We met the doctor later in a restaurant where many parents and staff wrapped up in the Children's Hospital in Birmingham UK hang out for some respite from the dramas of the day, the week, the year. The doctor said it was "a good result." From Ireland, he earns about 18,000 pounds (30,000 dollars) a year. He held my daughter's heart in his hand for 45 minutes and saved her life.

We've just moved to the USA. My wife is American and Danielle, my younger daughter, is 3 and a typical diabolical 3-year-old. One day she will need major surgery again; she may even -- god forbid -- need someone to hold her heart.

Danielle needed a special milk to aid her recovery which helped her put on the calories but affected her teeth. Now they are all decaying. Tooth decay and not dealing with it is a dangerous state for a person with a heart condition like Danielle's. So what? Go to the dentist and sort it.

If we were living in England it would be simple. Our cardiologist would arrange to have her teeth out at the hospital and monitor closely the operation in case anything went wrong. It would be done speedily at no cost except our contributions to National insurance.

But we're in the USA, the richest country in the world, who wants to teach the world about freedom, according to President Bush.

We go to the hospital where Danielle's cardiologists and the best doctors are. These are paid for by my wife Cassie's health insurance, which includes Danielle. However, the dentist at the hospital is not on the same insurance plan.

They get a social worker to try and help us get on the plan. That was 5 months ago -- and we still can't get her teeth out. We can pay 4,000 dollars (2,200 quid), or we can change insurance, or we can fill in or apply for all sorts of things -- and still the teeth don't come out.

In the end I suspect we will just pay any way we can. After all isn't that how capitalism really works? Insurance companies don't pay out, and doctors/dentists on 80,000 pounds a year get paid.

The Big Issue over here, coming up to the election of a new president this year, is health care reform. Boy, does this country need it! Millions of Americans have no insurance. People are dying because they can't afford the drugs to save them. Millions of dollars are wasted on so-called "social workers" who are basically fund managers. Older people are going on 1,000-mile coach trips to Canada to buy cheaper drugs on prescription. The slogan is "health care is not a privilege but a right." However, for disabled people like my daughter Danielle, and for many other, it's more than that. It's a matter of life and death.

When my wife lived in England, she came away with the impression that the health service was not working . She watched the news and programs like Kilroy ( our version of Oprah) and believed the negative things she heard. As an American, she never really understood that we criticise it because we are so proud of universal health care and the overwhelming majority of us in England want to protect it. God! I sound like Tony Blair!

Maybe we just expect that when we go to the doctor / to the dentist with our children, when we go to the emergency room or when we fall ill that it will be there. And usually it is -- free, with no person standing in the background saying "how are you going to pay for this?"

I've got to tell you: in the great rich and powerful USA, it isn't. It isn't expected. And the nice accountants are right behind you.

All the Democratic candidates are committed to heath care reform . Some, like Kerry and Dean and Edwards, are calling for an American version of England's National Health Service -- but can they deliver? Clinton promised this too, and he didn't deliver (Being unfaithful to your loyal wife can have wider consequences which hurt many people.).

I hope the Democrats win and keep their promises this time -- or go down with such a fight that it leaves ordinary Americans brought up on the selfishness of Reaganomics embarrassed. Most of all, I want Danielle to stay alive and find out what freedom is really about.

Posted Feb. 9, 2004

Johnny Crescendo (born Alan Holdsworth in Salford UK) is a disability civil rights singer and songwriter, founder of Britain's Direct Action Network, which "uses public demonstrations and non-violent civil disobedience to increase the awareness and liberation of disabled people." Visit him at www.johnnycrescendo.com

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Most people meekly accept the uniquely American view that human sickness and suffering are just another commodity from which money can be made. It doesn't have to be that way. I was once traveling in Sweden with an American woman. Her period turned into a terrible hemmorage. We found a hospital in Stockholm. She was admitted for 36 hours and received astonishing care. We assumed that we would spend the rest of our travel money on the bill.