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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"We repealed, then forgot": the long shadow of Section 28 homophobia

Why are deeply conservative views about the "promotion" of homosexuality still being reiterated to Scottish school pupils? 

Grim stories of LGBTI children being bullied in school are all too common. But one which emerged over the weekend garnered particular attention - because of the echoes of the infamous Section 28, nearly two decades after it was scrapped.

A 16-year-old pupil of a West Lothian school, who does not wish to be named, told Pink News that staff asked him to remove his small rainbow pride badge because, though they had "no problem" with his sexuality, it was not appropriate to "promote it" in school. It's a blast from the past - the rules against "promoting" homosexuality were repealed in 2000 in Scotland, but the long legacy of Section 28 seems hard to shake off. 

The local authority responsible said in a statement that non-school related badges are not permitted on uniforms, and says it is "committed to equal rights for LGBT people". 

The small badge depicted a rainbow-striped heart, which the pupil said he had brought back from the Edinburgh Pride march the previous weekend. He reportedly "no longer feels comfortable going to school", and said homophobia from staff members felt "much more scar[y] than when I encountered the same from other pupils". 

At a time when four Scottish party leaders are gay, and the new Westminster parliament included a record number of LGBTQ MPs, the political world is making progress in promoting equality. But education, it seems, has not kept up. According to research from LGBT rights campaigners Stonewall, 40 per cent of LGBT pupils across the UK reported being taught nothing about LGBT issues at school. Among trans students, 44 per cent said school staff didn’t know what "trans" even means.

The need for teacher training and curriculum reform is at the top of campaigners' agendas. "We're disappointed but not surprised by this example," says Jordan Daly, the co-founder of Time for Inclusive Education [TIE]. His grassroots campaign focuses on making politicians and wider society aware of the reality LGBTI school students in Scotland face. "We're in schools on a monthly basis, so we know this is by no means an isolated incident." 

Studies have repeatedly shown a startling level of self-harm and mental illness reported by LGBTI school students. Trans students are particularly at risk. In 2015, Daly and colleagues began a tour of schools. Shocking stories included one in which a teacher singled out a trans pupils for ridicule in front of the class. More commonly, though, staff told them the same story: we just don't know what we're allowed to say about gay relationships. 

This is the point, according to Daly - retraining, or rather the lack of it. For some of those teachers trained during the 1980s and 1990s, when Section 28 prevented local authorities from "promoting homosexuality", confusion still reigns about what they can and cannot teach - or even mention in front of their pupils. 

The infamous clause was specific in its homophobia: the "acceptability of homosexuality as a pretended family relationship" could not be mentioned in schools. But it's been 17 years since the clause was repealed in Scotland - indeed, it was one of the very first acts of the new Scottish Parliament (the rest of the UK followed suit three years later). Why are we still hearing this archaic language? 

"We repealed, we clapped and cheered, and then we just forgot," Daly says. After the bitter campaign in Scotland, in which an alliance of churches led by millionaire businessman Brian Souter poured money into "Keeping the Clause", the government was pleased with its victory, which seemed to establish Holyrood as a progressive political space early on in the life of the parliament. But without updating the curriculum or retraining teaching staff, Daly argues, it left a "massive vacuum" of uncertainty. 

The Stonewall research suggests a similar confusion is likely across the UK. Daly doesn't believe the situation in Scotland is notably worse than in England, and disputes the oft-cited allegation that the issue is somehow worse in Scotland's denominational schools. Homophobia may be "wrapped up in the language of religious belief" in certain schools, he says, but it's "just as much of a problem elsewhere. The TIE campaign doesn't have different strategies for different schools." 

After initial disappointments - their thousands-strong petition to change the curriculum was thrown out by parliament in 2016 - the campaign has won the support of leaders such as Nicola Sturgeon and Kezia Dugdale, and recently, the backing of a majority of MSPs. The Scottish government has set up a working group, and promised a national strategy. 

But for Daly, who himself struggled at a young age with his sexuality and society's failure to accept it, the matter remains an urgent one.  At just 21, he can reel off countless painful stories of young LGBTI students - some of which end in tragedy. One of the saddest elements of the story from St Kentigern's is that the pupil claimed his school was the safest place he had to express his identity, because he was not out at home. Perhaps for a gay pupil in ten years time, that will be a guarantee. 

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