THE POPULARITY of the PBS Britcom "Doc Martin" in the U.S. has nothing to do with the Cornish Riviera setting. An Englishman who is warm and dry is no Englishman at all. What really turns us on are the scenes in his "surgery" where no one ever pays a bill.

Contrast that with the bedlam of an American doctor's office. A panicky patient hunched over the front desk waving his insurance card at the frazzled nurse as she waits on hold for a claims adjuster in a distant state to rule on how many hemorrhoids are covered. When the adjuster finally comes on the line she can't hear him because the panicky patient lobs a barrage of questions and instructions at her. "Tell him it's not a co-pay because I just had one operation, not two. The first time he didn't get it all and had to go back in, so that counts as one!"

The other patients in the waiting room can hear all this. While they are reluctantly visualizing it, the debate shifts to whether the problem qualifies as a "pre-existing condition." Is there a hemorrhoid that doesn't? Nothing can pre-exist like a hemorrhoid, so you'd better not have one in the good old USA because your private health insurance might not pay for it.

We are currently in the grip of multiple hysterias, but the greatest of these is health care. We the People, those freedom-loving, government-hating, go-it-alone, do-it-yourself denizens of what our politicians call "the greatest country on the face of the earth" really want a National Health Service just like the Brits have, but we are afraid to say so lest it destroy our cherished self-image as the cowboy who rides off into the distance alone, like Shane, like Randolph Scott, like all of those grimly self-sufficient sociopaths we call heroes.

What Ronald Reagan called a shining city on a hill has turned into a landfill for exhausted, desperate, insecure Americans who crave the sensible solutions that other, supposedly lesser, countries have already found.