Doc Martin, recently concluded its decade-long, somewhat disjointed, but consistently entertaining run on various television venues. Like the eponymous House of a few years back, its main character, Dr. Martin Ellingham, was portrayed by a British comedian—not Hugh Laurie but Martin Clunes.
The comedy relied upon two premises: the doctor's complete lack of and ignorance of bedside manner (he commands every patient at least once to "stop talking"); and the fact that he's hemophobic. The sight of blood nauseates him, and he isn't always successful in squelching it.
I'll miss the series, the quaint, picturesque village that served as its setting, and the somewhat askew characters surrounding the skewed doctor. But this article was supposed to be about healthcare. And it is. For amid all the comedic trappings and quirky characters in Doc Martin resides an underlying and understated truth: In England, healthcare is a right, and it's free.
In a typical episode, patients visit the surgery (in U.S. parlance, the doctor's office), speak to the loopy but endearing receptionist, and await the doctor's brusque command to "come through." After the necessary treatment—sometimes on screen, sometimes off—the patients leave and go about their business. There's a record of the appointment, plans for a follow-up, or even a recommendation to see a specialist. It's just like America—except there's no bill.
Nothing will come in the mail. Patients don't have to run their cards.
They. Just. Leave.
The patients get better, or they don't. They need to go "to hospital," or they don't. They will follow the doctor's orders, or they won't. It's just like America—except it's free.
England and the United States—two civilized Western cultures. But in the U.S. more than ever, doctors belong to groups, hospitals belong to systems, and two-minute infomercials tout the accomplishments of some medical staff while patients foot the bill. As systems merge and, like an octopus, draw in other systems, costs increase, and the democratization of medical care vanishes: the wealthy will afford the best; the rest will take what they can get.
For all the lip service Americans pay to the concept of democracy, it should work for the sick as well as the healthy.
Of course, some will claim that Amrican practitioners are superior, though that belief is not quantifiable. Others will point out that Canadians frequently cross the border to circumvent their own free medicare. True. But by and large, these are exceptions and often commensurate with the wealth of the patient. And patient outcomes differ very little.
In America we have become tacitly accustomed to a system that centers on health care but relies on profit, and though we all trust our own doctors to do what is best for us, we can easily imagine decisions made by physician groups and hospital systems that consider only the bottom line. Patients frequently face choices involving a treatment that's "covered" vs. a more effective one that isn't.
Admittedly no system is flawless: Britain's National Health Service is currently facing a nurses' strike in England and Wales. But the basic premise of the NHS, the second largest single-payer healthcare system in the world after Brazil's, will remain the same.
I'll miss Doc Martin for the laughs and escapism but also for the vision of healthcare in a civilized nation. While here, in this civilized nation across the pond, where Americans stridently defend some vacuous Second-Amendment rights or passionately pledge themselves to a delusional ex-President, keeping themselves from dying is on the back burner...and even that burner does not seem to be lit.