Great Speech by John McCain – and some other thoughts

I know, I know. What am I, an Irish person living in Ireland, doing watching a speech about debating healthcare in the US? Well I’ve admitted to be a media junkie here before – I think I did anyway – and since the Brexit result last year I decided to browse through a much more varied selection of news – and I like PBS. To be honest I started watching this to see how John McCain was doing after the operation and I’m glad I did because this is a great speech. So I thought I’d post it here.

Great because it’s about getting things accomplished and improved upon, working for the people not for the party – and it has a strong streak of the American optimistic, can-do idealism/attitude – which is something really great, don’t lose that.

But obviously the idea of repealing a healthcare policy that gave millions of more people access to affordable healthcare and replacing it either nothing or something which makes healthcare dangerously expensive to millions is pretty much the opposite of great. John McCain doesn’t seem to be advocating that – he seems to want to find a better healthcare policy than the one that is now in place.

Our own healthcare system in Ireland is far from perfect. I would love if we could have a version of the NHS (the UK’s healthcare system) which I think in US terms would be like Medicare for all.

Very quick and basic overview of the way the health services work in Ireland is your first port of call is the family doctor – General Practicioner (GP). If you are on a low income and/or have serious health issues you may have a medical card which means that you can see this doctor for free. You also can access most services in the public healthcare system for free. You may also get your medicines for free paying €2.50 for each prescription item up to a max of €25 per person or family per month.

If you don’t have a medical card then you pay to see the GP and this typically costs between €50-60. You pay for your medicine. There is a scheme called the Drugs Payment Scheme which will means you pay a maximum of €144 for your medicine each month. You have to apply for this scheme. People without medical cards who pay PAYE tax may also be able to claim some tax back on their medical expenses – many Irish people are not aware of this though, so if you’re reading this and fall into that category be aware that you can claim back on expenses from the last 4 years.

If your GP refers you on to some hospital clinic or specialist, if it is just an appointment, some exam or day procedure and you go through the public healthcare system, regardless of whether you hold a medical card or not this service is free. Sounds good, doesn’t it? Unfortunately there is a sting in the tail – the waiting list for these public services can be very long – months or longer. The way around these lists is to “go private” and this could be expensive depending on the treatment or investigation in question. If you end up staying in hospital overnight in the public healthcare system this is free for medical card holders but the rest must pay €80 per night up to a max of €800 per year. Doesn’t sound too bad. Is there a sting in the tail? Well thanks to the Public Bed Charge people going through the public healthcare system who declare that they have private health insurance can be charged private rates for their health cover. Hospitals do this as a way to increase revenue – which is very understandable but it is driving up health insurance prices. And if you want private healthcare you definitely need health insurance as it’s very expensive (although I don’t know how it compares to the US). Also if you’re going into hospital for an operation and going through the public stream you could be waiting some time for that.

The last thing I’ll mention is that attending A&E will probably cost you €100. I lamented this fact to an American lady a few months ago. She then told me about an uncle of a friend of her’s who ended up in hospital in the US after having some sort of seizure or something and – I couldn’t really follow why – but he ended up being charged tens of thousands for the treatment he received. All I could say was “Well, well yeah … that’s obviously worse… – but still we shouldn’t have to pay to attend an A&E department. It used to be free. And it’s for accidents and emergencies!”.

That’s just a very brief and not very complete overview of how the health services work here. It doesn’t really explain why people are so dissatisfied with the system – this article does. It’s a pretty searing indictment of the state of things really. If you aren’t from Ireland I’d just advise skimming through it so as you aren’t left thinking the system described about sounds pretty great. The people working in the system here are great but the system itself is not – but it is a lot better than the system in many other parts of the world. It may not compare all that well to other European countries but there is a safety net – and I’m very grateful for that.

Still a version of the NHS would be amazing. Delivering such a system requires a determination by the people and their representatives to ensure people can access affordable healthcare. Accessible and affordable healthcare is not a luxury or a desirable state of affairs, it is a necessity.


The bill was debated and ultimately defeated because three Republican senators, McCain, Murkowski and Collins, voted against it.

I was kind of amazed by some of the US media coverage I saw about this. It was painted in terms of being a loss or failure of the Republican party or of the current administration. Some coverage was very negative about McCain voting to even allow debate on the bill. Why? How could opening up something like a bill on healthcare for debate be wrong?

It’s silly that this surprised me. I think a lot of the criticism of mainstream media is unwarranted, unfair and often just plain wrong. But there is something about coverage of politics (both in my own country and elsewhere) that really confounds me and that is the focus on political power plays rather than the actual policies proposed, debated and implemented.

You know what it’s like? – It’s like reading a critique of a play that goes on about the sets, the lighting, the costumes, how well the actors delivered their lines, but fails to mention what the play is about or discuss what its message is in anything but the briefest of terms.

That’s quite harsh criticism, I know. And there are some really great sources of detailed information out there – particularly in print media. And of course news is a business and it can be much more entertaining to watch people ridicule and score points off each other rather than to listen to long winded synopses of very detailed and complex policies and proposals. I get that. And the news is very entertaining these days. But maybe if our focus shifted towards this kind of detailed reporting we would all gain the level of knowledge needed to find intricate discussions on policies more interesting.

It’s something I’ve noticed when I’ve taken an interest in a particular topic there is a level of knowledge you need to attain and once at that level any kind of discussion about it will become interesting – or maddening if those talking take a position you find unreasonable, but it will certainly hold your attention. Obviously it’s possible to find very detailed information on policies yourself but it takes times and effort – more time and effort than one would expect in a world where news is reported on every minute of the day every single day.

But why would I want detailed information on US healthcare policy? I don’t – is the honest answer to that. I posted that video after watching it not because I have a special interest in the matter being debated but because I really liked what John McCain had to say about the role of the senate, its responsibilities, its stature and about focusing on getting things done for the people rather than “winning” for the party or their own aggrandisement. That is great.

I added more to post because I believe that healthcare is a right not a luxury and I wanted to make that clear. But it does feel a little ridiculous making that point when talking about the world’s richest country and not mentioning the terrible problems throughout the world that people have accessing healthcare. I’m not going to go on about that here. But I do want to say that no matter how wealthy your country is deemed to be, it doesn’t make much difference if it is failing you. Healthcare is right not a luxury and countries are only as wealthy as their poorest citizens.

Changed title to reflect added … ramble? maybe a bit of a rant? ranting ramble or rambling rant?

Of course there are things beyond policy that must be reported on…