I’ve seen two films this week. The first was Shrek the Third, and it was ordinary in the extreme. A bird of some kind entered the theatre and pecked around up in front of the projector. It could’ve been a seagull, but its neck was too long. The manager was kind enough to give us free tickets for our troubles, and for reference, this is what an Odeon Guest Ticket looks like!

I then watched Sicko, again for free thanks to Michael Moore’s implied approval of using other peoples’ stuff without their permission. I thought there were two or three genuine LOL moments, and that it was an excellent polemic for those who already agree with his ideas. However, it didn’t engage with the opposition beyond pointing out how evil and corrupt US lawmakers are. In all probability they really are evil and corrupt, but that doesn’t get to the bottom of why a lot of people oppose something so apparently beneficial as universal free healthcare.

There are problems with Sicko as an authentic documentary, but putting those aside and treating the film as a theoretically accurate portrayal of the various healthcare systems around the world, it is still steeped in us vs them rhetoric which I find distasteful: They have universal healthcare, so why can’t we? What is wrong with us that makes us dump sick patients into shelters? Why does Cuba get five cent drugs while we must pay hundreds of dollars?

The key to understanding the opposition is Margaret Thatcher’s superficially bizarre claim that there is no such thing as society. Contrary to popular belief, she was not denying the existence of the population at large, no matter how ignored by her they might have felt. The soundbite means that if the word we should mean anything, it should mean everyone. Every single human being. When we talk about us, we should be talking about the whole wide world of individuals, not arbitrary groupings like nations. And when we talk about universal healthcare, we should mean universal healthcare for absolutely everyone in the world.

To put it mildly, there are practical problems with that. Globally universal health care to the standard of the first world is probably beyond the means of this planet’s economy, and so folks like Michael Moore don’t really advocate universal healthcare. When they say things like “it is everyone’s right to free health care”, they don’t really mean everyone - they just mean Americans. There are many arguments as to why Americans should only look after other Americans, but they all boil down to declaring that Americans are inherently more deserving of healthcare than anyone else. The same argument is made (or rather, assumed, for nobody seems to discuss fundamentals here any more) in Britain regarding the NHS.

Accidents and tragedies happen, and somebody has to pick up the bill. Extremely unfortunate victims pay it all themselves. Others can afford health insurance, but that doesn’t cover all people and all types of tragedy, as Sicko does a good job of pointing out. Those must rely on charity, whether private (like Oxfam), or public (like the NHS). In Britain, the British taxpayer fronts the cash, but only for the maladies of fellow Brits. Money paid into the NHS only benefits British people, and this is what classical liberal-minded people object to. Why do only British people deserve free healthcare? Because they are the ones who pay into the scheme? Surely not, as that would exclude non-taxpayers from receiving NHS treatment. The real reason is simply because they are British, and this country has decided that British people are inherently more deserving of care than people elsewhere.

The problem is that that’s simply not true. Even the poorest Britons live a life of luxury and opportunity entirely beyond hundreds of millions of children in the developing world. Unfortunately the compassion which underlies support of universal healthcare does not extend beyond our borders.

What is the difference between a Briton and, say, a Kenyan? Ethically, none. Perhaps if the Briton in question is a friend, you might reasonably prefer to help him than the Kenyan, but in reality, the vast majority of our fellow citizens are unknown to us. Why does a random stranger in a country village in Cornwall deserve your compassion more than a random stranger in a country village in Nyanza? The answer is nationalism, and hence racism.

The government acts unethically when it redistributes income to people on the basis of nationality. Real charity is a private matter: individuals must have the freedom to give their money to causes that they see fit, and for all the flak that America takes in Sicko, Americans are supremely generous (being the most charitable even as a percentage of GDP). Perhaps not every American can get healthcare, but perhaps Americans also recognise that they are not first in line when it comes to needing it.