I had my first encounter with the US healthcare system yesterday.

I went to a GP with a minor ailment, and was told that the charge for the initial visit would be $200. (British readers: forget the official exchange rate. In purchasing power terms, $200 is roughly the equivalent of £200.) After that, it would be $70 a visit.

"So why is it so much more expensive the first time?" I asked politely, concealing my resentment.

"Oh, that's because the doctor has to take a detailed medical background," the receptionist told me.

Then the doctor came in. He didn't say good morning, and only reluctantly shook my hand when I proffered it. He showed me a piece of paper with about a dozen boxes on it: heart disease, diabetes, high blood pressure. "Ever had any of these?" he asked.

I told him no, and that was it - my detailed case history had been taken, and my 15-minute visit netted him about 22 cents a second.

It's no wonder the US spends twice as much as other nations on healthcare, and yet lags behind on basic measures like infant mortality and life expectancy. And nor is it surprising that inability to pay medical costs is the biggest cause of personal bankruptcy in this country.

We're still being bombarded with TV commercials opposing President Obama's healthcare reforms, most of them by the thoroughly sinister US Chamber of Commerce. And when I visited the website of my insurance company the other day, there was a banner ad on the home page: OBAMA'S REFORMS WILL INCREASE YOUR PREMIUMS.

The other day, NBC news did a segment comparing British and American government policies on swine flu. They interviewed a British GP who was also a visiting lecturer at Harvard, and therefore had detailed experience of healthcare on both sides of the Atlantic.

At the end, he threw in a nicely crafted and seemingly casual aside. "Of course the two systems are very different. It's survival of the fittest here. If you've got money you're OK, but if you haven't, you get thrown to the wolves." It was so refreshing to hear this one little home truth amid the overwhelming tide of anti-reform propaganda.