This is a story about affordable care...
I've been able to roll the dice a few times - following my dreams and chasing my ambitions - because of progressive liberal socialist policies put in place by the Labour government of 1945: most notably, the creation of the National Health Service.
I chose to leave an extremely well remunerated job with an American investment bank, with amazing private medical insurance and a brilliant team of occupational health doctors. That US-style of healthcare certainly gave me access to the very best treatment, whenever I needed it, but it was part of a "golden handcuffs" deal: a job that was so much better than anything I could get anywhere else, that I had to be insane to quit.
Life is a balancing act. You can have loads of money, but no time to spend it. You can have loads of time, but no money. You can have job security, but you'll be bored and constrained. You can have freedom and be your own boss, but you will carry all the risks and responsibilities. You have to choose what works for you.
While one friend has parked his tech startup dreams and has taken a salaried job, another couple of friends have just sold their tech startup. In the space of 6 years, I made myself sick with stress, trying to run my own tech startup; I went back to my old job at the American investment bank and stayed sick until I started rebuilding my life in London as an IT consultant. In the space of those 6 years, my friends had countless sleepless nights and worked relentlessly to build their startups to the point where they were worthy of investment or acquisition. In the space of those 6 years, my friend who originally introduced me to the tech startup ecosystem, built a bunch of cool tech and very gracefully pivoted into a job that really suits him, working for a company he really admires. In the space of those 6 years, my friends from the technology accelerator program we attended in Cambridge, raised millions of pounds of investment and sold their company to a tech giant.
Friends went to Silicon Valley to follow their tech dreams. One friend had to break up with his girlfriend. Another had to move his young children away from the family support network, and live with the risk that the USA would reject him and his family's request for residency. Imagine if I had moved to America. How would I ever afford the medical bills, when things have gone badly wrong? I would have been bankrupted many many times over!
Nobody's keeping a seat warm for me in a cushy job because I went to a posh school and a prestigious university. I have no trust fund or family money behind me. Running out of money has meant homelessness. Starting a business had to be profitable from day one.
There's just no way that I would have been able to pursue the opportunities that I have, without the National Health Service. In theory the UK and US are lands of opportunity, where anybody can start a business and become rich and successful. In practice, it's almost impossible unless you're already quite wealthy. The consequences of failure are just too much to bear, for most people.
My current business is consultancy. If I'm sick, I don't get paid. If I don't have a client, I don't get paid. However, I've calculated that I only need to work a few months of the year to earn the same as as the 'secure' job I gave up. It's a calculated risk. I might end up not being able to pay my tax bill. I might end up not being able to pay my rent. But, when things go well, they go really well. The odds are in my favour: if I can just get two or three contracts in a row, not get sick, maybe have some projects that run longer than expected, then I'll suddenly be way way way ahead of where I would be if I'd just plodded along with the golden handcuffs on.
I sat awkwardly on my leg and it went numb. My foot became swollen. My leg swelled up all the way above my knee. My kidneys shut down. I was admitted to hospital and put on dialysis. I haven't had any income since September. Surely this is why it's best to have a nice 'secure' job?
I've been stressed and depressed about losing a lucrative consultancy contract. I was literally about to start working again when I got sick. Contractually, I have no rights: the company could just award the contract to somebody else. I was going to have to start the search for a client all over again, meaning yet more loss of earnings.
Here I am in hospital. I've been here for a week.
I was seen by a doctor within an hour of arriving at Accident & Emergency. I've had two private rooms with amazing views over central London. I've been seen by top consultants, surgeons, registrars, nurses, phlebotomists, physiotherapists. I've been wheeled around by porters and served meals by catering staff. My bedding has been changed and I've been given clean gowns and towels. Numerous medications have been dispensed. I've had ultrasound scans and my blood has been scrubbed clean and drained of dangerous toxins by dialysis machines. My blood pressure, blood oxygen, pulse and body temperature has been monitored around the clock. Even the amount I drink and piss is meticulously recorded by the staff on the ward.
Nobody has ever asked me for my medical insurance details, credit card or discussed how I plan to pay for all this world-class treatment. Nobody is going to send me a bill when this is over.
As luck would have it, my client has decided they will wait for me to get better, so I can start my contract. Imagine if I wasn't able to take that contract in the first place, because of the risk of getting sick. Imagine if all the profit from my contract got wiped out by a humongous medical bill. How is anybody supposedly 'free' to become rich and successful, if they can't predict when they're going to get sick and how much it's going to cost?
This story is really a re-telling of three stories. The story of the friend who inspired me to follow my startup dreams and who inspired me to write about the importance of the National Health Service for social mobility; the story of the friend who succeeded, after 6 years of sacrifice, blood, sweat and tears, with countless sleepless nights and untold stress; and the story of me, who couldn't handle the chafing of the golden handcuffs, and got unwell because of the combined stress of running a tech startup with an unsupportive partner and unsupportive family.
I'm now lucky enough to have reconnected with old London friends, repaired friendships that were damaged or neglected when I got unwell, made new friends who are incredibly loyal and caring, and I have found an amazing lady who makes me feel loved to bits and completely accepted for who I am. Her family have welcomed me with open arms and most of the get well cards I've been getting have been from her family, along with offers of help to get me back on my feet.
While the welfare state is deeply flawed and it's an impossible task to get the social support that you need, as a single man whose life is imploding, the National Health Service has been the glue between the pooh, holding my shit together and just about keeping me alive. When you add in an amazing girlfriend, her family, loyal and caring friends and the rest of the social fabric that a person needs, you finally stand a chance of getting your life back.
I read with great dismay that the US Affordable Care Act (a.k.a. Obamacare) is being repealed. What the actual fuck, America?
If you wanted a case study for a society that's as close to perfect as you're going to get in an imperfect world, we should look to London. 300 different languages are spoken in London schools. The tower blocks of Canary Wharf sit in a London borough that's 46% Muslim. There are cycle superhighways, driverless trains, an underground railway that moves 5 million people every day. The Metropolitan Police are humble public servants, who protect the vulnerable and take people to hospital, involve social services and mental health crisis teams, rather than flashing their badges and drawing their weapons. The whole city exudes tolerance, inclusion and diversity: it's in London's DNA.
You might mistakenly believe that London is a city for the rich, but it's not: because of the National Health Service. The NHS employs 1.7 million people, and funded properly - like it is in London - it shows that socialism and multiculturalism can be made to work. The last piece of Britain's nationalised socialist infrastructure, not to be wrecked by the greed of capitalism; the NHS is a fly in the ointment for the Tories who want to sell everything off for private profits and damn the lives of British citizens.
I want the railways re-nationalised. I want the energy companies re-nationalised. Most of what comes out of Westminster is good for London but bad for the rest of the UK. What we're seeing is one rule for Londoners and another for everybody else. London gets state-owned public transport where 100% of the profits are re-invested in infrastructure. London has a remarkable set of public services that create jobs as well as keeping the residents well looked after. Socialism for London and capitalism for the rest of the UK... that sucks.
In my week in hospital, I've realised that London truly offers an enticing vision of a near-utopian society, so unlike the ugly one pictured in the dark minds of the populists. London is a European city, connected by train to Paris and Brussels. London is a mercantile centre, where East literally meets West at the Greenwich meridian line: the perfect time zone to deal with both Japan and San Francisco in the same business day. The peaceful co-existence of so many cultures in one crowded city is a modern miracle. I live here because of the immigrants, not in spite of the immigrants. London simply wouldn't function without its chaotic diversity.
Getting used to living in London is hard. The congestion is hard. The clash of cultures is hard. Seeing people who look and act differently is hard. Processing the humbling fact that the world is huge and complex is hard. Realising that you're in the racial minority is hard. Living a small, neat, efficient, considerate, reserved life, where you quietly observe and ask questions, as you discover your fellow Londoners have had incredible journeys, arriving here and building their lives, is hard. It's hard damn work, letting all this chaos and complexity assault your senses.
I don't want private hospitals, private health insurance, medical bills, policemen carrying guns, offensive foreign policy and an economy that offers no hope of escape from the socio-economic background you're born into, except for a tiny handful of sports stars, lottery winners, rappers and criminals. I don't want private prisons stuffed full of black people being used as slaves. I don't want a world of "us" and "them" with torture, pre-emptive strikes, invasion of sovereign nations, regime change and covert ops to destabilise other nations.
In a week in hospital, I've benefitted from everything that's great about Great Britain in the European Union and London's huge immigrant population. Only a tiny handful of the staff who've saved my life were born in Britain. Only a tiny fraction of the medical supplies and equipment were designed, tested and manufactured in the UK. I'm a stone's throw away from mosques where alleged firebrand hate preachers are supposedly plotting against the British people. Whitechapel Market is crowded with women wearing full-face veils, but I'm just another Londoner to them. If there's an exemplary organisation to demonstrate multicultural society working perfectly, doing life-saving work, it's the National Health Service.
Affordable care not only saved my life, but it's keeping my hopes and dreams alive, so I don't have to take a zero-hours contract McJob flipping burgers, just in case I get sick.