04 December 2006

Sex On The NHS

One thing I will definitely miss about England is the National Health Service. I know it's a popular subject to complain about, but most of those doing the complaining have never had to endure the institutionalized barbarism that passes for a health care system in the US. Ordinarily I can listen to American right wing talk radio without taking too much umbrage, even enjoying the flights of rhetorical fancy and invective, but when one of those clowns starts in with, "But we don't want socialised medicine like they have over in England," I very nearly want to reach inside my radio and strangle the goon.

Yeah, I think, maybe you don't want national health care because you're pulling down a few hundred grand a year and have the kind of medical insurance normally reserved for Congressmen and CEOs, but probably a hundred million Americans, one out of every three, are underinsured, badly insured, or not insured at all, and for them, even a relatively minor illness can turn into a nightmare. It should tell you something that nearly every American medical office has at least one employee whose sole job it is to navigate the bureaucratic labyrinth and determine what if any procedures will be covered by any given patient's insurance.

Yes, the NHS has its problems too, many of them down to mismanagement and atavistic ideology. Just as Social Security is the third rail of American politics, so the NHS is in Britain. Everybody agrees it needs reforming and can't continue to be run as a showpiece for 1940s-style socialism, but nobody dares suggest the necessary steps (means testing, for example; London billionaires pay nothing for excellent treatment, while poor people in less prosperous parts of the country are the victims of postcode rationing). So as an alternative the Labour government pours billions of pounds into propping up the NHS in much the same way that US government handed billions over to Halliburton to "fix" Iraq. The result: some money for pay rises for doctors and nurses, but far more money for quangos, consultants, talking shops and ill-advised computer systems.

As it stands, NHS medical staff are paid considerably less than their US counterparts, but at least in my experience, render far better service. This might be at least partly because money is not such an omnipresent factor in treatment decisions, but for whatever reason, I have never seen an NHS doctor who wasn't willing to take more time to understand my case, to go out of his or her way to ask questions that might shed further light on my condition, and to suggest a variety of treatment options that I might not even have considered myself.

Case in point: last week during a routine checkup, my doctor started querying me about my love life (there is none, thanks very much to any of you who were going to chime in with your own questions). Now some might interpret this as a gross invasion of privacy, but she explained (quite reasonably, I thought), that modern medicine needs to treat the whole person, not just a collection of symptoms, and that a happy, healthy sex life is an essential part of a happy, healthy life. She then offered to refer me for counselling if I thought it might be helpful in coming to terms with any emotional or relationship-type issues.

I almost had to laugh, as I'd been referred for precisely the same sort of counselling some three years earlier, and as a result had about a year and a half of the best talking therapy I've ever experienced (and given the vagaries my life has taken, I've experienced a fair bit). "Oh," she said, "did it help?"

As it happened, I told her, the therapy had helped me in very nearly every way but that for which it was intended, i.e., I hadn't found love, sex or romance as a result, but at the same time I'd grown far less bothered by their absence. Still, she persisted, maybe I'd like to try another round of therapy? And I could only think, as Yakov Smirnoff used to put it, what a country. In America they hand you a bottle of pills and shuffle you out the door as if you were on a conveyor belt; in Britain it's a dire medical emergency, worth shelling out great gobs of the nation's cash, if a fellow's having trouble getting laid.

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