As someone who has had their life saved by our public health system several times I've never begrudged paying taxes to maintain it. One of the best accomplishments of the last Labour government was its commitment to leaving a legacy of a first-class public services rather than going down the privatisation path advocated by some of our right-wing idealogues.

You only have to look at the United States to see what a nightmare it is when you mix profiteering with healthcare. Barack Obama made health reform a central platform of his successful presidential campaign. Given that tens of millions of American citizens have no healthcare and close to a majority are underinsured, you'd think it would be breeze getting it through Congress.

But it seems a bizarre madness is sweeping that country these days. The world's first democracy has always had a strand of crazy running though it, which has frequently been a source of strength. But since Obama became President, something scarier has been let loose. Seemingly ordinary people are mobilising noisily to oppose reform and keep their overpriced, inaccessible, ruthless health system. None of this universal, open-access health coverage for them. Apparently that's socialism.

Like people the rest of the world over, New Zealanders shake their heads and can't quite work out what those nutters can be thinking.

Part of it is they've never known anything else so they can't imagine what it might be like not to live under a fear-based system: fear of bankruptcy if you get a cancer diagnosis; fear of being denied medical care if you lose your job or have a pre-existing condition; fear of spending the rest of your life buried under wads of insurance company paperwork.

But that's only a small piece of the explanation. To really make sense of what's going on you have to look at the money and power that's at stake - that and the fact that a good chunk of Congress has been bought and paid for by the interests that stand to lose the most if Americans were to change their system. So it's not madness at all, it's just capitalism doing what it does best - fighting hard, and dirty, to protect its interests.

But it seems the organisers of opposition to everything Obama are at risk of unleashing something they can't control. And so industry-sponsored madness spreads, into the town hall meetings where they insist that a public health system would mean forced abortions and euthanasia.

Republican vice-presidential candidate Sarah Palin claimed that the real agenda was to set up "Obama death panels" to decide who would live and die under socialised healthcare (that is, killing grandma). This nut job could have been a heartbeat away from the most powerful job on Earth. In many ways the US is becoming more a negative than a positive role model. And we can learn a lot from it, about things like keeping corporate money out of politics, about defending what we have and opposing the encroachment of the private profit-makers into matters that involve the public good. Thanks to our small population, we're also probably safe, for now, from 24-hour cable TV, which in the US is just making the crazies crazier.

There's an argument that another even less savoury element underlies the screaming and yelling in America - racism. The mad-dog "birthers" who deny Obama is a natural-born citizen are its most obvious face, with those who labelled the new Supreme Court Justice Sotomayor a racist. But reports from the healthcare town halls of offensive signs and slogans and shouting show it goes much deeper than that.

One of the good characteristics of New Zealanders is that we have high regard for public service and healthy scepticism of corporations. In a couple of months we may well see the US join the rest of the civilised world where all their citizens have the right to healthcare, a right that in our country we take for granted.