A message to you, Rudy!
With our Parliament in recess I've skedadled to New York, where public debate is dominated by -- with Britain's dear old National Health Service featuring prominently in the arguments used by those against the Obama reforms.
The is regularly dismissed by US critics of reform as "socialised medicine". When you tell them there is all-party support for the NHS and that all mainstream right-of-centre parties in Britain and across continental Europe regard the concept of a health service provided collectively for everyone and free at the point of use as not particularly "socialist" -- just a feature of a civilised society on which there is broad consensus on left, right and centre -- they either don't believe you or think you're making it up.
But it is striking just how far apart America's Republicans (and anti-reform Blue Dog Democrats) are from, say, the British Conservatives, the French Gaullists and the German Christian Democrats on this issue.
The -- and it is not my purpose to explain it today. Obama has abandoned the reform plan on which he campaigned and left it to Congress to come up with reforms he will find acceptable. Suffice to say that nobody is proposing a British-style National Health Service or even the sort of compulsory comprehensive insurance systems that exist in Europe.
The thrust of reform is to give most of the 47m Americans who do not have health insurance some cover, either through new, government-provided insurance or government-mandated employer insurance; and to give ordinary families with inadequate health insurance cover a better deal.
For America's Right, this is as near to "socialised" medicine as dammit and the slippery road to the NHS. And you ought to hear what they think of our health system: third world medicine, massive queuing, no choice of doctors or hospitals, antediluvian facilities. For those of us reared on the inadequacies of the NHS, you suddenly become quite defensive. 
When on CNN dismissed Britain's NHS with the claim that "nobody goes to Britain for healthcare, they all come here if they can" I found myself shouting at the screen: "Hold on, Rudy, it's not as bad as that."
Indeed, somebody might like to point out to him that London alone is a world-class medical centre to which patients flock from all over the world for state-of-the-art medical procedures. That the great medical university cities of Glasgow, Edinburgh and Manchester have world-class teaching hospitals and research (was not invented in Manhattan!). And that Britain is a world leader in many medical areas, including cancer research.
But enough patriotic outrage. Brits know that the NHS can be slow, frustrating, bureaucratic and that there is still too much delay and waiting, despite the improvements that the . But Americans might like to ponder that it is better to be in a queue for health care than not qualify for any at all -- which is the plight of those 47m Americans who have no health insurance.
Nor are the problems confined to them. Ordinary Americans with health insurance are finding that their insurance doesn't cover all the costs of their care -- 25m are deemed "under-insured" -- and are having to stump up for some of the cost of their treatment. Even those who think they are fully insured are having to dip into their own pockets to meet costa (payments called "deductibles").
As somebody who has benefited from health care on both sides of the Atlantic I'd have to say that US health care at its best is probably the best in the world. But often that "best" is not available to ordinary families -- and not at all to those under-insured or without insurance. For the Brits, there is something comforting and reassuring that, if you are struck down by catastrophic illness or in need of expensive operations, being able to afford your treatment will not be an issue.
Of course the British and American health systems are not as far apart as some make out. Britain has a flourishing private health care system -- something the US critics never mention when they talk about the danger of a state monopoly of health care -- which mainly works in harmony with the NHS.
And America already has plenty of socialised medicine in the form of (for the old) and (for the poor), taxpayer-funded schemes which cost 4% of America's GDP and, in absolute terms, means the US already spends many, many billions more on "socialised" health care than the NHS.
Indeed the incredible cost of US health care is breath-taking, whether you're a reformer or anti-reformist. The US spent some $2.2 trillion (£1.34 trillion) on healthcare in 2007. It is a mind-boggling number which amounts to over 16% of US GDP. That is nearly twice the average spent by other rich nations with advanced health systems -- yet you have to wonder if this is value for money when, by most measures, the US is a less healthy nation than other rich countries, on everything from infant mortality to longevity.
The Brits often think their NHS is bureaucratic, wasteful and costly; they may even be right, though it is still one of the country's most valued institutions by voters of all persuasions. But compared with America's, you could be forgiven for concluding that the NHS cheap and efficient. Take that Rudy!
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