If You Can Afford It, Dial 911: It’s America, Baby.

Last week a post cropped up in my Facebook feed from a friend who had taken the J train from Brooklyn to Manhattan. Somewhere across the Williamsburg Bridge a man fainted, hitting his head on the doors before collapsing to the floor. 

Immediately commuters around him leapt to their feet, working together to try to take care of him. New Yorkers are like that, you know. They’re about as tough as you can get when they have to be, but it’s a city with community at its heart in times of need.

Somebody hit the emergency button to communicate with the driver and he was met at the platform at the next station by two subway officials. “Can we call you an ambulance?” they offered. “No”, he replied. “It's too expensive.”

This is the reality of life – and death – here in the United States of America, where a ride in an emergency services vehicle costs the patient, on average, around £1700. Now, everybody reading this knows that a journey of two to three miles in an ambulance cannot possibly cost £1700 – and that’s before any sort of treatment is given.

To be fair, there are no circumstances under which the services of an ambulance can be denied due to the patient’s inability to pay (with or without insurance). Let’s say you get hit by a bus and the Grim Reaper – scythe in hand – is toying with the idea of dashing to your side. You’d be rushed to ER (A&E) and treated long before before you’re even asked about insurance – but just because you’re treated, it doesn’t mean you won’t be billed for it later. That is a certainty. And let’s say you have health insurance. Does the hospital work with your insurance company? If they don’t – the term is “out of network” – you’ll find yourself transferred to another hospital that hopefully does. But some insurance policies don’t even get you that far.

Can’t deal with any of this? Neither can I. And we haven’t even begun to scratch the surface of the American Health Industry and How They Get Away With It (my capitals) – it’s a complex, fragmented, confusing mess.

Most of my friends here in the States are mainly covered by the Affordable Health Care Act (see Obamacare), Medicaid (insurance for the poor) or Medicare (insurance for the elderly) – all of which exist to ensure that those people who live on next-to-nothing can gain the necessary access to the medical attention they need. But if the man in the White House gets his own way, those affordable healthcare options might be on their way out. But here’s the other thing. The majority of people here in full-time employment get their health insurance from their employer. Which raises a whole smorgasbord of questions about people being tied to their employers for the security of being covered for healthcare.

I know. I know.

Now. Here’s one thing that’s important to remember. Americans are raised to believe that you are responsible for paying for your own healthcare and not the healthcare of other people. That is how a responsible citizen thinks. It has always been this way. Just like I was raised to believe that the National Health System – funded from central taxation and

National Insurance contributions – will take care of all of us regardless of our social or economic background. That is how a responsible citizen thinks. It has always been this way.

So I suppose all of this is really getting me onto the subject of saving that greatest of all British institutions: the NHS, the oldest (and the largest) single-payer healthcare system in the world. Fight for it – and against privatization. Don’t allow Britain to descend into a chaos state where people have to consider whether or not they can afford to dial 999. I see and hear nightmare stories here all the time. You hear tales of folk in the States whose insurance policies have lapsed, who then get sick and find themselves in a situation where they’re unable to pay their medical bills and end up losing their homes.

I often wonder which country I might be living in, if and when this body of mine needs emergency attention. Who can tell? I just hope I can afford that ride in the ambulance.

Matt Roper is a British comedian based in New York City. His relationship with Lush goes back to 2011 when he appeared before the muddy festival-goers of Lushfest, returning the following year to curate the line-up of the comedy stage. As he travels around the world, he shares his musings with us here in a series of writings — a sifting of thought from a restless but always seeking imagination.

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