difficult patient.

Day two. I’m woken by a man’s voice.

“Miss Margolis?”

Medicated and soporific, I murmur something.

“Uh,” I say, perhaps.

The owner of the voice draws back my curtain and, to my drowsy horror, I’m met not by one person, but a crowd. I’m sprawled out in a star shape and half my face is coated in dried-up saliva. The man (a doctor) has brought along an eager troupe of young med students, to ogle my freak hand. A few pretty blonde girls in white coats jot down notes as the doctor points to bits of me and says sciencey things. Blood rushes to my cheeks.

“I am not a monster!” I want to say.

The doctor ushers the students away, and I go back to sleep. I’m next woken by the Food Bringer.

“Breakfast,” she says as she drops down a tray containing something that might be egg. I pick at whatever it is and endure a rush of overwhelming sadness. I can’t clear my mind of the fact that I’m in a place where a lot of people come to die. In another room, someone is hacking up a lung. Unable to concentrate on even the trashiest of American TV, I spend what seems like an hour poking holes in a polystyrene cup with a pencil.

“Mary, don’t touch that!”

My brother-in-law arrives with coffee. Having just been doped up with more painkillers, I gaze blankly at the ceiling while he speaks gibberish over the phone to my insurance company. Kind and attentive as the hospital staff may be, it’s hard to appreciate that you’re recovering when you have that constant, underlying fear of a giant bill.

“I know you’re in there, Mary!”

Carmen is arguing with a nurse in Spanish. I make out the words “Medicare” and “Medicaid” – America’s vestiges of socialised healthcare. Poor Carmen. I hope she’s covered.

Somewhere nearby, I can hear a nurse talking about the government shutdown.

“They just have to have their ObamaCare,” she says, her words oozing contempt.

I begin to wonder how the Republicans have managed to convince even those in the very midst of a system that punishes the poor, that the slightest implementation of state-funded healthcare is an evil, communist conspiracy.

Day three. A good-natured Polish nurse has just hooked me up to a drip and given me an injection of blood-thinner in the stomach. Carmen is leaving.

“Get better, darling,” she says, “And remember – if you need anything – money talks.”

She chuckles and exits my life. With her final words to me, Carmen may have been joking – but she’s neatly summed up the bare-faced callousness of the American healthcare system. This isn’t a hospital; it’s the Wild West. As a foreigner with travel insurance, I’m lucky enough to observe American healthcare from a safe distance. But to someone fully enmeshed, like Carmen, ObamaCare is a tiny drop in the murkiest of quagmires.

Eleanor Margolis is a freelance journalist, whose "Lez Miserable" column appears weekly on the New Statesman website.

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The hidden joy of charity shops

Mary saw her colleagues at the charity shop every day, but she didn't tell them she was sleeping on the 31 bus.

Camden is a bric-a-brac kind of place – market stalls, blaring music, occasional offers of weed. But the back room of the Sue Ryder charity shop on Parkway is immaculate, with hooped petticoats waiting to be steamed and crockery stacked neatly on the shelves. I’ve come to talk to the shop’s manager, Oya, and one of her volunteers, Mary*, and they are waiting for me with milky tea and chocolate-chip cookies.

Mary is nervous. She is afraid of having her real name printed. “It’s shaming to tell you my story but I believe if I tell people at the right time, good things will happen,” she says. Now in her fifties, she arrived in Britain four years ago from Italy, without friends or savings, having left her husband. The jobcentre gave her an Oyster card and told her to volunteer at a charity shop to improve her English. “So we put her on the tills,” says Oya. “That’s what we do with anyone who gets sent to us to learn English.”

But Mary had a secret. She couldn’t find anywhere to live, so every afternoon, when she finished her shift at the shop, she would go to the jobcentre and laugh and joke with the staff there to cover up the reality that she didn’t have anywhere else to go. When the jobcentre closed, she would ride the 31 bus through the night, from White City to Camden and back again. It was the best way to stay warm. Then, every morning, she would arrive at the shop early, brush her teeth in the staff bathroom and change into fresh clothes – washed in a friend’s hostel room. No one else knew.

The charity Crisis calls people such as Mary “the hidden homeless” and says that it is almost impossible to estimate how many of them there are in Britain today. Most homeless people don’t qualify for accommodation in shelters but eke out their time shuttling between friends’ sofas, insecure rented accommodation, bed and breakfasts or sleeping rough on the streets.

Eventually, the shop manager – Oya’s predecessor – asked Mary what was wrong and her story tumbled out. Between them, with help from the jobcentre staff, Mary found a studio flat and moved from volunteering on the tills to working at a nearby convenience store, where she is now a supervisor. Both she and Oya have to stop to reach for tissues while telling me this story. “Sue Ryder is my family,” says Mary. “Sometimes I want to cry but there are no tears left. And Allah would be angry if I dared to cry now, with all that I have.”

Despite having a paid job, Mary still volunteers at the charity shop on Friday mornings. She leaves at 3pm to work the evening shift at the convenience store. She and Oya are firm friends outside work. Mary brings in home-cooked lasagne for Oya and her daughter – “She says, ‘Eat some tonight, freeze the rest for Ella’” – and Oya invites her round and cooks her Turkish food on Friday nights. “She’ll say working here saved her life,” says Oya. “I’ll say I made a friend for life.”

The reason I’m here is a selfish one. Volunteering for a charity is the perfect antidote to a culture that can often feel mercenary, cynical and ruthlessly individualistic. I wish more people did it. I’m also here because in December, I wrote a piece defending charities from accusations that many do not turn every penny of donations into outlay on their projects. But running charity shops requires upfront investment – on electricity, rent and wages – so it’s too simplistic to demand that all the money they receive should go straight back out of the door.

That article prompted the management of Sue Ryder, which operates 457 shops with 12,000 volunteers, to get in touch and invite me in. Some of their volunteers, like Mary, need to learn English and other skills before they can get a paying job; some are serving prison sentences; others are youngsters sent unwillingly by their schools for work experience. (Jackie, who now manages one of the charity’s shops in Aberdeen, had previously been imprisoned three times.)

Not that everything is rosy in the charity shop back room. Oya says that some people use them as a “dumping ground”. I tell her that I once read a story about a donation of tights that had a used sanitary towel still stuck to the crotch and they nod: “We had that.” Oya is very proud, however, that the store “doesn’t smell like a charity shop”.

As well as providing jobs and raising money, stores such as this one provide a useful social barometer. There are around 9,000 charity shops in the UK and their number rose 30 per cent in the five years following the financial crash of 2007. Since then, the economic downturn has increased trade significantly. Last year at the shop in Camden, the number of donation bags increased by 52 per cent and takings went up by 8 per cent, yielding a net profit of £65,000.

In Camden, close to chichi Mornington Crescent and Primrose Hill, the donations can be eyewateringly expensive (recent finds include a £1,200 clarinet and a £980 Prada handbag), while the cheapest brands stocked are Marks & Spencer and Next. “More people are charity shopping,” says Oya. “And not the people you’d expect. They’re suited and booted. Sometimes they’re famous.” Mention is made of an EastEnders actress spotted in the store.

Because of her work, Oya has been invited to a garden party at Buckingham Palace on 12 June and naturally she is taking Mary. A trip to buy hats is coming up and their enthusiasm is infectious. Here in the back room of a north London charity shop, as the three of us – a Turkish-British Muslim, an Eritrean-Italian Muslim and plain old white agnostic me – drink milky tea, I feel the most British I have all year. These guys really love the Queen. And they love being friends. Stepping out into the sunshine, my overwhelming feeling is: maybe we’re all going to be OK.

*Her name has been changed

Helen Lewis is deputy editor of the New Statesman. She has presented BBC Radio 4’s Week in Westminster and is a regular panellist on BBC1’s Sunday Politics.

This article first appeared in the 19 May 2016 issue of the New Statesman, The Great Huckster