When I was twenty-two I sat the Foreign Service exam. I was living in Singapore at the time and my head was filled with images of the diplomatic life, culminating in an ambassadorship. My expectations were in check — while ambassador to France or Italy would be nice, I’d accept being addressed as your excellency in a third world country. Unfortunately it was not to be. I passed the aptitude portions of the exam but failed the personality test, apparently lacking the fundamental building blocks of diplomacy.
Since assuming the mantle of dual American and British citizen earlier this year I have found a way to fulfill my dormant ambassadorial ambitions. I now regularly indulge in self-appointed responsibility for defending those aspects of either British or American life that require defending to the respective other side of the pond. I am equally willing to serve as the ambassador of tepid but real beer and cricket as I am of (the majesty of) Target, Taco Bell, customer service, and ice, without which one could not know the pleasures of iced tea. There are, of course, quirks perpetrated by both of my home nations that merit no defense: baked beans for breakfast and Sarah Palin spring to mind. In such cases I invoke a sort of diplomatic immunity which looks a lot like only claiming to be a citizen of the non-offending country.
Of late it appears the UK’s National Health Service (the NHS) requires my ambassadorial services in America. In the past few weeks the insults to this fair institution bandied about on U.S. cable news have infiltrated the British airwaves and inflamed the UK populace. It’s not that the NHS is without fault. It’s more akin to someone criticising your family, as in you’re allowed to speak ill of your own but that doesn’t make it kosher for someone outside the clan to do the same. (Especially when that someone rebelled more than two hundred years ago thereby severing all family ties.)
My personal experience with the NHS over the past four years has been good, even great. What sticks with me most is how my local NHS surgery got me in on the same day earlier this year when I noticed my speech was slurred (and there was no alcohol involved). The NHS GP progressed my treatment rapidly to specialists — who were admittedly paid for by my private health insurance –who got me diagnosed and treated within days. Yes, private health insurance is still widespread in the UK amongst employees of mid to large sized companies despite the existence of the NHS. Private and public care co-exist and, in my experience, cooperate quite nicely in the UK, a situation that currently seems unfathomable to many in the US. But lest you discount my arguments as the preserve of the coddled, privately insured, I offer as evidence my Uncle-in-law Alan, who survived open heart surgery at the hands of the NHS last year and has the pig heart valve to prove it. He can be found in a small village off the Morecambe Bay riding his bike along the canal path or drinking a pint at The Royal on any given day.
Of course the whole defense of the NHS is largely irrelevant in the context of the Obama administration’s current health care proposal. It does not legislate a nationalised health care service at all but rather different mechanisms that are attempting to reach the same end: universal access to health care for citizens. I note with no little shame that America is the only rich country in the world not to have embraced this principle. But my interest is not just in national pride for both of my home countries. It is distinctly personal. Should fate be cruel and decide to cash in the option on chronic illness it took out on my behalf earlier this year, my ability to return to America to live without impoverishing my family will be dependent on the passage of at least one part of the current proposal, that which prevents insurance companies from failing to cover pre-existing conditions. And fond as I am of ice and Taco Bell, returning to America is an option I’d like to keep open.