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 problems with ending encryption to fight terrorism

Forcing tech firms to create a "backdoor" to access messages would be a gift to cyber-hackers.

The UK has endured its worst terrorist atrocity since 7 July 2005 and the threat level has been raised to "critical" for the first time in a decade. Though election campaigning has been suspended, the debate over potential new powers has already begun.

Today's Sun reports that the Conservatives will seek to force technology companies to hand over encrypted messages to the police and security services. The new Technical Capability Notices were proposed by Amber Rudd following the Westminster terrorist attack and a month-long consultation closed last week. A Tory minister told the Sun: "We will do this as soon as we can after the election, as long as we get back in. The level of threat clearly proves there is no more time to waste now. The social media companies have been laughing in our faces for too long."

Put that way, the plan sounds reasonable (orders would be approved by the home secretary and a senior judge). But there are irrefutable problems. Encryption means tech firms such as WhatsApp and Apple can't simply "hand over" suspect messages - they can't access them at all. The technology is designed precisely so that conversations are genuinely private (unless a suspect's device is obtained or hacked into). Were companies to create an encryption "backdoor", as the government proposes, they would also create new opportunities for criminals and cyberhackers (as in the case of the recent NHS attack).

Ian Levy, the technical director of the National Cyber Security, told the New Statesman's Will Dunn earlier this year: "Nobody in this organisation or our parent organisation will ever ask for a 'back door' in a large-scale encryption system, because it's dumb."

But there is a more profound problem: once created, a technology cannot be uninvented. Should large tech firms end encryption, terrorists will merely turn to other, lesser-known platforms. The only means of barring UK citizens from using the service would be a Chinese-style "great firewall", cutting Britain off from the rest of the internet. In 2015, before entering the cabinet, Brexit Secretary David Davis warned of ending encryption: "Such a move would have had devastating consequences for all financial transactions and online commerce, not to mention the security of all personal data. Its consequences for the City do not bear thinking about."

Labour's manifesto pledged to "provide our security agencies with the resources and the powers they need to protect our country and keep us all safe." But added: "We will also ensure that such powers do not weaken our individual rights or civil liberties". The Liberal Democrats have vowed to "oppose Conservative attempts to undermine encryption."

But with a large Conservative majority inevitable, according to polls, ministers will be confident of winning parliamentary support for the plan. Only a rebellion led by Davis-esque liberals is likely to stop them.

George Eaton is political editor of the New Statesman.

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