Sicko in South Bend, Indiana

I like Americans. I really do. Most of the people I have met here have been nothing short of delightful. However, there are some things that I don't like about America. Being here has made me more aware of some of my deeply held Australian values, like belief in a proper, taxpayer funded social welfare system. There are many problems with the Australian system and I have complained loudly about many of them over dinner with friends, but Australians still collectively believe in providing for the basic needs of all our citizens, including whatever health care they may require.

One of the things that amazes Australians about the United States is the absence of free universal health care. There are flaws in our system, certainly, but it is baffling to us that it is possible for a citizen to be denied much needed health care because they can’t afford to pay for it. Although I knew this was the case, it wasn’t until I saw Michael Moore’s documentary Sicko that I realised just how hideous the outcomes of such a system can be.

There is a scene in the documentary where a woman is shown being dumped out of a taxi outside a charitable refuge. She is plainly confused, staggering around in a daze, and dressed in a backless hospital gown. According to the management of the refuge, this happens quite often. People who are found to be unable to pay their hospital bills are summarily ejected from the building and dropped off outside a refuge, even if they’re still very sick or under the influence of strong painkillers.

It’s a powerful scene, but part of my mind had refused to accept it. After all, it’s a shockumentary, right? This is Michael Moore’s job and he’s good at it. He’s going to find the worst cases to make his point. Surely this isn’t actually something that happens routinely in a civilised country?

On my one night in Indiana I saw it first hand. I had decided, for sentimental reasons, to spend the night in South Bend, Indiana. It’s the home town of a dear friend of mine who now lives in Sydney and I thought it might be interesting to visit the place she left. After I’d had my up close and personal Sicko encounter I wanted to go straight back to Sydney myself.

I was driving through town looking for the place I was staying, when I noticed an African American man staggering down the street. He was wearing those hospital scrub-style clothes that are made out of blue paper and dragging a plastic bag behind him on the pavement. I pulled over in the next block and watched him for a minute or two.

If I hadn’t recently seen Sicko, I confess I probably would have written him off as a drunk or drugged indigent, despite the hospital garb. You see a lot of homeless people in cities in the USA, more than I’m used to. Still, a closer inspection seemed to undermine that assumption. The plastic bag he was dragging was partly torn and I could see his normal clothes spilling out. They seemed clean and fairly new, white trousers with a leather belt and a shirt with a collar. It didn’t seem like the attire of a homeless man. His shoes were also in good condition. I’m sure it’s not easy to keep your running shoes white when you live on the street. I’m not homeless and mine have gone an unfortunate sort of yellow-grey. I could see tape on his fingers and chest where monitors had been hastily removed.

I jumped out of the car and walked up to him, just as another man crossed the street with his children to get them away from the man in scrubs.

“Hey man,” I said. “Are you okay?”

He looked surprised, although his eyes were unfocused. “Fine. I just got out of the hospital. I’m walking home.”

“That’s tough man,” I said. “Walking home from the hospital. Can I call someone to come and pick you up or something?”

“I’m fine,” he said, although clearly not fine. He wobbled over to a park bench and sat down. “I’m just walking home. No insurance.”

I took a closer look at him. Clean fingernails, neatly trimmed. Clean hair, recently cut. Clean teeth. Maybe early 40s. This guy doesn’t just have a home, he has a job. “Are you sure there’s nobody I can call for you?”

“Nah,” he said. “I’m just walking home.”

“Okay. Good luck man.” I walked away feeling bad on many levels. I felt bad that such a situation could exist. I felt bad that I couldn’t help because I’m too chicken to let a stranger into my car, even one who can’t walk or see straight. I felt bad because nobody else seemed likely to help.

Just then, a police car passed on the street ahead. I took off at full sprint and chased it down at the traffic lights. I suspect the two cops were slightly freaked out by the arrival of a panting Australian at their car window. They only opened it the tiniest crack. Such suspicion, and I wasn’t even wearing hospital clothes.

I told them about the guy on the park bench and explained that I was worried about him. I asked the officers if they would see that he got home okay. They said this kind of thing happens once in a while and they’d check on him.

The sick feeling stayed with me for several days. Election propaganda has already started to fly in this country and, in general, the left wing is promising to reform health care, while the right wing is insisting that America already has the best health care system in the world. I heard a right wing radio announcer exclaiming that the health care system is obviously fantastic because a Canadian friend of the Clintons’ came to the USA for surgery, and what will happen to all the Canadians who want to flee their socialised medicine for proper care in the USA? To that insane announcer and all the others who share her view, I say that the quality of health care should not be measured by the best care that lots of money can buy, but by the quality of care that is available to everyone. There is some government supplied health care in this country for people who are on welfare, but there are also clearly some big gaps in that system. In a country where the minimum wage is not enough to live on, a person can work hard as a casual employee and still not be able to afford health care.

A civilisation should not be judged by the status of the powerful, but by the status of the weakest citizens. The strong will flourish anywhere, under any system. That rich people from other countries come here for top quality treatment they can afford to pay for while your own citizens suffer is not a national achievement that anyone should be proud of.

I have heard smart Americans, nice people that I like, tell me that universal health care would not work in this country, despite the fact that it seems to muddle along tolerably well in most of the rest of the rich white world (and parts of the poor world too). There seems to be a widespread view here that nationalised health care will somehow instantly result in substandard treatment. All the Canadians, Australians, New Zealanders, British and European nations with universal health care who are alive and fairly healthy today would seem to suggest an alternative interpretation.