I am an American with dual Irish-American citizenship, and lived in Northern Ireland for six years under the British National Health Service. While there, I was diagnosed with a cancer that required major surgery, 26 weeks of chemotherapy and five years of follow-up monitoring, including many scans and blood tests.

I didn’t pay a single penny for any of this, just like any other citizen. Everyone there knows the health system is there for them whenever and however they need it.

When I told my Irish in-laws that in the U.S., people might have to pay thousands of dollars for the same services, depending on their insurance plan, or even be unable to get treatment at all due to lack of funds, they were incredulous. They already knew that our system was not comprehensive, that it varied greatly according to circumstance and that if they were to travel here, they’d better get good health insurance first. But they didn’t know exactly how barbaric it is – to the point of actually allowing poorer people to die, and others to become bankrupt.

Neither they nor anyone else who lives with the security and freedom of guaranteed health care would ever choose the American non-system, which is unreliable (unless you are very rich), ineffective regarding health outcomes, unfair and very expensive. It is, in fact, what they most fear.

It is Don Vose, in his letter of May 2, who displays naivete – not those who advocate for single-payer health care.

Nancy O’Hagan

Portland