A$2,000 fish-hook? Is that possible, even in the world-centre for excessive conspicuous consumption – the United States?

Yes, is the answer. That’s what an ordinary fish-hook cost a lady I met in America last week.

She was someone who enjoyed fly fishing. She got a small hook embedded in a finger.

Given its barb she couldn’t just pull it out. She went to the local hospital’s Emergency Room to have it safely dealt with.

“Credit card, please” was the first response of the clerk at the desk. She handed it over. She then had the hook removed, two small stitches, and an injection against infection. It took ten minutes.

“I’ve deducted $2,000 from your card” said the clerk, “but you’ll be able to get it back from your Health Insurance”.

But she couldn’t. This lady was self-employed. The small print of her Health Insurance policy included an exclusion for “sports injuries”.

So she had to pay from her own pocket, the equivalent of £1,400 sterling.

This lady had the cash available to pay. She’s middle class. Her husband has a very good job.

But that did not reduce her outrage about how she felt cheated by an avaricious health industry.

And there was something else about her. She had had lived in the UK for some time.

So she knew the truth about our NHS, as opposed to the extra-ordinary fibs about it which are the common currency of the vested interests in the US, campaigning against “socialised medicine”, as they like to call it.

So I listened to a eulogy of praise of our NHS, and exasperation about why and how the US, with its wealth and its praiseworthy values, was incapable of agreeing to sensible health care reforms which would end the obscenity of people being denied health care because they could not afford the requisite insurance.

There’s intense debate today in the UK about how the NHS should be run.

But, thankfully, no debate that health care should be free at the point of use, dependent on need alone.