On the first morning of my new job in California, the head of HR came into my gleaming office with a shopping list.
What sort of dental cover did I require? How many of my children needed insurance? My job status brought top-of-the-range medical cover, but did I want any extras? Prescription glasses? Chiropractors? I could even set aside a proportion of my salary towards additional “uninsurable” costs, like therapy, or the cost of babysitting. They’d send me a credit card and I could buy whatever I wanted, tax-free.
This was an eye-opener. I’d expected the system to work a bit like private medical insurance in the UK, where you pay an annual premium and they give you a list of what’s not covered and which hospitals you can’t stay in. In Britain, if you’re lucky and your employer pays the bill, you’re taxed on value of the benefit. By contrast, in America it’s a highly sophisticated, complex and expensive industry. In the US the number of insurance administrators and advisors comes close to the number of doctors.
With half a dozen insurance cards stowed safely in my wallet in case I was run over by a bus, I felt secure in the arms of the best system in the world: for those in the system. A feeling not enjoyed by those 47 million Americans who rely on the public hospitals, Medicare (for the elderly) and Medicaid (for the poor). Obama’s dilemma is how to enfranchise the 47 million without lowering the excellent healthcare standards of the comfortably insured.
The republican scaremongers are using our antiquated NHS system to beat Obama’s reforms. I shouldn’t have thought for one moment that his administration was considering using the NHS as a model for US healthcare. There’s much that’s good about the different systems but they are just that: completely different.
When Joanna first came to the UK, she had a blocked sinus that was causing her incredible pain. “How do I find an Ear Nose and Throat specialist?” she asked, picking up the Yellow Pages. “You don’t,” I said, and rang the local GP in Hampstead. “Come on down,” said the chirpy receptionist, and twenty minutes later Jo walked out of the surgery with a prescription and a huge smile on her face. “They said it was free – what amazing service”, she said and has been hooked on the NHS ever since. She excitedly rang her girlfriends in LA to tell them that the day after our baby was born the wonderful GP in our village trekked out to the house unannounced to introduce herself, followed by a number of healthcare visitors.
But when it came to the pregnancy and birth, Jo opted for the private route. You see, in the US you expect a completely different level of service. The thought of antenatal appointments with a succession of complete strangers and delivery by an unknown midwife without the skills and training of a surgeon filled Jo with horror. Sure, it kind of works over here, and most people are happy enough because they know no better. In America you choose your own consultant who sees you right through your pregnancy, and then personally delivers your child.
In my experience, the country with the best and most equitable system is France. Like America, it operates on a private but insured system. Patients choose their own physicians who in turn have autonomy over their own medical decisions. It’s all paid for by a combination of public and private insurance, however basic insurance is compulsory and universal. There’s no wasteful system of GP referrals, no waiting lists and minimal bureaucracy. It costs far less than the American system, but a lot more than ours. My hunch is that Obama will plump for the French model; shame we can’t afford to do the same.
Sunday, August 16, 2009
Sunday, August 9, 2009
On Saturday night BBC1 found itself with a real scoop. For the first time a major network was broadcasting a football manager’s team talk live at half time. The fact that it was in the middle of Newcastle United’s opening game in the Championship made it even more exciting.
Except that, sadly, the team wasn’t there. Alan Shearer was in the commentary box, meticulously unpicking the failings of our team’s first half performance. Bright, attacking football was giving the team good possession, but they were one-nil down because nobody was finishing the job. My namesake Mr Gutierrez was tearing up the left wing and then lobbing poor crosses to nobody. Why, suggested Shearer, don’t our midfielders go up to help out?
I wouldn’t have thought they had BBC1 on in the team dressing room, but thankfully a few minutes later the opposition goalmouth was full of yellow and orange shirts (that’s our ghastly new away strip). Kevin Nolan passed the ball to Damien Duff, who in turn passed it to the back of the net. Told you so, said Shearer, as 1700 travelling supporters went wild. The manager-in-waiting, like the great statesman he is, politely waiting for the team to be sold so he might be hired back to finish the job he started last season, was auditioning for the role in front of millions of viewers. Goodness knows what West Bromwich supporters must have thought of such unashamed BBC bias.
What is it with Mike Ashley’s fear of selling? Earlier in the week the Office of Fair Trading referred his company Sports Direct to the Competition Commission for failing to sell some stores. Don’t they realise there’s a bit of a monopoly going on here in Newcastle as well? We only have one football club to support (sorry, Mackems and Smoggies, after 50 years, a transfer of my allegiance is never going to happen). The damage caused by all this indecision is not just to the club: it generates gloom across the entire region. If yesterday’s rumours are true, and Ashley has decided not to sell and instead install David O’Leary as manager, then that’s fine by me. Please just get on with it: it’s the uncertainty that’s killing us.
Mind you, I’ll say one thing for our current demise: I’ll probably have a better view of the action at the first home game next weekend. As I moved back to Tyneside mid-season a couple of years and five managers ago, I could only get season tickets in the corner near the goalmouth. You needed binoculars or an earpiece tuned to local radio to find out what was happening at the other end. But tickets are like gold dust and I was just pleased to be part of the crowd.
So a few months ago, more in hope than expectation, I wrote to the club to see if there was a chance of moving closer to the halfway line. The day after the deadline for renewals I had a phone call from a nice lady in the box office. “About your request to move seats,” she said wearily. The voice didn’t sound optimistic and my heart sank. “Well, I do have some nearer the centre – in fact they’re right in the middle”. “You mean at the back?” I suggested warily. There was a pause, and I immediately understood why she might be a little stressed. “Well, to be honest, you can have almost any row you want. How about second from the front?”
The fans have voted with their wallets. Nice one. But if next week there’s black and white smoke coming from St James Park and we finally have an owner and a manager, you can be sure the place will be packed and the crowd cheering as loudly as ever.
Sunday, August 2, 2009
This morning a man in the Meteorological Office in Bracknell is sitting in front of his weather charts with a smug grin on his face. As the rest of us wait gloomily for the next downpour to wipe out the cricket at Edgbaston, or gaze out at the rust forming on our shiny new barbecues, he’s positively beaming.
Only he and I know why he’s so happy. You see, like me he’s invested in a holiday home in England. Not for himself to enjoy – he has more sense than to risk the English weather for his own vacation. He rents it out to those optimistic enough to believe that England can still produce the long hot summers we read about as children. Earlier this year, as the recession bit, his holiday let bookings fell off the cliff along with the value of his property. So I reckon he panicked. Over a cup of strong-to-gale-force coffee in the Met Office canteen, he thought up a wonderful wheeze.
“Let’s announce a long-range weather forecast for the summer”. “That’s impossible”, said Tomasz Shufflepants (a strange name for a British weather forecaster, I know, but his real surname is even weirder). “Nobody can say what the weather is going to be like that far ahead, not even with our squillion pound new computer.” “It’s hard enough predicting the weather for this afternoon”, added Rob McElwee, with that mysterious stare he thinks female viewers interpret as enigmatic charm. “You know how we play spin the coin for next week’s forecast?”, chirped up little Dan Corbett, “We could do the same for August”. “Who cares about the summer?” added Tomasz. “It’s always wet in England. Even worse than Poland”.
“Ah, that’s where you’re wrong”, said our man with the holiday home. “What do you think the odds are on a some sunshine in August?” he asked. “A tiny bit better than fifty-fifty, I suppose”, conceded Shufflepants. “Exactly: it’s odds-on, then”. “Well they’re not very good odds”. “Perhaps, but so long as we warn there may be 'heavy downpours at times', we should be covered".
So it was that on 30th April 2009 our Met Office published its famous press release that began: ‘The coming summer is odds on for a barbecue summer’. The following week, I had a flood of enquiries for my holiday home, Barnhill House: the whole of August was sold out within days. Thanks, Met Office. And commiserations to my clients who moved in this weekend to yet another downpour.
Of course I’ve no evidence whatsoever to support this outrageous conspiracy theory but it’s hard to imagine why else the Met Office would have made such a rash announcement about something so clearly unpredictable. Unless, perhaps, someone there has shares in B&Q, whose sales of barbecues have gone through the roof this year. Or maybe one of the forecasters writes cookery books on the side. I’ve been given several “Summer Grilling” books this year and there’s a whole pile lying remaindered in a bin in my local bookshop. Sometimes I open the pages just to slaver over the photographs and imagine the smells that should be emanating from my new patio, built in response to Met Office optimism. Jo and I even got our lovely Californian garden furniture out of storage, dusted it off and waited.
We’re still waiting, along with Alan, our farmer neighbour, who is looking for three consecutive days of rain-free summer to crop our hayfield. Otherwise it will go for silage and the alpacas in the next village will go hungry. But I’ve told him not to worry, because the Met Office has told me exactly what the weather will be like over the next few weeks. They absolutely, confidently guarantee it will be warmish and fairly sunny every single day for the next month. Unless, of course, it rains.