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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Leader: Trump and an age of disorder

Mr Trump’s disregard for domestic and international norms represents an unprecedented challenge to established institutions.

The US presidency has not always been held by men of distinction and honour, but Donald Trump is by some distance its least qualified occupant. The leader of the world’s sole superpower has no record of political or military service and is ignorant of foreign affairs. Throughout his campaign, he repeatedly showed himself to be a racist, a misogynist, a braggart and a narcissist.

The naive hope that Mr Trump’s victory would herald a great moderation was dispelled by his conduct during the transition. He compared his country’s intelligence services to those of Nazi Germany and repeatedly denied Russian interference in the election. He derided Nato as “obsolete” and predicted the demise of the European Union. He reaffirmed his commitment to dismantling Obamacare and to overturning Roe v Wade. He doled out jobs to white nationalists, protectionists and family members. He denounced US citizens for demonstrating against him. Asked whether he regretted any part of his vulgar campaign, he replied: “No, I won.”

Of all his predilections, Mr Trump’s affection for Vladimir Putin is perhaps the most troubling. When the 2012 Republican presidential nominee, Mitt Romney, warned that Russia was the “number one geopolitical foe” of the US, he was mocked by Barack Obama. Yet his remark proved prescient. Rather than regarding Mr Putin as a foe, however, Mr Trump fetes him as a friend. The Russian president aims to use the US president’s goodwill to secure the removal of American sanctions, recognition of Russia’s annexation of Crimea and respect for the murderous reign of the Syrian president, Bashar al-Assad. He has a worryingly high chance of success.

Whether or not Mr Trump has personal motives for his fealty (as a lurid security dossier alleges), he and Mr Putin share a political outlook. Both men desire a world in which “strongmen” are free to abuse their citizens’ human rights without fear of external rebuke. Mr Trump’s refusal to commit to Nato’s principle of collective defence provides Mr Putin with every incentive to pursue his expansionist desires. The historic achievement of peace and stability in eastern Europe is in danger.

As he seeks reconciliation with Russia, Mr Trump is simultaneously pursuing conflict with China. He broke with precedent by speaking on the telephone with the Taiwanese president, Tsai Ing-wen, and used Twitter to berate the Chinese government. Rex Tillerson, Mr Trump’s secretary of state nominee, has threatened an American blockade of the South China Sea islands.

Mr Trump’s disregard for domestic and international norms represents an unprecedented challenge to established institutions. The US constitution, with its separation of powers, was designed to restrain autocrats such as the new president. Yet, in addition to the White House, the Republicans also control Congress and two-thirds of governorships and state houses. Mr Trump’s first Supreme Court appointment will ensure a conservative judicial majority. The decline of established print titles and the growth of “fake news” weaken another source of accountability.

In these circumstances, there is a heightened responsibility on the US’s allies to challenge, rather than to indulge, Mr Trump. Angela Merkel’s warning that co-operation was conditional on his respect for liberal and democratic values was a model of the former. Michael Gove’s obsequious interview with Mr Trump was a dismal example of the latter.

Theresa May has rightly rebuked the president for his treatment of women and has toughened Britain’s stance against Russian revanchism. Yet, although the UK must maintain working relations with the US, she should not allow the prospect of a future trade deal to skew her attitude towards Mr Trump. Any agreement is years away and the president’s protectionist proclivities could yet thwart British hopes of a beneficial outcome.

The diplomatic and political conventions embodied by the “special relationship” have endured for more than seven decades. However, Mr Trump’s election may necessitate their demise. It was the belief that the UK must stand “shoulder to shoulder” with the US that led Tony Blair into the ruinous Iraq War. In this new age of disorder, Western leaders must avoid being willing accomplices to Mr Trump’s agenda. Intense scepticism, rather than sycophancy, should define their response.

This article first appeared in the 19 January 2016 issue of the New Statesman, The Trump era