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Posts Tagged ‘Politics’

A letter came in the post last Friday and after I read it, all I could do for a few minutes was stare at it in shock.  I sat down and put my hand on the couch to steady myself, and then read it again.  It wasn’t so much the news that it brought — though that was bad enough — but the way it made me feel: vulnerable… so, so very vulnerable and out of control.  The letter was from the girls’ insurance company and it informed me that, due to “increasing [insurance company] financial losses”, the premiums for their cover will be increased from October by 350%.

The girls are covered by the state’s CHIP programme — the only long-term cover I could find that they qualified for when we lost our health insurance because M was suddenly laid off three months after we arrived in the US.  Because the girls are US citizens, they did not qualify for the insurance policies that are usually offered to incoming immigrants.  And because we had just moved from abroad, they did not qualify for most normal insurance policies which, I discovered to my utter bewilderment, all seemed to have “residency requirements” that disqualified anyone who had not lived in the US for the last 6 to 24 months.  My daughters had both been recently diagnosed with potentially life-threatening food allergies (my elder daughter to eggs, my younger daughter to no less than eight foods, which later rose to 12) which had had a huge impact on our daily lives, and I was desperate to get them onto a good, long-term policy that would give us some peace of mind.  We were still reeling from a string of devastating events that had begun almost as soon as we arrived and had consumed nearly all our mental, physical, and financial resources (besides M losing his job and our insurance, I suddenly developed incredible pain that debilitated me for months before we got on top of it, the medical bills started rolling in and  ate up half our moving fund, we found we had to pay the IRS a huge sum which wiped out the other half of our moving fund, the house we were renting was put the market, we were going through  all the stress, isolation, and disorientation that an international move almost always brings, and it felt like we were doing everything wrong).  Looking for insurance under these circumstances was turning into a nightmare and when I found out the girls qualified for CHIP, the relief  was so strong I burst into tears.

The coverage was excellent; the price surprisingly affordable.  The programme is funded by the state, but administered through a choice of several large insurance companies.  I picked the one that we’d been on with M’s previous job, out of sense of familiarity more than anything, and got the girls signed up as fast as possible.  Each month a bill arrived with bold letters telling me that one missed payment would result in permanent cancellation of the policy — I began sending the premiums in two months in advance just to make sure I never paid that price.  In a world that felt like it was falling apart, knowing the girls had such excellent coverage gave me a sense of stability that I clung to like a rock in a stormy sea.

So as I read that letter — and reread it, and then read it again — all that stability seemed to drain away and the horrid, terrifying, desperation of a year ago rushed in to fill its place.  Could they do this?!?  Could they just casually send me a one-page letter which matter-of-factly stated they were increasing the premiums not once, not twice, not three times, but a full three-and-a-half times what they were now?  No warning, no alternatives, no choice…  This is our only option, this is our salvation!..  Could they do this?!? I rang M up at work and he listened patiently while I told him the news, then began to cry, and then composed myself and told him I’d be alright and thanked him for listening.  My tears were more out of fear and uncertainty; we will  be able to make the new payments (just, and with sacrifices), but it’s what they represented — the lack of control — that put me over the edge.

When I told my mother, she was shocked, then horrified, and then began to rant.  Was this what Obama had in mind for the middle and lower classes?!? Or was it the Governor’s doing?!?  It didn’t seem ethical!  I pointed out that it wasn’t Obama’s doing — his reforms haven’t even taken shape yet, let alone been enacted — and it wasn’t the Governor’s either.  It wasn’t to do with the CHIP programme itself at all.  It was the insurance company’s doing: they take the money the state gives them and then set their price within an approved range — but times are harder now than were before, there are these “increasing financial losses”, and so they’ve raised their price.  And, no, I told her, it didn’t seem ethical… but I don’t know that I think ethics plays any part in this.

I have to admit to feeling rather annoyed with her, to harbouring some deep-set and mostly unjustified feelings of blame.  I had been concerned about healthcare before I moved back to the US… concerned… afraid… frightened…  But my mother and my father and my sister had all assured me that I was making a mountain out of a molehill.  It’s fine, they told me.  It’s a system!  It’s not the system you’re used to, but it’s a system.  As long as you work hard, you’ll be fine.  My husband, I thought to myself, does work very, very hard.  And I do too, in my own way.

My had mother added that she didn’t know anyone who had a healthcare problem.  What about my sister?, I asked, pointing out that she’d gone for years without health insurance, avoiding going to a doctor even when she needed one.  “Oh… yes… ” my mother’s voice trailed off, and then came back again with strength, “But she never had a problem!”  I felt misgivings at that, paused, and then… brushed them aside.  It would be fine.  It would be fine.  …And so if there is blame to laid, perhaps some goes to my mother for closing her eyes to the problem, but some goes to me too for choosing to believe.

There is series of ads for one of the largest insurance companies in the region which they run on television all the time.  It shows someone walking a dog, or jogging, or riding a bike.  At some point the camera closes in on the person, and they look directly into it, before raising a hand and pressing it with palm forward and fingers spread, so that it appears to be just on the other side of the glass of the television screen.  And as the person fades out of focus, the handprint remains, glowing blue and pulsing gently, and a warm and reassuring voiceover says, “Giving you a greater hand in your health.

As I sat there staring at this letter, with its incredible, horrible news, I had to wonder: is that hand meant to be pulling us up… or pushing us away?

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As the healthcare debate picks up pace, I find myself being asked with increasing regularity what I think of Britain’s healthcare system.  Six months ago, I’d have jumped into the answer with gusto, but these days…  I don’t know, I am just so fatigued by all the fear-mongering and hysteria, the ignorance and the downright idiocy of the current debate that I can hardly summon the energy to add my voice to the cacophony.

But the other night when a friend of my mother’s emailed me and asked that now-familiar question — what was my experience and what did I think of British health care? — and I was surprised to discover that, once the initial weariness had worn off, I found myself turning her question over and over in my mind, composing my answer.  When I sat down last night and started my reply, the words fell out me, my fingers tapping rapidly at the keyboard and my mind so engrossed in the assignment that I was stunned when I finally looked at the clock: it was 2.30 in the morning.  I had been so consumed because what I had to say had been bursting to come out, an outraged truth that was tired of being bottled-up and was begging to be told.

When I lived in the UK, I railed against the NHS (the National Health Service).  I cursed every delay, every perceived inconvenience, every way it differed from the care I had received in the US.  But I moved to the UK only a few months after graduating from university and, until then, I had been covered on my parents’ very generous insurance so I had experienced American healthcare only as a dependent.  I was judging my British experience from a lofty and privileged position of someone who’d always had gold-plated insurance.  And I was naive, because I’d never had to pay for it, never had to worry it wouldn’t be there, never really had to deal with the paperwork.  I never really understood what I was comparing the NHS to at all.

I also realise with hindsight that a lot of what I held against the NHS had nothing to do with the system itself and actually were issues that could happen in any system.  I blamed the whole system when the loo in my local doctor’s office or hospital wasn’t clean enough.  I blamed the whole system when the only space I could find at the hospital carpark was miles away in the very furthest corner.  I blamed the whole system when the doctors’ receptionist was grumpy or I didn’t much like my doctor’s manner (or his diagnosis).  But the truth was that I believed in the healthcare system I had grown up in and I didn’t like the idea of socialised medicine — I didn’t like socialised anything — so I saw problems with it where-ever I chose to look.  And I held onto that belief right up until I arrived back in the United States, and discovered that grumpy receptionists and dirty hospital bathrooms and annoying carparks can happen in any system — because they have nothing to do with the system itself.  They’re management issues, human nature issues, and they happen everywhere.  And a lot of the fear that Americans have about change in their healthcare actually center around these kind of issues that have nothing to do with the system itself, be it socialised or for-profit.

So my return to the US and my sudden immersion in the American healthcare system was a rude awakening for me and it made me look at both systems a little more realistically.  There are great things about healthcare in the US — great things — and I truly do believe that the quality of the care here is second to none.  But there are great things to be said about Britain’s system as well and the trouble is that, at present, far too few people are saying those great things and far too many here in the US are beginning to believe utterly ridiculous things about the NHS.  Let me play a small part in putting that right by outlining my experience of the British healthcare system.

  • First, I’ll start by pointing out that the NHS is truly one of the most socialist — almost Soviet — healthcare models that a country could possible choose.  Unlike the health systems in France, Germany, and most of the rest of the developed world, it is totally government-run, almost totally centrally-controlled, and supported entirely through taxation.  It is mammoth — the single largest employer in Europe, which is incredible when you realise it serves a small country with only 60million people.  And with that kind of size come huge problems — consultation times are too short and it takes too long to get test results, amongst other things.  It is not a perfect system by any stretch of the imagination.  But it’s important to realise that when I talk about my experience, I am talking about the kind of system that truly is the very far extreme of what the nay-sayers are claiming will be the end result of public health provision in the US.  The British system is the very stuff of their nightmares and yet, the truth is, it’s nothing like what they imagine.
  • My healthcare in the UK was never dictated by a bureaucrat.  Decisions were made by me and my doctor alone, and whatever we decided was the right course of action was the course that was taken.  The scope of care available to me was far, far wider than what is covered even by the ‘very good’ insurance policies I’ve had here in the US.  There were no limits on the number of times I could see my doctor, or the number of tests/procedures/consultations/etc that I could have in a year (or month or lifetime…)  Whatever was deemed medically necessary by my doctor was covered — period.  In fact, I’ve experienced a lot more limitations on my care since I’ve moved back to the US — the most memorable of which was when I had to beg the insurance company to cover a single visit to a nutritionist when E2 was diagnosed with 12 food allergies and was severely underweight.  That simply never would have happened in the UK — if she needed it (and she did), she’d have got it (as her sister did after being diagnosed with a single allergy). To illustrate the point further, when I gave birth to E1, I stayed in hospital for five days because she had problems with breastfeeding — and that was entirely my decision.  I was free to leave hospital whenever I wanted, be that after one day or after a week, and I had the full support of the midwives to stay until they were sure we were breastfeeding properly and ready to leave — no administrator/bureaucrat/insurance company made that decision for me!
  • There are delays — there are delays — but to be honest I have experienced delays just as bad here in the US.  In the UK, I might have to wait weeks or months to see a specialist if my case was not urgent, and that was frustrating.  Here in the US, when I was in excruciating pain last year (so bad that I lost control of my bodily functions when the pain hit), I was referred to a breast surgeon by the ER doctor (7 hour wait in ER) — but the trouble is that we had to call five medical centers before we could find a surgeon who could see me any sooner six weeks, and even then it was only because they had a surprise cancellation.  And the last time I needed to take E2 to the allergist here in the US, the earliest they could fit me in was two months later.  There are delays in both systems.  And by contrast, you can get very speedy service in the US… and you can get it in the UK too.  When I needed to see my GP in the UK, I rarely had to wait until even the next day.  When I thought I’d found a lump in my breast, I saw the doctor the next day and was sent to a specialist within the week.
  • I had my choice of doctors.  My small rural town had two GP offices (a GP is a General Practitioner, a family doctor) with about 5 GPs in each office — I could choose either office and any GP in that office I chose.  I could choose to go to the GPs office in a neighbouring town if I prefered (though some offices limit the regional area they’ll cover).  I could change GPs at anytime for any reason, no questions asked.  When I had my babies, I had my choice of any of the hospitals in the region, or a homebirth (the midwives in my area loved doing homebirths!).  When my GP referred me to a specialist, he’d send me to whomever he thought best, but if I wanted someone or somewhere else, I could request that, no problem.  And I always had the option of a second opinion, either through another NHS doctor or a private doctor.
  • I never once received a bill in the UK.  There are no copays, there are no deductibles, there is no such thing as max-out-of-pocket.  I have an NHS card which I showed at my GP’s office when I registered, and from that point on, I never had to fill out any forms or show any ID ever again. In fact, I think I lost my NHS card years ago — I have no idea where it is. It doesn’t matter — I don’t need because I am covered for everything once I am registered with my GP.  When I stepped on a piece of glass and sliced up my foot, I went up to the local hospital, was seen immediately (rural hospital on a Tuesday afternoon), they took note of my name and address, patched me up, and I went home — simple as that.  No bills, no paperwork, no hassle.  Yes, Brits pay to cover it in their taxes, but the cost spread across the entire country and so it isn’t nearly the burden that insurance is for Americans.  In fact, Brits spend only 8.4% of GDP on healthcare, compared to the 16% of GDP spent by Americans and what they get back is a system beats the US on so many basic measures of healthcare results.  This is good quality care.
  • Brits believe that healthcare is a human right and are happy to have a system that covers everyone, all the time.  They are HORRIFIED when they hear stories of Americans who have to hold fundraisers to pay for desperately-needed operations.  It blows their minds that anyone goes bankrupt or loses their home because of medical bills.  The idea that someone would lose their coverage because of a pre-existing condition or because they are so sick they can’t work is totally alien to them.  These things simply do not happen in Britain.
  • Even with a comprehensive healthcare system that is available to all and completely free (at the point of delivery) the UK still has a healthy private system running alongside the state system.  There are numerous large private insurance companies providing private health insurance to those who’d like to have it (or whose companies want to offer it).  There are private hospitals up and down the country.  Most specialists practice both within the NHS and also privately (they split their weeks).  You can pretty much get your healthcare however you’d like — on the NHS, through private insurance, or paid out of your own pocket.  I hear people in the US saying that with in the British system, you can’t see anyone but your government-assigned doctor, but that is totally untrue.  And you can chop and change your care as it fits your life — I’ve had my care for an medical issue start on the NHS, and then switched my care to my private insurance if it suited my needs better.  I’ve had other medical issues that I stayed with the NHS for the whole way.  And when my husband had an elective medical procedure done that was covered by neither the NHS nor insurance, we simply paid for it out of pocket.  It’s a flexible system and the private sector has not been quashed by the fact that there is a comprehensive, free public system running alongside it.
  • Because healthcare is not tied to employment, companies are free to focus on their core business and people are free to make career decisions (and life decisions) based on what is best for them instead of what preserves their healthcare.  Brits never worry about keeping their healthcover — they never worry about pre-existing conditions; they never worry about continuity of care if they change jobs; they never get trapped into a bad-fit job because they have to keep their healthcover. They are much freer to be entreprenuers than Americans, because their only worry is whether their business will succeed, not how they’re going to provide healthcover for their families when they’re self-employed.  Companies, particularly small companies, are free to focus on their core-business because they not burdened by the administration of healthcare for their employees — they never have to pay someone in HR to manage health benefits; they don’t have to juggle insurance companies and negotiate lower premiums; they don’t lose employees because their healthplan isn’t as good as some other company; they don’t see their bottom line rocked by a sudden rise in premiums.  Decoupling healthcare from employment is hugely freeing to both individuals and employers, and can actually a very good thing for the economy at large.
  • When things go wrong, the government answers to the people in a way that insurance companies never do.  For example, there was a cancer drug called Herceptin which was not covered on the NHS because of the cost.  A group (led by Ann Marie Rogers) began a campaign to change this, suing their local health trust, and gained huge public support.  They ultimately won their case and got their local trust to offer the drug — but because of the political pressure this campaign had created, the government extended the drug to the entire country.  Imagine trying to convince an American insurance company to cover some expensive drug that they don’t want to cover, and then having that decision convince every other insurance company to do the same.  And again, when I moved to the UK fifteen years ago, wait times in the NHS were much worse than they are now — but the public got fed up with it, made their voices heard in the General Election, and the new administration made cleaning up the NHS one of their highest priorities.
  • There is an emphasis on preventative care and the simplest way this happens is that people actually go to see their doctor when they are sick.  Because there’s no cap on visits and no copay and everyone is covered, hardly anyone hesitates to go to the doctor when they need to, which gives them a chance to catch little issues before they become big issues and spot contagious diseases before they spread to the rest of the population.  And here’s another way the focus is on prevention: when I had my babies, the midwives came to my house to check on us every day for the first 10 days after the baby was born, and then the Health Visitor (a community nurse) came to the house once a week for six weeks, and then I could go to her clinic (held once a week in town) for as long as I wanted after that with any concerns I might have (as well as being able to see a doctor — my choice).  It’s all done to ensure the mother and baby are healthy and well, to support breastfeeding, and to catch problems as early as possible.  I was utterly shocked when I found out that most new mums in the US are simply sent home with their babies, with no follow up in the first six weeks, and left to muddle through as best they can!
  • None of this actually tells you anything.  Isolated anecdotal stories (like these) don’t actually give anyone the information they need to decide the merits of one system over another.  All it does is tell you whether my particular doctor was good or bad, whether the nurse I encountered was having a good day or a bad day, whether the receptionist liked her job or hated it.  There are good stories and bad in both systems, and it just depends on who you talk to.  It’s much like public schools. You could ask parents across the US to tell you what they think of their kid’s school and you’d get a whole spectrum of answers: some schools are good, some are bad, some districts are rich, some are poor, some teachers are passionate, some have lost the will to live. But none of these things tells you whether the overall concept of publicly-funded schools is a good or bad one. If you drew your conclusions based on a bunch of stories from a handful of people about their personal experiences, you’d only be getting part of the story. And it’s no different with the concept of public healthcare.

I can sum up my experience of the British and American healthcare systems in one simple sentence:  given a choice between the two systems, I’d choose the NHS in a heartbeat.  And though this is the experience of only one single person out of millions, unlike so much of the propaganda and hysteria surrounding the current healthcare debate, it is the absolute Gospel truth.

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Addendum:  This is an incredibly important issue with a lot of misinformation flying about.  If you have experience of both the US and UK healthcare systems, I invite you to please leave a comment here and let us all know what you think of both systems.  This debate needs more voices of experience and a lot less uninformed fear.

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An envelope arrived today from the insurance company and I knew immediately that it would be the paperwork for E2’s trip to the Emergency Room. Every time we’ve got one of these envelopes before, it’s always been bad news — thousands of dollars worth of bad — and so my hand nearly shook as I began to open this one. I quickly scanned past line after line of itemised costs and focused on the big number at the bottom…

Just over $3000.  My heart stopped.  $3000 in one night!

And then I looked over to the box marked “Amount You Owe Provider”. It said $25. I closed my eyes with relief and lent my head back against the wall, and thanked God in his heaven that my kids are covered by the state’s CHIP programme (the only policy that I could find in the entire marketplace that they qualified for). To owe so little for a bill so high is really quite extraordinary here in the US.  Even most “good” policies here would require me to pay a percentage of that amount and the most common split I’ve seen is 80/20. That would put our portion of E2’s impromptu night in hospital at $600 and — with a gas bill that was higher than that last month and M’s hours ever fluctuating — even that reduced amount would have been a crippling bill for us to pay.  And if, God forbid, we’d been uninsured…

This is why I believe, wholly and completely, that the US healthcare system is fatally flawed and needs to be overhauled entirely.  I have heard the arguments for the status quo — argued with passion, most often, by people who have never been in a position of being trapped by their (un)insurance.   I understand the concept of a person neatly choosing the coverage they need, of deciding how much deductible and max-out-of-pocket they want to budget for.  But the reality is simply not that neat.  Most people can’t choose the coverage they want, because their healthcare options are dictated by their employer.  And buying the policy that suits your pocketbook best simply doesn’t work once you have a pre-existing condition — and we will all have one eventually — and so you can no longer pick and choose freely in the marketplace.  And even when you can, the cost of buying that coverage outright is completely prohibitive for most people on average wages.

Buying healthcare coverage is completely unlike any other purchase a person usually makes in their entire lives.  Nothing other than healthcare is so fundamentally compelling — truly life and death — and yet has such devastating potential to create skyrocketing and utterly unmanageable costs literally overnight.  Healthcare provision is quite simply in class by itself and, as such, it has to be treated differently.  To leave to the marketplace as if it were any other ordinary commodity is…  well, is to create an unacceptable situation like the one we’ve got at the moment.

And it’s unacceptable because of this horrifiying thought:  if, when that on-call doctor told me to take E2 to the Emergency Room… if I’d had to think about what 20% of that trip was likely to cost, then I might not have been hesitating solely on account of the snow and my mistaken belief that things weren’t yet that bad.  I might well have been weighing up the doctor’s advice — and my daughter’s well-being — against my wallet.  And if — as so easily could have happened to us — we’d been completely uninsured, I think it’s quite likely that I would have followed my own flawed judgment and waited to see how the night went, and thus brought on all the unthinkable consequences that could have created.

It was not us that night, but there are 47 million others.

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When Barack Obama brought Michelle and their daughters out onto the stage in Chicago before he gave his victory speech, I surprised myself by being overcome by emotion.  As tears welled up in my eyes, M looked at me quizzically and asked, “But…  was he the one you wanted to win?”  He knew I hadn’t known who I wanted to vote for the whole time.

“It’s not that,” I said.  “It’s not whether I wanted him to win or not…  It’s that…”  I actually had to stop for a moment to get my words out.  “It’s just that, when he was born, he wasn’t even able to drink from the same water fountain as our two girls would have.”

I don’t know how familiar M is with that bit of American history, but I saw the full realisation pass across his face.  He looked back at the telly, to the four joyous faces of that small family on the screen.

And he nodded.  “Yeah.”

No matter what changes are in store, the change our country has undergone during this man’s lifetime — that that little boy could grow up to be elected President — that is a change I can believe in.

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I have angonised my way through this entire election, loving and loathing both candidates for different reasons but in equal measure.  There are key issues which are critically important to me and, unfortunately, the candidates had neatly divvied them up between the two of them, leaving me in a quandary.  If I vote for one candidate and his issues, then I am voting against half the issues that really matter to me.  And if I vote for the other candidate, then I sacrifice an equal number of key issues on the other side.

I have argued with myself for months now, and especially in the last two weeks.  I have gone over and over it all in my mind.  How likely is it that either candidate would actually be able to implement what he’s promising?  How true do I believe each is being to the man he really is?  How much does each  of these key issues even mean to me?  I have watched the debates, read the websites, poured over newspapers and magazines, watched the talking heads on telly as they talk, talk, talk…   But nothing has come any clearer.  In the end, it comes down to the issues for me — and those issues that are so important to me are evenly divided between them no matter which way I look at it.

All the way to the polling station, sitting in my mother’s passenger seat because our car most inconveniently decided to not start, I listened as she chatted away to me about her hoped-for result under the assumption that my hopes would be naturally the same as hers, whilst I silently tried — at this eleventh hour — to bloody make up my mind! My mother’s voice faded into the background as I closed my eyes and prayed for some clarity.  I don’t believe for a minute that one candidate is God’s Own, but I do believe he could help me to cut through the fog and see what’s truly important to me.  I determined I was going to make up my mind — now.  We were driving to the polling station, for heaven’s sake!  So, I swallowed hard and… made my decision.

Standing at the back of the the queue, I abruptly changed my mind.  After 20 minutes, as I neared the voting machines, I changed it again.  Each time, I was sure — I knew who I was going to vote for.  The whole time, I was actually grabbing at straws.

When, at last, I stood in front of my voting machine and looked at the choices before me, I was suddenly at an utter loss, just as I have been through the whole campaign.  I stood and looked at those names, the rest of the world shrinking away from me as that screen enlarged to engulf my whole field of vision.  What to do?  What to do?  I started to walk my mind through the whole dilemma again — there was this issue, there was that issue, this aspect, that aspect…  And the whole time, I was acutely aware that I was standing, completely motionless, in front of my voting machine while others stood waiting — and watching — in that wearisome queue.

Suddenly, one set of issues rose up out of my consciousness and sang to me — sang about how very important they were, how vital they were, how very much more they mattered than anything else.  I heard and embraced them, and quickly reached up and pressed one set of names.  Before I even had a chance to sink back into that horrid pit of indecision, I pressed the big red button at the top of the machine that locked in my vote, and then picked up my handbag and marched determinedly out of the room.

And then, it hit me.  As I walked down the hallway, back along the queue full of people still waiting to cast their votes, I realised I’d made a mistake.  I imagined the other guy winning and I felt good.  I imagined my candidate winning and I felt… a little afraid.  I had angonised for months and then made a split-second decision, but there had been a Truth that had stayed hidden the whole time, and I realised to my sudden horror that I had voted for the wrong man.

All I can do now is sit helplessly in front of the telly and watch as the results slowly roll in …and hope against hope that the man I voted against wins this election.

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When I say I don’t get the resistance to a ban on peanuts in schools with allergic students, this is the reason: Food allergy sickens teen. Here we have a student who is known to the school to have a severe nut allergy and her teacher chooses to use peanuts as the item the science class will measure and study, instead of the plethora of other items that might have worked instead (seeds, beans, peas, etc).  The teacher’s work-around for the student’s allergy was to have her miss the lesson (hmmm… educational priorities?).  And then it backfired when the peanuts were left exposed in the room overnight so that, when the student went into the classroom the next day and breathed the air, her allergy attacked and she ended up in hospital for two days and on steroids for a week in order to stay alive.

When I was in school, chewing gum was banned because it was inconvenient to clean up off the desks and floor.  Walkmans were banned  because they were distracting to students.  These days, there are restrictions on mobile phones and and GameBoys and iPods.  There have always been changing rules about how students are allowed to dress, depending on what is perceived to be a fashion-shock too far at that particular time.  All of these restrictions garner some resistance, but they are usually accepted eventually and just become part of the established norms of going to school.  And yet, none of these things have anything like the gravitas of being able to actually kill one of the children attending the school.

I have never advocated a blanket ban on peanuts in all schools.  But, ever since this became an important issue to me, I have always said that I think it is reasonable to look at each situation on a case-by-case basis and, where there is a student with a severe allergy, to ban that substance if it is reasonably possible to do and such a ban would provide a reasonable return (in terms of safety) for the effort.  By “reasonably possible”, I mean that the food is relatively easy to eliminate — for instance, peanuts, which are used in a limited number of foods, are much less troublesome to ban than soy or milk, which are used in a great number of staple foods.  And by “reasonable return”, I mean that the school has to weigh up the impact that ban would make in improving the safety of the allergic student — a child with a life-threatening allergy would benefit much more from a ban than a child with a milder (stomach-upsetting) allergy.  So, I have always supported looking at each individual case and the school taking both these elements (as well as a third: the child’s age) into account before making a reasoned decision on whether to implement a ban during the time that child is a student at the school.

I know that any ban will never be a guarantee of safety for an allergic kid — and I doubt any allergy-parent, after years of learning the hard way how to deal with such a dangerous condition, would ever be naive enough to think it would — but it would go a long way to reducing the risk.  It’s a simple numbers game: the fewer foods containing the allergen that are around, the less chance there is that the allergic child will come into contact with it.   And the danger is not just in the eating, as that news story clearly shows.  Even if that student had not been so allergic that the peanut-fumes alone could send her into attack, it would appear there was no thought given to the possibility of contact-reactions.  With that many peanuts in the room, surely one or two would end up on floor, and the peanut dust would have been spread to hands and desks and books and doorknobs.  When there is a child with severe allergies, taking drastic steps such as implementing a ban affords the allergic student more than just the obvious benefit of proscribing their allergen, it also focuses minds — in a way that that clearly hadn’t happened here.

Yes, a blanket ban of peanuts in all schools would be a crazy over-reaction.  And yes, banning peanuts with no consideration of other allergens is short-sighted and unfair.  But I do believe that bans, when individually assessed to be both reasonably practical and effective for each particular case, can be a very good thing.  And the on-going and vehement resistance to something so beneficial and reasonable confounds me.  There are a lot of people who are very vocal about their conviction that peanuts (or other allergens) should never be banned, ever, no matter how dangerous they may be to one of the children in school.  There are a lot of people who feel it is better for that child to be segregated at lunch, miss lessons and fieldtrips, and bear the responsibility of fully managing a life-threatening condition — even at the tender age of only six or seven — rather than have anyone else be inconvenienced by a ban.  If anyone can tell me how it is reasonable for schools to ban gum because it is messy, iPods because they are disruptive, and crop-tops because they are distracting, but not peanuts because they are deadly to one of the students, I am all ears.

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I am trying to figure out how (or whether) to teach my toddler about race. It’s never been a issue before — she wasn’t old enough to verbalise any differences in people she might have noticed and, to be honest, there simply weren’t many differences to notice. So much of rural England is startlingly homogeneous, and the area we lived in was 99.9% white, according to the latest census data. To someone who has never lived anywhere so lily-white, that might seem odd or even suspicious — it did to me at first — but it’s not. These are simply rural farming communities populated mostly by the natives, just like rural farming communities around the world. It just so happens that the native population is white.

It thoroughly delighted me that one of the most multicultured and integrated places in town was our tiny church, only 15 rows deep and which contained four Americans, two French women, quite a few Irish, two Indian families, a German, a Slovak couple, a group of Poles that seemed to grow every week, four Filipinos, and a man from Mauritius, along with all the English natives. E1 was particularly fond of the Mauritian and, every now and again, I would wonder if her fascination with him was because his skin was a beautiful deep chocolate-brown. But it was just as likely that it was because he always had a twinkle in his eye and a smile for her, and always always picked up her bear when she dropped him.

So, I didn’t really think about whether she might notice a difference when we moved to the US, to this immigrant city with its mixed population of blacks and whites. People look different here. Even the white people look noticeably different, being mostly descended from immigrants from southern and eastern Europe, instead of the pale Northerners we are used to seeing. It gave me a moment of surprise at first — this sea of dark brunette heads the first time we went to our new church — in the same way that rural England’s whiteness initially looked strange to me.

But the other day, I got my answer as to whether E1 has noticed. We were shopping in the supermarket and passed a black man stacking the shelves. “Mummy, look!” she said loudly, “There’s Barack Obama!” The man smiled graciously at her and several other shoppers laughed, but I was mortified. Of course she’s seen Barack Obama’s picture on telly and picked up his name, but it never occurred to me that she would make the blanket connection between the words “Barack Obama” and his skin colour. But then, why wouldn’t she? She carried on repeating joyfully “There’s Barack Obama!” down the rest of that aisle and halfway up the next, as I hissed, “That’s enough. Ok. Yes. Ok. There he is, now that’s enough!” and hoped desperately that we wouldn’t pass any other black men before I could bundle her into the car. We didn’t , mercifully, but I was left with a dilemma: how do I handle this? How do I un-make that connection in her mind?

Stuck in the allergist’s waiting room this week, and bored, we looked out the window and counted cars in the parking lot. How many red ones? How many silver ones? A green car pulled up and a black man got out. “There’s Barack Obama!” No, no, that’s not Barack Obama. The man opened the boot and pulled out a briefcase. “He has a suitcase, Mummy! That… that brown man has a suitcase.” I suddenly looked around the waiting room, unsure of whether “brown” is offensive in the US — the terms and sensibilities are so different in the UK that a person forgets — but we were alone. I struggled to think what to say to her — do I correct her? Admonish her? But the thing is, she was right — his skin was a pale-coffee brown. She knows what black is: black is a Crayola colour, and he was nothing like it.

So, I am unsure what to do. Right now, my daughter sees the world in terms of brown. Some people are dark brown; some people are light brown; sometimes, right after a bath, she is pink. That’s as far as it goes in her mind, and I rather like that. I want her to let her see people this way — all on the same one spectrum from light brown to dark brown — for as long as possible. I need teach her enough to stop her from offending people with her innocent comments, but I do not want to divide the world into “Black” and “White”. Not yet. She’s not even three. I am not yet ready to introduce her to the complicated politics of colour.

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