The recent defection of Senator Arlen Specter from the Republican Party over to the Democratic side of the aisle has given the current administration an incredible amount of freedom to push forward on certain policy measures. Once Al Franken is seated, this will bring the number of Democrats in the Senate to a filibuster proof sixty. So what do they do with this opportunity that's just dropped into their laps?  I live in the San Francisco, which is both (on the whole) a very affluent area, and one in which many people consider themselves fairly left leaning.

One of the things, then, that's been much discussed here is some sort of national health service, or socialized medicine, and so one. Call it what you will; the vision is largely the same - a federalized service, which is free at the point of use, and is paid for out of our tax dollars. My question is this, however; are these people ready for the reality that this will bring?

There are many, many good reasons for having a health service funded by the government. It takes the profit motive out of health care (I'll admit that many would suggest that's a bad thing, but that's not really the thrust of this argument, so let's not get distracted), it means that the poorest are always able to have access to healthcare, and it means that people don't have to take on crushing debts should something unfortunate befall them.

I don't really want to get into the whole issue of how this would be funded; I'm not an economics expert, and nor do I claim to be.  I just want to paint a picture of what it's like to actually experience the healthcare. I should say now that I'm basing this on living for twenty years in a country that has a national health service.

Here's, basically, how it works. Obviously there are variations on this, but a pot of money is set aside for health. This is then broken down by state, region, city, or whatever. For each sum of money, an actuary will look at the tables of those getting sick and needing care, and make a determination at the beginning of the year (or quarter, etc), of what operations are going to be funded, how many of them, and also the level of staffing and other considerations. Since they are dealing with huge numbers of people, compromises have to be made. This is the nature of the beast. So it can frequently happen that I, as an individual, am unable to immediately get the health care I need. I should point out that this doesn't apply to life threatening conditions, but say I need a hip operation, it might be that I have to wait a period of time. And we're not talking about a week here - it could easily be a few months. But that really is the nature of the beast - by necessity, I am treated as a number, a statistic, and not a person.

So here's my thought - is affluent middle class America prepared to accept this trade off? They've been used, all their lives, to having healthcare on demand - and now there's a chance they might not.  I don't know if they'd be so pleased.

I guess we won't know until it happens - what do you think?