The Sound of Summer

The heat of summer brings a distinctive sound to the eastern USA — not children playing or lawnmowers thrumming but the incessant shrill buzz of the cicada.

As humans we’re often not aware of the soundscapes that form the background to our lives — we react to particularly loud, unpleasant or evocative noises but tend to tune out the quieter waves of sound that can vary so much from place to place. Case in point: the sound of cicadas. While walking the dog this morning I found myself unexpectedly “tuning in” to a sound I’d never heard until I came to the US — the high-pitched whine that you hear everywhere outside the city throughout June-September, and most especially in August. The sound rises to an incredible crescendo around 9:00pm after a particularly hot/humid day, when the crickets join in.

(Click on the above link if you’ve never heard the sound. As cicadas aren’t exactly photogenic, I’ll illustrate the rest of this post with pictures I took of neighbors’ gardens showing off their summer colors.)

Cicadas — Magicicada periodical cicada to use the scientific name — are downright weird. Deposited as eggs in trees, the ant-sized young fall to the ground, burrow down near tree roots, and stay there for anywhere from one to 17 years. Yes, 17. The entire brood eventually reemerges at the same time, with ground temperature playing a key role in the cycle. The nymphs hike up the nearest tree, shed their exoskeleton, grow wings and (in the case of the males) start making a racket to find a mate. Apparently, the males have organs on their abdomen called tymbals. Muscles pop the tymbals in and out, which creates the distinctive cicada shriek, with different species having different sounds. (Yes, I looked all this up; the internet is a wonderful thing.)

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Cicadas are harmless, don’t fly very fast, and aren’t particularly destructive to human crops or plants. So, most of the time, we don’t really notice them; unless there’s a particularly big swarm, in which case there can be quite a few exoskeleton husks littering the patio or the sidewalk every morning.

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While reading up on cicadas before writing this, I found out that many of the big 17-year Swarm X (as in Roman numeral ten) appears to be emerging four years early this summer. Scientists’ best guess is that global warming is leading to longer periods of ground temperatures above 64 degrees Fahrenheit, causing the grubs to grow faster and emerge sooner. We won’t know if this is a permanent change that will lead to the development of a whole new brood, until another 13-17 years have passed. Either way, they’ve certainly been noisy the past few weeks.

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On the other hand, I see the other summer noisemaker, crickets, far too often. Especially in our basement. People in the neighborhood claim that crickets are prevalent around here because there used to be a cherry tree orchard in the area; as that would have been 100-odd years ago, it doesn’t seem likely. Whatever their origin, I’ve found out over the years that the best way to get rid of them is to lay out strips of sticky tape, particularly duct tape. They jump on and can’t jump off. Sounds cruel, I know, but anything that looks that much like a large jumping spider deserves whatever it gets.

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Still, the sound of cicadas and crickets calling out their presence every evening is a reminder of just how much life is lurking out there in the quiet gardens of suburbia.

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Tipping in America

What’s with Americans and tipping? It’s one of the odd little quirks about this country that I still find baffling. You’re expected to tip not just the restaurant server but the guy at the bar, the hairdresser, the cab driver, the hotel porter (actually, everyone you encounter who works in a hotel); even the garbage workers and newspaper deliverers leave envelopes for “holiday tips” in December.

fullsizeoutput_a31Tipping is totally embedded in pretty much any service interaction here. The standard at a restaurant is 15%, with more for “good” service. If you’re paying by credit card, there will be a line at the bottom of your bill (which is called, confusingly, the check) for you to add the tip. Some places even have handy little calculators printed at the bottom of the credit card slip to help you figure out what 15-20% of your bill comes to.

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If you go to use the credit card machine in a cab, they usually now include a stage in the process where you stipulate the size of tip you want to add (and in my experience this defaults to 20-25%, which can feel downright extortionate — unless you’re traveling on the corporate expense account in which case, why not?!)

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The only time I ever got a tip when working in the UK was when I was a student and working part-time in a big London department store, as a server at an “American Style Ice Cream Counter” (yes, really, the irony does not escape me). A young mother who spoke little English stopped by with her son, who gleefully pointed to the biggest sundae on the menu, a colorful concoction that cost about 3 pounds and came complete with red-white-and-blue sugar sprinkles and a little American flag decoration. When she gave me a 20 pound tip I assumed she’d made a mistake and tried to explain that this was too much, but she laughed and insisted, indicating that I had a nice smile and had made her son very happy. Needless to say, that 20 quid went right into my pocket, not into the near-empty shared jar where we were supposed to put any meager “tips” we received. (It wasn’t until later that it occurred to me that a woman who appeared Arab, judging by her clothing and head scarf, may not have been used to getting friendly service in 1984 London, but that’s another story.)

Anyway, back to the States: why is tipping so prevalent in this country? Are Americans such generous people that they’re willing to fork over extra cash to anyone who does a good job? Well, no, not exactly. Some cursory online research suggests tipping actually took off in this country during Prohibition — definitely not one of America’s finer moments — when bar owners struggling to make any money encouraged tipping to help their beleaguered staff makes ends meet. Whatever the origin, it’s now actually enshrined in the labor laws in many states; which means that businesses are allowed to pay their staff less than the state minimum wage in jobs deemed to be partially-dependent on tips for their pay.

Given that most wait-staff in most restaurants work incredibly long hours for very little money already, this can be downright exploitative: “It’s not my fault you didn’t take home much money tonight, you should’ve worked harder and gotten bigger tips.” It also means the wait-staff take the brunt of any kitchen screw-ups that leave the punters less than happy. Doubtless restaurant owners will claim they couldn’t afford to stay open if they had to pay all the staff minimum wage, but I find this hard to (pardon the pun) swallow. If paying your workers minimum wage means you can’t stay open, then there’s something very wrong with your whole business model. And I can’t be the only person who would go out of their way to patronize any establishment where tipping was off the menu.

Either way, for Americans it’s automatic. So what happens if you fail to tip appropriately? The first (and only!) time I was guilty of this was not long after I first came to the States. Then-boyfriend and I were at a club waiting for the band to start up (Gil Scott Heron, I think). It was one of those places where you sit at a little table in the smoky darkness and a waitress brings your drinks. The young woman told me the total and I carefully gave her the exact amount, thinking I’d made life easier for her by not forcing her to scramble to find change. I got the iciest glare imaginable as she stalked off; the boyfriend recoiled in horror and hissed, “Why didn’t you tip her?” He then explained about the 15% rule and I just about passed out from shame. When the same waitress grudgingly delivered a second drinks order sometime later, I over tipped so massively out of embarrassment that I think our table got the best service for the rest of the evening.

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Such moments make the whole tipping expectation excruciating for a Brit. We absolutely cannot bear to Do The Wrong Thing in public. So I still go into paroxysms of anxiety every time I go to get my hair cut, take a cab, or have a porter carry the bags to a hotel room. And probably continue to over tip massively as a result.

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4th of July: Flags, Hotdogs, and Fireworks!

Tomorrow is America’s birthday, which means three things will be ubiquitous across the country — flags, hotdogs, and fireworks.

But first up, let’s get one quibble out of the way: no, the Declaration of Independence wasn’t really signed on July 4, 1776. According to the History Channel’s ‘9 Things You May Not Know About the Declaration of Independence,’ 12 of the 13 colonies at the Second Continental Congress in Philadelphia voted in favor of the motion for independence on July 2nd. After a couple of days of debating and revising Jefferson’s draft, the Congress officially adopted the Declaration of Independence on July 4. However, the actual signing didn’t take place until almost a month later. Check out the full article here if you really like to know these things. But no-one cares because 4th of July isn’t about historical accuracy.

Wave the Flag

Back to the current day. The first thing you notice as July 4 approaches is that the flag starts to appear — everywhere. Americans cheerfully wave the physical flag far more often than Brits. The only time I can remember the Union Jack being plastered all over people’s houses and various buildings back when I lived in the UK was at the time of the Queen’s Silver Jubilee in 1977. (There was a similar outpouring of flag decorating at the 2011 royal wedding, followed by the Queen’s diamond jubilee in 2012, and around the time of the London olympics that same year.)

The rest of the time, aside from some ironic t-shirts at the height of the punk era in the late ‘70s, overt public displays of the Union Jack in the UK are pretty much limited to fringe right-wingers. But not here. Many people put out Stars and Stripes flags at various times of year (Memorial Day, Veterans’ Day) and in the week leading up to the 4th the shops are full of flags, large and small. Many of our neighbors will be hoisting the flag on their own porch flag poles — the same poles that fly pumpkin-decorated motifs at Halloween, snowmen images at Christmas, and flowers, shells, or pictures of flip-flops (yes, really) as summer gets underway. This Alamy stock photo gives you an idea of what I mean.

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For a real explosion of flag mania, you can’t beat the annual parade put on by most towns and cities across the country, usually led by local dignitaries followed by some floats from local businesses and other organizations. Interestingly, overt political displays or any partisan lobbying is Not Done. It’s the one time of year when no-one wants to see a banner advocating for/against anything. It’s all about the United part of the name USA. The Philadelphia parade lays claim to the city’s historic importance in all this, with period costumes and Independence Hall as a backdrop.

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Our own little town has its own quirky take on the parade — after the local dignitaries, fire trucks, and band, the kids get to join in. There’s a competition for the best decorated strollers and wagons, tricycles, and bikes. (I swiped the picture below from the web to give an idea of how far some people go in this.) When our sons were young we spent many a July 4 morning attaching flags and streamers and other decorations to their bikes (having forgotten to get anything in advance and having to wing it at the last minute), then walking beside them as they proudly peddled around the town. They never won, but it was great fun.

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Hotdogs

Which takes us to the food. There are countless fabulous food options in this country, reflecting the incredible diversity of its population. But hotdogs are the second key ingredient of any 4th July celebration. At the end of our town’s parade everyone gathers in the town square for hotdogs courtesy of the fire company. Across the country, in back gardens and public parks, families will be firing up the grills for cookouts large and small. This means hotdogs, burgers, and pretty much anything else that can be cooked over an open flame. And beer. Lots of beer.

As a vegetarian I can’t really opine on the best way to eat a hotdog (I’ve never been a fan of those tofu-based ones that are like tasteless rubber). Some combination of onions and/or relish (pickles) and/or mustard seems to be standard. But however you like your ‘dog, best not to ask what the thing itself is made of.

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Light up the Sky!

Which takes us to the final essential component of the 4th of July — fireworks. Here in Pennsylvania you cannot buy ‘aerial fireworks’ without a permit (although there’s apparently a state law loophole that makes acquiring a permit pretty much as simple as downloading a form from the web, which explains some of the noises we’ll be hearing tomorrow night); but in other states you can buy almost anything. Hence displays like this one at a Walmart in Indiana.

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And yes, there will be news reports from across the country on the 5th about people losing fingers, eyes, and sometimes more, as a result of backyard firework accidents. Go figure.

For those less pyrotechnically inclined, there are plenty of public firework displays to go to come sundown. Our neighboring township puts on a great display every year and of course Philadelphia itself goes all out.

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The Mosquitoes Are Back: Summer in Philadelphia

Summer has arrived on the eastern seaboard. I know this not because of the date or the temperature (although they are both relevant), but because I’ve just been inflicted with the first mosquito bite of the season.

The calendar says the official start of summer is the equinox on June 21. Most Americans say it begins on Memorial Day weekend — roughly equivalent to the Spring Bank Holiday Weekend in the UK. The Monday of Memorial Day weekend (the last full weekend in May) is a Federal holiday to remember those who died while serving in the country’s armed forces. But around here it’s mostly noted as the date when summer businesses start to open “Down the Shore” — which is how Philadelphians refer to the New Jersey beach towns.

The weather is certainly getting in a summer mood; it’s been climbing rapidly the past few days. This is today’s forecast (92 Fahrenheit means 33.3 degrees celsius) and the car’s temperature reading a few minutes ago.

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An orange air quality alert (issued by the Delaware Valley Regional Planning Commission) means that “air pollution concentrations within the region may become unhealthy for sensitive groups … children, people suffering from asthma, heart disease or other lung diseases, and the elderly.” The heat advisory means “hot and humid conditions are expected…heat and humidity may cause heat stress during outdoor exertion or extended exposure.” Lovely. The local news is reminding people to check on elderly neighbors and relatives. If either advisory turns red (which can happen come August, when the heat and humidity really build), it basically means don’t go outside today, and if you must then try not to breathe.

But for me, the real Start of Summer is the day of the First Mosquito Bite — which happened to be today. When I first came to the States, back in August 1985, I had no idea that mosquitoes were a serious concern. My first night in the graduate housing dorm I innocently threw open my bedroom window. Next morning I woke up with two massive bites on my leg — I freaked, grabbed my neighbor from the room next door, and asked if she had any idea what could have caused these? A New Yorker with a well-developed sense of disdain she laughed at me and said, “Mosquito bites of course. There must be a hole in your window screen.” I hurried back to my room, and as I slammed the window shut I realized that yes, there was a screen I was supposed to have pulled closed once the window was opened. Lesson learned.

So now it’s time to start checking regularly that there are no puddles of stagnant water collecting at the bottom of the drain pipes or around the garden furniture, and to put dunks in the bird bath (little rings of Stuff that gradually dissolve over the course of a month, harmless to the birds but lethal to mosquito larvae). It’s also time for the daily decision: stay indoors; spray self with lethal chemicals to keep the mosquitoes at bay; wear long sleeves and trousers and cook; place lit citronella candles all over the back yard (which are patchily effective at best and smell kind of icky); or risk getting eaten up. There’s a reason anyone who has the time/money tries to decamp Down the Shore as often as they can in the summer.

It’s also time to start closing all the blinds at the back of the house (which faces west) every afternoon, to try to reduce the heat radiating in through the windows in a bid to ease some of the burden on the air conditioning. Yes, we have central air conditioning — nice, cool dry air that blows out of the same vents that the heat comes through in the winter. My very first summer in a rented apartment in West Philadelphia, we had no air conditioning. Just strategically placed fans. I woke up one morning in early August nauseated and shivering from what I later learned was heat stroke. So we graduated to one air conditioning unit, placed in the bedroom window. We basically migrated to the bedroom for the summer, emerging only for quick forays to the kitchen for food. As soon as I got home from class or work I’d take a shower then stand and drip in front of that window unit to cool down. But now I’m a proper grown up and central air is absolutely essential for me to survive a Philly summer.

Meanwhile, the poor dog is Not Happy. She detests the heat just as much as she detests the snow. The last few mornings she’s gleefully bounded out of the back door, only to quickly slow down and visibly start to droop. Within minutes I’m getting the baleful doggie look: “Why are you making it so hot?” She can only get a walk first thing in the morning or late in the evening (when the mosquitoes are out. Joy). As soon as she comes inside she flops down in front of one of the air vents, where the wood floor is nice and cool.

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Yesterday I actually saw people walking their dogs at midday, which strikes me as pretty harsh for something that’s basically wearing a fur coat in 90 degree weather. I read somewhere that you should rest the back of your hand on the sidewalk; if you can’t hold it there for at least five seconds, then it’s too hot to walk the dog.

At least the humidity isn’t at its worst yet. When the glasses fog up in the five seconds it takes to walk from the house to the car, THAT’s when you know that summer is fully underway.

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The 13 Things I Miss Most About Britain (and the 4 Things I Definitely Don’t)

People often ask me: What do you miss the most about Britain? The obvious answer is certain people, particularly the bevy of nieces and nephews who are now producing offspring of their own. Beyond that, it’s actually a hard question to answer. How to describe the misty grayness of an October morning in London; the dulcet tones of a BBC radio announcer; or the deep satisfaction of a properly brewed cuppa. The following list is personal, idiosyncratic, and incomplete, and may not make sense to anyone who’s never been to the UK.

In no particular order, here’s what I miss the most about Britain:

1.Accessible wilderness that’s not all that wild: places like the Lake District, Snowdonia, the northern Cornish coastline, most of Scotland, and the fells of East Anglia. Places that may be only an hour or two’s drive from wherever you are, and none of which include bears, mosquitoes, or having to wear fluorescent jackets to warn off hunters with guns.

2. Public footpaths and the whole concept of rambling.

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3. The National Health Service.

4. Good public transport systems in major cities.

5. Certain places like:
– the lovely villages of Leicestershire
– seaside towns like Whitby, with its grey stone buildings and steep streets and seagulls          screaming overhead
– the graceful curve of a street of Georgian era houses found in most larger towns
– Leicester’s Clock Tower and covered market

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6. London. Pretty much anything and everything to do with London.

7. History everywhere: Roman ruins, iron-age barrows, a landscape indelibly marked by thousands of years of intense human habitation.

8. Imprecise weather forecasts like “sunny spells and scattered showers” (which is likely to be apropos for most of the year)

9. Certain foods like Marmite, McVitie’s digestives, proper chocolate, and really good chips. Not french fries, chips. Fat, crispy on the outside, fluffy on the inside, and preferably served in paper with salt and malt vinegar.

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10. Place names that resonate with 2,000+ years of history (if it ends in “…cester” it’s an old Roman military settlement; names ending in “ …ton” reflect a Saxon heritage; those ending in “…by” likely were founded by Vikings)

11. Pubs: particularly older ones with a sense of place and time that can’t be found anywhere else, places where the emphasis is on socializing with friends and family, maybe with some pretty decent food thrown in, and really good beer.

12. Being able to find vegetarian options in most restaurants (at the very least, people who don’t look at you like you’re some kind of mutant weirdo because you ask, “Is there anything vegetarian on the menu?” They may not have it, but there are enough vegetarians in the UK now that most establishments can take the question in stride.)

13. Real ale, served at room temperature, with just a slight head, pulled fresh by a publican who knows how to keep and serve beer properly. (“Light beer” is right up there with “iced tea” in my lexicon of Things That Should Not Exist)
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And just for good measure, here are the four things I definitely do NOT miss:

1.The dead weight of history: “But we’ve always done it that way”

2. The weather: unlike here in the eastern US, you often can’t tell just what the season is

3. The unspoken class judgement that many strangers make about you, based on your      accent and educational background

4. The giant spiders that invade every home, every September, no matter where you live. I’ll take the current springtime mouse invasion over the autumn arachnids any day.

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Spring is sprung!

Spring has definitely sprung here in the eastern USA, bringing lovely colors, cascades of pollen, and a resurgence in wildlife.

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The trees around the neighborhood are sporting their spring finery, with pink and white blossoms everywhere. Even the non-blossom trees are looking spiffy in their new, bright-green leaves.

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Being a city lass, I have no idea, unfortunately, what most of these trees are.

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These beauties are all over the area, bursting forth in spectacular big pink blooms every spring.

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But with the beauty comes the pollen. Which means, at the least, five minutes sluicing yellow sludge off the car windows every morning.

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You also have to be careful not to track too much of the stuff into the house after walking down the street.

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For allergy sufferers, it also means 2-4 weeks of gasping and wheezing and sneezing. An allergy doctor once told me that the combination of flora, pollution, and wind patterns (something to do with air mass getting trapped) makes this mid-Atlantic region particularly bad for allergy sufferers. The TV ads for various remedies are certainly in full swing.

The weeds are also bursting forth with a vengeance. For some reason, thistles like the two small flower beds at the bottom of our front path. I went away for a couple of days this weekend, and came back to find that the little two-inch thistle heads that had been nudging up above the ground on Friday are suddenly foot-tall menaces. I think Pennsylvania thistles have some triffid DNA. I’ll be spending the next five months yanking the things out of the ground — along with dandelions, some kind of weird non-flowering wild geranium, and wild grape vine that grows rapidly and quickly overwhelms even the hardiest shrubs and trees. (The white stuff littering the path is spent blossom from our flowering cherry tree; it’s been cascading down like snow every time the wind stirs.)

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Along with the pollen and the weeds, the mice are back, apparently looking for somewhere with a ready food supply — i.e., my kitchen — for their spring breeding. I’m all for live and let live, but not when it comes to uninvited guests in my house. So the mouse traps are now baited and strategically placed on countertops and in the corner of the pantry. As the bait is little blobs of peanut butter, I have to be careful where they’re located or the dog (who loves peanut butter) will get a nasty shock.

I haven’t spotted the local chipmunks yet; they, at least, stay out of doors. I suspect they’re nesting behind the big air conditioner compressors as the dog is suddenly very interested in sniffing around there.

fullsizeoutput_17The rabbits are also reappearing in the back garden — at this time of the year the mature adults are feeling bold, waiting until the last minute to lazily hop under a bush whenever the dog goes outside. In the picture above you can just see one of the locals, hanging out next to the birdbath. In a few weeks the younger ones will be out and about, and they tend to be a bit more skittish. Thankfully, the dog hasn’t caught one yet — she just chases them out of the garden and then snacks on their leavings. That’s right, some dogs think rabbit poop is a delicacy. No words.

Along with blossom, pollen, weeds, and rodents, the seasonal fauna known as lawn care companies are also slowly reappearing on the suburban streets. By mid-May, the sound of big ride-on lawnmowers and hand-held trimmers will be thrumming and slicing their way across the neighborhood most mornings, until early October. You know when someone’s lawn is about to get its weekly cut by the loud clangs as the company trailers park on the street and drop their loads. Yes, there are some hardy souls who cut their own grass every weekend — but ‘round here, not many. The gardens can be pretty big, the grass grows very rapidly, and for the allergy sufferers mowing the lawn on a Sunday afternoon is a serious health hazard. So much easier to pay someone else to do it while you’re out at work, so you can enjoy a tidy lawn at the weekend.

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Paying for Healthcare in America

Can someone explain to me what it is about paying for healthcare that gets Americans so riled up? It’s one of the three things about this country that still totally baffles me after 30+ years — the other two being their attitude toward guns and the death penalty. (“Keep the government away from healthcare and guns, but it’s OK for the government to kill people.” Um…)

Expensive But Broken

When it comes to healthcare, the statistics from the OECD are telling: the USA is the only developed country with no single-payer national healthcare system; it has the highest rate of infant mortality in the developed world; and it has the lowest life expectancy. It also has the highest obesity rate and the highest proportion of people aged over 65 with two or more chronic health problems. Yet actual spending on healthcare per capita far exceeds that in other countries.

As someone who grew up with a flawed-but-functioning national health system, it’s pretty obvious that the delivery of healthcare in this country has gone seriously awry. If you’re employed in a job with a halfway-decent wage and benefits package, you (and, likely, your dependents) will be covered by some form of private insurance scheme. These can cost you little-to-nothing in premiums (if you’re lucky enough to have snagged the kind of public sector job that comes with crappy pay but great benefits); or, they can cost hundreds of dollars every month to cover you, the spouse, and the kids. Coverage varies: some plans only cover ‘basic’ care; some don’t cover mental health treatment; some only cover 75% of the cost of an in-hospital stay. Even with insurance, you’ll be paying some kind of copay for every doctor visit or prescription; and often there’s a deductible that you have to meet first each year, before the insurance coverage kicks in.

Here, the private insurance companies reign supreme. Some on the political right get hysterical at the notion of the government ‘controlling’ access to healthcare, saying it will lead to rationing. I don’t know what planet they live on, because the insurance companies already control and ration. Just because your doctor may have prescribed a particular drug or procedure doesn’t mean the insurance will cover it; and given the staggering cost of healthcare here, very few can afford to buy services ‘out of pocket.’

Still, if you have insurance and a doctor recommends an MRI, or you have to get one of the kids an X-ray because that ankle is swelling up alarmingly after he fell off his bike, you don’t think twice. The care will be first rate, the diagnosis almost-certainly accurate, and you’ll get clear instructions on what to do next.

But if your job doesn’t come with health insurance? Or it did, but you got fired? Or the spouse is fighting cancer and you start a new job and the health insurance plan won’t cover pre-existing conditions for the first year? Well, then you’re screwed. Yes, there is Medicaid, but only for the poorest. Eligibility and coverage varies by state, but can be defined by an annual income as low as $11,000 for an individual or $24,000 for a family of four. Yes, there is Medicare, but only if you’re 65 or older, or disabled, and even then you may want to buy some form of supplemental plan because Medicare isn’t always as comprehensive as you’d think.

Some Healthcare History

When Obamacare (the Affordable Care Act) went live in 2016, about 24 million people finally got access to health insurance. You always could buy individual plans, but they tended to be staggeringly expensive. Now, companies have to offer plans that cover pre-existing conditions, and government subsidies make the monthly premiums affordable for most on low incomes. It isn’t perfect, but the problems are the kind of thing that can be fixed, and the payoff has been huge. I know a number of people in their twenties who work two or three jobs in the service world (choreographers, hairdressers, writers) who were ecstatic to finally be able to afford the peace of mind of insurance. “Next time I get a really bad cough, I can go to the doctor before it turns into pneumonia!” That was a real conversation I had last year, with a 27-year old dancer.

So why the hell does America not look after its people with some form of national health insurance? When Medicare was first introduced in the mid-1960s, the intention had been to create a universal, national scheme. But facing resistance from some in Congress the government at the time first focused on the relatively-uncontentious proposal of insurance for the over-65s. The intention was to then introduce a similar scheme for children and pregnant women, but it never came to pass.

Far as I can tell from some superficial research, introducing coverage just for the over-65 crowd backfired massively because — surprise, surprise — it quickly became a very expensive scheme. Given the rudiments of how insurance works in ANY marketplace — payment by all to provide coverage for a few — that shouldn’t be a surprise. Older people tend to be sicker. In any event, by the late 1970s the “it’s too expensive” narrative had become enshrined and national health insurance was dead in the water.

Healthcare as Commodity

So here we are in 21st century America, a country with excellent care that’s not available to everyone. A country where private insurance companies, not doctors, dictate what prescriptions or procedures are worthy of coverage. A country where prescription meds are widely advertised on TV and doctors’ offices spend inordinate amounts of time processing insurance payments. A country where people with chronic conditions spend hours sending in claims, arguing with the insurance company over what treatment will be covered, and forking over small fortunes in copays. A country where one awful accident can literally push your family into poverty, or where people have to sell their homes to pay the healthcare bills. A country where the cost of healthcare is the number one cause of personal bankruptcy.

Yes, I know the NHS (Britain’s National Health Service) is far from perfect. Some prescriptions or procedures aren’t available and wait times for appointments to see specialists can be absurd. But, no one asks you to fill out forms about your insurance information when you’ve just rushed the kid to the hospital emergency room.

Healthcare in America is widely seen, especially by the political right-wing, as just another consumer good. For many of the current crop of Republicans in Congress (who, incidentally, get great coverage with their own insurance plan), it’s something you ‘choose’ to buy, and if only the government would get out of the way the competitive marketplace would ensure it would be affordable for anyone. Which is, of course, rubbish. Suppose you slip and fall on the ice and break your leg in four places and can’t work for three months; or, one of the kids is diagnosed with cystic fibrosis; or, that odd-looking mole on your thigh turns about to be stage two melanoma that is on the verge of metastasizing. Think you can afford to buy the care you need? Think again. The commoditization of health care just doesn’t work (re-read that comparative OECD data in paragraph two if you don’t believe me.)

Perhaps the furor over the Republicans’ deeply-flawed plan to ‘replace’ Obamacare — a plan that would deprive 24 million people of health insurance and allow companies to once again deny pre-existing conditions — has awoken more people to the staggering iniquities of the system. Perhaps, in a few years, we’ll finally get a universal single-payer system here. But I doubt it.

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