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“America just caught up with the rest of the world. Now everyone gets free healthcare! Why are they so angry?”

“I thought you were supposed to provide for the poor. Why are people against the Bill?”

“Wait–I’m confused. Didn’t Obama just do a good thing?”

The British can’t see what the fuss is all about and it’s really not their fault–America’s non-stop party squabbling is not helping. Barack Obama signed the US healthcare bill as law, the entire country went into a rage and if you’re not American, you probably don’t understand why…

BECAUSE nobody is explaining ANY of it properly.

Let’s break this down, nice and simple.

The United States government has never paid for health care. Never–in it’s entire life. Why? Because it’s not in The U.S Constitution, the foundational legal doc for America’s existence. In the name of freedom and independence, The Constitution encourages taking total personal responsibility for oneself (health care and all). Well, the first people to take advantage of that freedom were health insurance companies–the ‘shops’ of healthcare, if you like. Americans ‘shop’ for the best doctor or dentist, they always have; they’ve never known any other way. Gradually, health insurance companies became competitive. If someone couldn’t afford to shop, the government wouldn’t pay for you but they’d help you try to get ‘discounts’, so you wouldn’t stop trying to afford shopping.

This sounds sadistic to the British. Why? Because the British government cut out all this ‘shopping’ business: it promised to pay for health care–no shopping or competition involved. In Britain there’s only government-funded hospitals, government doctor’s surgeries (offices) and government ambulances. (Unless you’ve chosen to pay private insurance.) Nobody in Britain remembers life before the NHS because the ‘pay-for-a-doctor-or-die-in-the-street’-method, was considered primitive and inhumane. Since 1946 the NHS is how it’s ‘always’ been. The biggest disadvantage of the NHS is that you can’t buy a ‘better’ doctor–you just take what you’re given. But if everyone else in the country is also at that disadvantage then, none of us will ever know or want any different, right?

From day one, Britain and America’s models have been as different as chalk and cheese. This is the first difference between our countries that nobody bothers to explain.

The only universal healthcare America has, is what the British would consider ‘discount’ schemes. These are Medicaid, which covers low income families and Medicare, for over 65’s and the disabled. Medicare is 100% federally-funded/managed; Medicaid is 50% state-funded, 50% federally-funded and 100% state-managed. Medicare is an automatic entitlement (i.e you grow old, you claim it), Medicaid is determined by eligibility (i.e show proof of income, we’ll decide if you pay all/part of the fee). Both are in trouble. Why? Because the Health Insurance companies are getting more expensive. Medicare is claimed by fewer people these days, but it is also bankrupt because insurance companies are expensive ; approximately 4 people’s taxes pay for 1 person’s Medicare. Medicaid is also increasingly expensive because states charge high premiums for revenue, making it inaccessible anyway. Neither work.

Still with me at this point?

So what do you think happened? There are an estimated 308 million Americans to provide for. They’re all fed up with the greedy health insurance companies. The government’s ‘help’ programs are failing. Everything’s been badly managed and has spiralled out of control. Then along came Barack Obama.

Of all the changes Obama promised to make during his presidential campaign, healthcare reform was the biggest. To quote: “I’ll make our government open and transparent…No more secrecy, that’s the commitment I’ll make to you as president. And when there’s a bill that ends up on my desk as president, you the public, will have 5 days to look online and find out what’s in it before I sign it, so that you know what your government’s doing…and you can decide whether your representative’s actually representing you.” Now that sounded like change we could all believe in. Inspirational stuff.

Except when he became president, he did the exact opposite of all these things.

Last year a healthcare reform bill 1500 pages long was written, in obscure legal jargon, which an average man cannot read nor understand. In November 2009, this bill was hurried through the House of Representatives without the public getting to read it. On Sunday 21st March 2010, the House voted 219-212 and Obama signed the bill as law. The public were only given 36 hours to read it online.

The American public, even some of Obama’s staunch supporters, were furious. Every step of the way.

To pay for the new reform, the Obama administration says it is taking $500 million from Medicare. Hold on, isn’t Medicare bankrupt? That’s right–it’s a hollow wall. As a result of this bill, health insurance companies are raising their rates and collecting federal funding at the same time. Hold on, aren’t health insurance companies already rich from overcharging people? That’s right–they’re still the controllers of health care. The reform doesn’t take effect for 3 years. The total predicted spending costs are currently at $2.5 trillion. Hold on, didn’t Obama say he would cut people’s taxes to help recover from the recession? Yes, that’s what he said. America’s national debt is already past $700 million and the country is still in a recession.  This can only mean one thing: the American people would have to pay for it…all.

As a friend of mine said, “…He put out a bill that most people can’t stomach in this economic climate…He tried to do too much all in one go.”

To think that the health care reform bill has created one problem, is wrong. It creates several separate problems. The country has gone berserk and torn itself down the middle because many Americans are fiercely against any sort of government dependency. Many believe that a move like this bill, is an enormous and dangerous step backwards. America’s emancipation from British rule was to abolish government dependency, establishing an American government which would represent and preside over the people, not provide. Because once upon a time, a British government once said it would provide for it’s American colony…it robbed them instead. America never forgot that.

And that dear friends, is what all the fuss, is all about.

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“ALL ANIMALS ARE EQUAL, BUT SOME ARE MORE EQUAL THAN OTHERS”
– George Orwell, Animal Farm, Ch. 10

A common saying is that we are two nations divided by a common language. The author of this statement forgot to mention the difference in cultures. This year, a Brasilian contestant on Big Brother UK angrily exploded when a British housemate told him to “shut up”; this took over YouTube UK that week. Thousands of comments were left by the YouTube community, some explaining that the harmless phrasal verb in English carried a much stronger meaning in Brasil, where the purpose of use for the words “shut up” was far ruder than English speakers were aware of. Sadly the backlash to this was the “well, you’re in Britain now, get used to it” mentality. This Brasilian had only been living in the UK 2 years, since 2007. Since when did other people decide when an immigrant’s time of adjusting was over?

This got me thinking. When I met my other half, we spent at least 2 years getting over the various cultural differences between Americans and Britons. The question I am most asked by any Briton or American is, “Is it different over there?” My answer is, yes but do you really care to know? Despite my great efforts to adjust to the American life, I have found that most Americans I have met have very little interest in understanding what not to say to/how not to offend a Briton. For these few people, the thrill of hearing my dull explanation of what it’s like to drive on the left for the 300th time that day, or what the word “bloody” means, is enough for them. They quickly dream up the first thing they know about Britain, open their mouths without thinking, and throw it at me. Not at any, any one point, do these people stop and think, “Wait…is what I am about to say, offensive to British people?”

“You guys drive crappy little cars, don’t you? And they’re all old too, right?”

“You guys have centralised healthcare don’t you? What’s that like?”

“Don’t you have accidents because you drive on the left?”

“Do you all listen to the Beatles?…What about Oasis?….I like Blur. Do you all listen to Blur?”

“I heard you all have really bad teeth in Britain. Is the dentist expensive over there?”

(The trick here, is to look at them, blink, and stay silent for the first 5 seconds. That way, they hear themselves.) The sad thing is, Americans are not stupid. They are warm, lovely, intelligent people -for the most part. But coming into contact with a Briton is like sudden sensory overload; the bubbling overexcitement causes them to completely lose their decorum…..and they talk without thinking. This leaves British people with a bad impression….which they then take home with them and perpetuate.
The same thing happened to my husband. He lived in Europe at a time where Americans were despised, and British people lost their minds talking to him:

“Why is your whole country so fat?”

“So are you just another ignorant American?”

“Your president’s a ********”

“St Louis? Never heard of it. Anyway……”

The problem with the British, is that we have a very inflated sense of who we are in the world. In one respect this is understandable, thanks to the British Empire, the years before the Boston Tea Party, and our position in the world as far as economics and politics go. Har har, we all poke fun at the Americans, but if that is all you say to an American in your midst, don’t be surprised when he returns home with a bad report about you. No native of a country big, small, great or weak, should ever have the right to talk so badly to a foreigner that it permanently damages their trust in you and wrecks their opinion of your population, never mind the country.
Going deeper and past small encounters, there is then the nonchalant American, which most British immigrants to America end up either living with, close to, or working with. These are the Americans that British expats will take their adjustments from as they learn the way things work in the US, whether they are in-laws, colleagues/co-workers, business clients or friends. The trouble is, while we are silently studying, taking notes and making our adjustments, these Americans have no idea that we are any different to them because guess what? They’re not studying us. This is where cultural misunderstanding begins and ends. This is the defining line that keeps our two countries at arm’s length.

There is this song about immigrants that is echoed around the world by natives living in their own countries. It goes like this: “You’re in (insert country name) now, get used to it.” I think it is completely unnecessary for anyone to say this to an immigrant unless it is glaringly obvious that the legal alien is exhibiting absolutely no signs of adaptation. To the fervent immigrant trying desperately to learn their new life, it is unhelpful, callous, segregating, conceited vain-glorious talk that damages their trust in you. Some of you may be shocked to hear this, but my fellow British people treated my American husband this way in the 3 years he lived in London. We are all, not one person exempt, ALL guilty of having treated a resident foreigner in our country, this way at some point in our lives. The average person’s response is, “Well you’re the minority! Do you expect the rest of the country to bow down to you?” NO! That is not what is being asked of you. Law-abiding immigrants want help from natives, the kind of help that puts love into a handshake, the kind of help that listens, studies, and most importantly applies your own personal adjustment to us.

I am now wearing my husband’s shoes and it is not pretty. There are British and European customs I have extended to my fellow inhabitants, that people have inadvertently mopped the floor with. I spend entire evenings reminding myself to give people the benefit of the doubt, every single day I leave my house. The few small times I’ve had the courage to be able to communicate back that “I know you didn’t mean it, but where I’m from that’s really rude because….” I have quite often been met with “So what.” That’s not an answer. That’s not helpful. That stops me trusting you because it took me some courage to explain that. I’m not asking you to become British. I’m asking you to step beyond your comfortable little boundaries to get to know what makes me tick, how not to hurt my feelings, because I’m really, really trying to understand you, understand your peoples, understand your culture and your country. I am learning about what is important to you. Does it kill you to learn what’s important to me too? How will we ever get along?

When my dad first arrived in Britain he could not believe how, when friends were joking with each other, they playfully tapped each other round the head. In Thailand and a lot of Eastern countries, this is a grave insult and a great disrespect because your head is where you carry your crown of authority. Many British people couldn’t care less about this and refused to respect his beliefs, so my dad discarded them as friends. He made a few good, life long friends who took the time to respect this belief and many many others, people he’d bend over backwards for.

I’ll put you out of your misery and stop with one last note. Respect the person you are talking to and listen to them.