What meal will you always remember?

As most of you have likely already surmised from my writing, I suffer from a severe mental difficulty, that I am obsessed by, consumed by and terrified by food and eating. I fight this all day every day. I can still write and teach and speak. But it makes life unimaginably painful. I have tried almost everything possible to improve the situation but it has only gotten worse. More than anything, I blame the inept public medical system in the UK and Canada for their incompetence in attempting to address not just mine but everyone’s medical issues, especially mental health ones. It is a system designed for emergency response rather than preventative or long-term treatment. The specialists and generalists are both paid regardless of success rate and their success is in no way linked to outcomes or even effort. They have no incentive to help. Waitlists are incredibly long, people often waiting years for basic treatment to begin but worse than that, patients are simply ignored and dismissed. This is not a lack of funding. It’s a lack of intent. There is plenty of money for healthcare in these countries. There’s just far too much paperwork, too much administration, far too much oversight and absolutely no reason for any of the medical professionals to want to do anything but sit in their offices and dismiss patients. If you got paid the same amount every day for sitting in your office ignoring everyone or actually doing a good job, which would you choose to do? If you think you’d work hard, you might be a far better person than most. Most humans are lazy and will do as little as possible to get by in life. What’s wrong with the system? Simply put, we are rewarding laziness and dismissiveness.

It’s an easy problem to solve. Private medical practice works. As much as I am a hardcore communist who believes in the elimination of money and commerce and the forced equality of possessions and results across all humans, we live in a capitalist society where money is the one and only mark of success. It is what people are motivated by. Sure, some people are motivated by an intrinsic desire but those people are few and those desires pale in comparison with the ability to make money and have a pleasurable life — except for a very small number of people who truly do sacrifice themselves for the greater good. If you haven’t noticed, though, most of those people are already very rich before they start doing it. Most but not all, of course. But still most.

The solution is to eliminate public provision of medical care while maintaining public payment for it. Regulate costs to keep them manageable and reasonable but instead of paying the doctors and nurses and technicians directly, provide the money as it would be given by an insurance company, to cover the payments for individuals seeking treatment. That way, the medical professionals are competing for business and good treatment is rewarded by more success, good reputation, increased patient requests and, as a result, far more profit and a better income. Lethargic and lazy practitioners are punished and eliminated to a large extent from the system. Excellent doctors and nurses and technician are rewarded, as they should be, given more than they get now for doing a good job and helping people. Those who help more people and give more attention, more care, more treatment get a better life in return. Those who don’t help leave the profession and make room for those who will put in the time and effort and caring.

Sure, it’s our human duty to care and be compassionate to others. But if you want to see just how much that isn’t working, spend a few hours in a public hospital in the UK or in Canada. Then go to a private hospital in New York or California and see how much better it could be. Ask people in the waiting room in any department how long they’ve been waiting. How much attention they feel they’re getting and if the treatment and testing is reasonable given the level of their suffering and how long they’ve been fighting with the illness. Ask if the doctors seem to care about them. If you haven’t noticed that public healthcare is failing, you’ll be stunned by the results.

If you hear politicians talk about how important it is that people not have to pay for medical treatment, they’re absolutely right. If you hear them say that the only way to accomplish that is to have public-maintained healthcare, they’re off their heads. It costs vastly more for each patient seen in either of those countries in the public system to be treated than it does in the private system. Private hospitals are vastly more efficient. They have far less overhead but the medical professionals are paid better. They embrace new technology and are not hampered by the whims of the government. The follow regulations but they’re not forced to maintain massive staffs and stick to rudimentary paperwork — on paper, in many cases, or public works projects for digitization. The government should keep us safe and healthy. It’s a useless hospital administrator, though. It should play to its strengths. Pay the bills. Let the professionals do the rest.

What does this have to do with the meal I will always remember? Because I remember every single meal. I am terrified after I eat, every time. I spend hours, sometimes days, shivering in panicked fear. It sometimes stops me from being able to accomplish anything but most of the time I am relegated to sitting and working through the rest of the day in unbelievable panic. I believe there is a solution to this, that someday I may be able to eat a meal and forget about it after. That I might be able to prepare to eat in the moment rather than thinking about everything I’m going to eat for hours, days, sometimes even weeks before — every measurement, every amount of time to prepare, every single detail. But because of the medical system in the countries where I have lived, I see no real way out of the mess because the only way to have doctors pay attention to you, unless you’re unconscious and bleeding from the head, is to pay for that attention. And without getting better, my earning potential is intensely diminished.

Of course, there will be many who tell me that if I believe the American medical system is far better, I should get out and move to America. And yes, I would love nothing better than to be able to go back to the west coast where I am so much more at home and spend the rest of my life there without once having to entertain the thought of returning to the hateful shores of the once-imperial British Isles. I’d get on a plane this afternoon given the opportunity. But there’s a problem. I’m not an American.

That doesn’t stop a lot of people who want to live there but they have to have something before they can go and it’s a fairly large and significant something. They have to have a job offer — which then allows them entry into the country. And if I were able to get hired for a full-time position that would pay me enough to live and to get the treatment to solve these problems, I’d probably not need the treatment anymore. How are we spelling catch-22 these days?

So I will have to fight alone until I don’t have to fight anymore. Then I can go to the home that’s not mine but feels closer than anywhere that legitimately is. There are few places I even feel slightly at home. Without money, none of them ever will be. Why is money the thing that determines our futures? Why do we still cling to an ancient system where those who have money do well and those who don’t aren’t really equal in any sense of the word? What does it matter if we have the right to vote if we don’t have equal ability to choose where to live or where to study? The world isn’t going to hell. There is no handbasket. There is no descent.

The world is hell. Right here, right now. Hell isn’t other people. It’s that other people are better, are worse, simply aren’t other people but are players in a game. Until we are equal, not in opportunity but in life, practical everyday life, we won’t be free. We’ll just be trapped.

And those people who tell you that equal opportunity makes us free, that money doesn’t lead to inequality as long as we work hard, that free speech is what’s important, not that we have the same daily lives, you’ll notice something about those people. They all have money. Not always masses of it but always plenty. They’re not afraid of how to pay for their next doctor’s appointment or rent payment. Money is like air. It’s only a problem to those who can’t get enough of it to live.