On Jan. 24, I got a text from the UK’s National Health Service telling me if I had returned from Wuhan and felt ill, to call a number to arrange a phone consultation. The request to stay away from my local NHS facility was polite but firm: “Please do not attend.” One month later I got another text, with a longer list of countries (China, Hong Kong, Italy’s Lombardy region, Japan, Macau, Malaysia, Republic of Korea, Singapore and Taiwan). If ill, self-isolate and call 111.
I found it reassuring that the NHS knew how to reach not just me, but most people in the country. If coronavirus escalated, it would be able to locate us and instruct us on what to do. Since everyone living here legally is covered through the NHS, the incentives in the system were aligned to stop the virus. The NHS was responsible for us. If we all got sick, it was on them to take care of all citizens.
There are no such incentives in the US, where I am from. More than 27.5 million people have no insurance, and would likely fear coming forward for testing because they could be charged for treatment. Research and technology and resources might be richer, but the ethos was poorer: even since the advent of Obamacare, healthcare exists foremost for the employed and those who can pay. And it’s on you to figure it all out—the forms and deductibles, co-pays and pharmacy benefits. If you have insurance, it is in the interest of the insurer to pay as little as possible.