Being a tech and gaming writer, I don’t talk about politics much on this blog, but I’ve been following the attempts of the Democrats to reform healthcare in the US closely. As someone who lives in a country with a fairly robust healthcare system, it beggars belief that any developed nation could allow its citizens to fall through the cracks so readily that you end up with random developing-word-style ‘field clinics’ being inundated whenever they appear. It’s also shocking that people who’ve had and recovered from a major condition (such as cancer) find it extremely difficult to get coverage from that point on. That’s how pet health insurance works in the UK, but to have a similar system for humans is just crazy.

Since Obama came to power, the Democrats have struggled to come to some sort of compromise with the Republicans, before ultimately going it alone. Over time, the Republicans gradually withdrew any kind of support and than had fun spouting all kinds of bullshit about health systems elsewhere, such as the UK’s NHS. This backfired to some extent once people looked past the bluster and examined the facts. One of my favourite posts was by Alex Massie, who quoted Ezra Klein’s research where he noted the NHS costs about 41 cents for every dollar the US spends per capita on health. Massie’s point was that if the US did a straight switch for an NHS-style system and dropped its standards slightly, it’d have 59 cents in the dollar to do with as it wished. That money could improve infrastructure, social circumstances, or just be ploughed back into the health system, making US services the envy of the world in every conceivable way, but for no extra cost.

As far as I can tell, opposition to these viewpoints is centred around the thorny issue of ‘communism’ and ‘big government’. A certain chunk of Americans (roughly half) doesn’t like ‘being told what to do’. They’d actually rather pay more than twice as much as they need to for health because they have the choice to do so. The fact the poor are stuffed is irrelevant to the ‘anti’ crowd, as is the fact that the US effectively has an enforced lock-in anyway, just in the commercial arena rather than at state/national level. (‘Anti’ campaigners also avoid the difficult point that the British system is actually at least three-tier—‘free’/tax-paid coverage for all, but then you have levels of additional ‘private’ services that one can ‘top up’ with if you can afford to do so.)

To my mind, one of the very best responses to this argument came in a comments thread for The New Republic’s The Coming Conservative Health Care Freakout. Someone with the ID ‘singlspeed’ notes that if anti-healthcare campaigners are truly against state support then they should stop being hypocritical and give up all of it. “For all those out-of-work, underemployed or retired, red-meat, red state conservative ’Merikans that are getting social security, disability, medicare and unemployment benefits that rue the day about how big gubmint and taxes are ruining America, I suggest they forfeit all aspects of government that they benefit from,” he says. “No more calling 911 for any emergencies, no using the interstate highways for you, no flying (FAA controls the air paths), no buying gasoline or using electricity (those are gubmint subsidized industries), no buying any food product that includes corn or high-fructose corn syrup (all heavily government subsidized), don’t buy California lettuce (it uses Federally subsidized water to grow it), don’t go to a state university that accepts Federal grant dollars for science and medical research, stop using that Social Security check to pay for your rent…”

As of yesterday’s vote, these points are, to some extent, finally moot. The bill that’s on the table is far from perfect, but as James Fallows says in Why This Moment Matters, “the significance of the vote is moving the United States from a system in which people can assume they will have health coverage if they are old enough (Medicare), poor enough (Medicaid), fortunate enough (working for an employer that offers coverage, or able themselves to bear expenses), or in some other way specially positioned (veterans; elected officials)… toward a system in which people can assume they will have health-care coverage.” And in any reasonable light, that alone can only be a good thing.