Wednesday, November 02, 2005

Sidebar Thought on Sixpence House

This started out as part of the previous post, but I think it's turning into a full-fledged thought of its own. (And this is also part of my new drive to have shorter, punchier posts.)

There are connections I wished Collins had made in Sixpence House, and one of them has been bugging me. Early on, he visits his dying 83-year-old grandmother, and makes the point that, under UK National Health, 83-year-old women with brain cancer are not given much in the way of treatment (as they would in the States, in many cases), but allowed to die relatively naturally.

Later on, his son has to go to a doctor for a small accident, and he notes with bemusement that, since his family aren't "residents," the cost of the doctor visit will be twenty pounds. The woman who tells him this thinks this is quite a high payment, of course. And the implication is that the UK setup is so much better than the way the US organizes healthcare. (And it certainly is, for a couple with no regular employment or fixed address.)

But the two things are inextricably linked, and Collins must know this. The UK system has made certain choices in its priorities, and the US system has made other choices. Choosing not to spend vast resources on old, sick people means that things will be cheaper for everyone else. Collins's son's doctor visit costs twenty pounds because someone's grandmother is dying of cancer.

We can argue about how to make those choices, and whether there's some happy medium in between the US and UK schemes, but the two things are not separate. I wish Collins had realized that in this book.

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