"I didn't realise it was... That Bad."

Last Thursday, I went to a screening of the final presidential debate, sponsored by the Uni. Sussex Politics Society. Discussion was led by Professor Robyn Kolodny, an American professor on a Fulbright exchange who is an expert on American politics and election campaigns.

I was stunned by the turnout. A classroom meant to seat about thirty was overflowing; students were standing in the back and sitting on the floor. A few Americans came, but by and large the students were British, judging by their accents.

It's striking how much people here care about the American elections; one English girl even said she'd spent her summer in Florida campaigning for Obama, which reminded me of a South African acquaintance who's spent months in America doing the same. The awareness and interest 'across the pond' - I also saw a huge photo of Palin this weekend on the front page of the Bergen Tidende, the newspaper in Bergen, Norway - is a constant reminder of how much the American election does influence the rest of the world.

And the general assumption: everyone is for Obama. The president of the Politics Society talked about watching the elections in East Slope bar on November 4-5: it'll be a party "unless the wrong side wins", he said, to laughter. "Joe the Plumber" drew a lot of laughter, too; most audience members seemed to view McCain with incredulity, almost as a joke.

After the first segment, people asked Prof. Kolodny to explain - what's Acorn? who was Ayers? The most interesting part of the event, though, was the discussion following the healthcare segment of the debate. (Video is no longer available, but here's a transcript of the debate.)

In Britain, the NHS (National Health System) is free. I repeat: FREE. Everyone is guaranteed healthcare; it's treated as a right. Private insurance and care is also available, for people who want top-notch care or more expedient surgery. I'm no expert on the system, but so far my experiences have been good; I saw the doctor for a persistent sore throat, quickly and free of charge, and a friend of mine was seen quickly and taken care of well when he sliced off the tip of his finger. And what I sense so far is that, by and large, the English seem happy with this system.

So when McCain used "England" as a dirty word in the healthcare debate, some students seemed bewildered:

McCain: "Senator Obama wants to set up health care bureaucracies, take over the health care of America through -- as he said, his object is a single payer system. If you like that, you'll love Canada and England."

And it's true - one of the biggest fears in the American psyche is that we'll have to wait months to see a doctor, that we won't be able to get a good doctor. That's what we always hear about Canada and England - that the quality is terrible and the waits are long. We're scared.

From this side, it looks different. Students seemed shocked at the cost of private medical insurance: an average of $12,000 a year for a family, an expense McCain's $5,000 tax credit won't begin to assuage.

(For a useful summary of both Obama's and McCain's plans, information on how they would benefit different demographics, and links to independent analyses, check this out.)

One girl raised her hand. It seems so obvious that Obama's programme is better, she said. I guess I just don't understand why Americans would vote for McCain.

Professor Kolodny explained it well. Our American healthcare debate is framed in terms of choice and freedom, she said. Americans cling to the idea of choice in their health care - the idea that "I can go to any doctor I want" - but that choice is, in fact, only an illusion. You can go to any doctor you want... IF that doctor is on your insurance plan. IF (for some people) that doctor accepts Medicaid or Medicare, which many doctors don't because government remuneration is far less than what they'd get from the private sector. IF that doctor can accept more patients. IF you can get an appointment.

We're also obsessed with the idea of "on-demand healthcare". We want to be seen NOW - we don't want to wait. Yet in the States, you'll often have to wait weeks for an appointment. But we believe we have control over the situation, because we spend an entire morning on the phone calling different clinics, waiting on hold, until we find that at one place we can get in in six weeks while at all the others it'll be two to three months. Is that truly "on-demand"? I remember calling around to find someone to see me when I needed to send in my health information to the Marshall Commission. I had two weeks between being invited for an interview and flying to Chicago on 13 November; there was no one who could see me before early December, including the student health service at UMass, to simply give me a physical.

I added that our system is so complex that few Americans really understand it - even those who make an effort to do so. Robyn pointed out the amount of paperwork we have to do each time we leave the doctor's office: Was it an auto accident? Because then your auto insurance has to pay. Which insurance company pays for this, what do you pay out of pocket, what's your medical history... Sometimes, she said, she spends an hour on filling out forms after visiting the doctor.

I realised as she spoke that these sensibilities - of choice and freedom - are deeply ingrained in my psyche - but that British students were hearing the issues framed in new terms.

After the showing, a few people stayed around to talk. One English girl said to Robyn, "I didn't realise it was... I don't want to say it, but... that bad." Hilary and I laughed, but it was telling: to most of the rest of the world, it's common sense that the GOP platform is ludicrous, and American political rhetoric is often absurd.