"Explain It To Me!"

"What is wrong with your country?"

I was just tucking into a plate of spaghetti alle vongole at a local trattoria when my friend Federico posed the question to me.

"Lots of things, but not as many as a year ago," I answered. "What are you talking about?"

Federico, a big man with an even bigger personality, does not beat around the bush. In his heavily accented English, interspersed with Italian, he answered:

"You are rich country! You have everything! How is it possible that people go to the hospital and they have to leave because they have no money? How can the doctors send away someone who is having an infarto (heart attack) because he is poor!? Explain it to me! How is it possible?"

How can I, or any American, answer that simple question?

Let's see, I could try explaining that:

1. Insurance companies and hospitals are businesses. They need to make a profit. It's the American way.

2. Doctors might not make as much money under a national health care system and they don't like that.

3. The insurance and medical lobbies exert powerful influence over our legislators, who can't or won't stand up to them because they are afraid it will hurt their chances for re-election.

4. Many people with health insurance don't want to think about those without it. It's not their problem.

5. Lots of people, like an American I met on vacation here in Tuscany, don't want to pay "more of my money in taxes so we can provide health care to the homeless."

6. Prominent people declare that "health care is not an intrinsic right."

7. Six senators who represent less than 3% of the population of the United States can bring health care negotiations in Congress to a standstill.

8. Many Americans and legislators have a fear of anything that "reeks" of socialism, even if it works.

9. We are not embarrassed to be the only industrialized country in the world that does not offer health care to its citizens, despite having the best trained health care providers and medical infrastructure in the world.

10. The Republican Party wants President Obama to fail. They will do anything, including stacking town hall meetings with angry, inarticulate citizens and making up scare stories about "death panels" to bring this about.

Federico looked perplexed. "But this is not about politics! People could die because they have no money to pay the doctor! They can't buy medicine that will help them live! That is not right!"

I could not find the words, in Italian or English, to explain that away.