Bill of health

  • Jon Kelly
  • 7 Oct 08, 06:27 AM GMT

NASHVILLE, TN: Beware when life imitates art. In 2007, Molly Secours was a successful film-maker who had just completed a documentary about Americans impoverished for want of health insurance.

Then doctors told her she had uterine cancer: now she too faced financial ruin.

"The financial stress was almost as bad as the diagnosis and the treatment," Molly, 45, grimaced.

Molly Secours "All the time I was thinking: how am I going to pay for this?"

Having spoken to so many patients left destitute by illness, Molly had made sure she was insured. But her policy - the best she could afford - had only covered 80% of her treatment costs. She was still faced with a bill of more than $40,000.

Unable to work as she underwent chemotherapy, Molly watched her credit card debts spiral upwards. She assumed she would lose her home, her car - all her material possessions.

But her friends came to the rescue. They organised a fundraising concert in her adopted home city of Nashville which, together with an internet appeal, raised some $30,000 - enough to keep the creditors at bay.

When I met her, Molly was back at work having just received an all-clear from her latest check-up. But she was on her way to a rally in support of healthcare reform: she desperately wanted Barack Obama to win the election and introduce a universal safety net.

Back in New Mexico, I encountered a story very similar to Molly's. After I blogged, I was struck by the polarization among readers' comments: back home in Britain, people often find it difficult to understand why Americans run their health service as they do. The fact that 47 million of them have no coverage seemed shocking to a country reared on the NHS.

Nashville seemed an ideal location to explore why Americans might feel otherwise. The city might be best known for its country music, but it can also claim to be the healthcare industry capital of the US.

Paul WrightPaul Wright offered a perspective on why so many support the system here. The 60-year-old could point to the fact that the United States spends far more per capita on health than any other country in the developed world.

Paul didn't want to see the system radically changed. The company he worked for, a commercial tyre firm, contributed to his insurance as part of his overall employment package. And here in America, he said, people had a duty to look out for themselves.

"I agree with John McCain on this one," he said.

"Here in the US, you can get treatment almost immediately if you need it. I've heard stories about people in Canada having to wait.

"At the end of the day, I think there does have to be personal responsibility."

It was a tough, uncompromising view of the world - but one in keeping with the American virtue of self-reliance.

Liberals and conservatives could argue about whether Molly or Paul's outlook best expressed the national ethos. But I wanted to hear the story from the sharp end of the health care system.

reginaReginald Coopwood Reginald Coopwood met me outside the Nashville's Metropolitian General Hospital, where he served as chief executive.

His was a difficult job, he told me. Here in Davidson County, he added, some 56,000 people - 10% of the population - had no health insurance. He expected the figure to rise as turmoil on the financial markets started trickling down.

"We're going to have more with people losing their jobs," he said.

"It's going to make the issue real for a lot of people."

He could be right. But whether either US presidential candidate will be able to overcome cultural hostility to universal healthcare isn't something I'd want to predict.

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