For expatriate wonks like me, it was a perfect evening: small gathering of friendly people in a hotel lounge, beer and snacks from the bar next door, and playing on the wide screen TV, Michael Moore's "SiCKO." I didn't require any prompting to get my ire up over the American health "situation" (I refuse to call it a "system"). Fighting "Medicare HMOs" has been my lot over the last decade or so: first over my mother's stroke-away-from-home (when her insurance company insisted she stay at their facility, but refused to fly her there), then over my 94 year old father's yo yo hospitalization/discharge/hospitalizations (where, in one 24 hour period, he was in four different institutions).
So last night there were several of us with "SiCKO"-like stories. Though some people shared certain commentators' distaste for Moore's idealized picture of foreign health care systems, others (including me) felt that his depiction of the general separation of health care delivery from payment by patient accorded with reality in places like Britain, Canada, and France.
The real revelation of the evening was the approach taken by the US Democratic Party towards overseas voters, especially via "Democrats Abroad" (the sponsors of our gathering). Through its website www.votefromabroad.org, the Democratic Party is treating overseas voters as "The 51st State," for its "Democratic Global Presidential Primary 2008." This is a sea change from the situation that has prevailed for overseas Americans, who have had to struggle to register, request absentee ballots, and cope with international postal systems getting their votes back home in the (sometimes forlorn) hope that they would be counted.
As good as the Democratic initiative is, it still falls short of what other expatriate communities enjoy in terms of representation in their home countries. French citizens living abroad, for example, have no fewer than 12 Senators from overseas "electoral districts." This, in addition to the "Assembly of French Citizens Abroad" for the 2 million French expatriates. For the 6.6 million Americans living and working overseas, the Democratic initiative is simply the best move yet in recognizing this massive "constituency." I suppose we should count our blessings: at least those of us who still maintain links to our home states can vote for our Congressional Representatives and Senators; taxation without representation is still the lot of the more than half a million citizens of our nation's capital, Washington D.C.