Even before moving to England four years ago, I often went without health insurance. Self-employed people like me with pre-existing conditions – in my case, a non-functioning thyroid – do not qualify for medical insurance in America.

The statistics say nearly 50 million Americans live without health coverage, but I suspect the number is much higher. In my own circle of family and friends, more than half do not have access to basic health care. They either can't afford the premiums or have been denied insurance by all viable providers.

While recent reports calculate that Americans spend 16 percent of their income on health care, my exceptionally hale and hearty parents spend closer to 30 percent of their income maintaining their health. Medicare deducts $96.40 each from their monthly Social Security checks. Their Medicare supplement costs an additional $320.46 a month. Then there is the prescription plan at $73 a month.

You would think with nearly $600 worth of medical coverage, additional out-of-pocket expenses would be minimal, but it's not so. Recently, following outpatient surgery for a torn rotator cuff, my mother had to fork over $156 for the 20 dainty pain pills prescribed by her surgeon. She'll probably have to do it again next week. Her "insurance" refuses to cover her for the post-surgery medication required.

We are so used to living without the option of seeing a doctor when we're sick, without vision-saving tests, without the aid of medication when we're in pain, without lifesaving operations, without the basic human dignity of being able to ask for help when we need it most, that the unthinkable has become the norm.

In "the land of the free and the home of the brave," it is the most natural thing in the world to live without health care. But it is wrong. Dead wrong.

Our friends in Europe are incredulous that Americans not only tolerate a system that refuses to provide health care for all but willingly accept this ferocious affront to freedom. My British husband, Richard, often asks, "How can a country call itself free when citizens are denied the dignity of health care?" Good question. Does anybody have the answer?

When I moved to England in 2005, Richard and I looked forward to returning to America within five years. Two years later, he was diagnosed with a rare and deadly cancer: osteosarcoma of the jaw.

We spent all of last year fighting for Richard's life. It took all our time, all our energy and enormous resources from an army of nurses, doctors and surgeons to save him.

Because Richard worked for a major pharmaceutical company, we had private medical insurance – insurance we could never afford on our own – which we used in conjunction with the National Health Service, the publicly funded health care system in the United Kingdom. But it was the exemplary nurses, doctors and surgeons with the NHS who saved us again and again.

Compassionate NHS nurses came to our home several times a week. Our local NHS doctors made house calls, too. When possible, tests and therapies were done from home. An NHS prescription card, bought for about $50 a quarter, paid for the lion's share of Richard's medications. Our local hospice also provided desperately needed support.

I estimate Richard's surgeries and treatments surpassed the milliondollar mark. Under the NHS, our only co-pay was a few hundred dollars in prescription costs. Last spring, the NHS began providing cancer patients with free prescriptions.

Eighteen months after being diagnosed with osteosarcoma of the jaw, Richard is blessedly free from cancer. He suffers from post-chemo peripheral neuropathy and a speech impediment after having his mouth rebuilt from tissue taken from his stomach. But he is a healthy, optimistic, happy-to-be-alive man: a walking testament to the dedicated professionals working for the NHS. Living proof that universal health care is one of the best ways to be truly alive and free.

Had this happened in America, the outcome might have been different. Early diagnosis played a crucial role in Richard's recovery. Treatment was never delayed or denied. Equally important, nobody asked for a credit card to save my husband's life.

America is the only developed country in the world to allow our health to be politicized and commoditized beyond recognition. In the United Kingdom – England, Wales, Northern Ireland and Scotland – all 61 million residents are fully covered by the NHS from birth to death. The U.K.'s budget for universal heath care is 100 billion pounds, or $160 billion. It is funded by our taxes. Any British politician who does not enthusiastically support the NHS is unelectable.

We recently celebrated my father's 80th birthday. Our plans to join him and my mother in Oregon will never be realized without comprehensive, universal health insurance. Many Americans living in Europe find themselves in the same situation. We vote and hope that one day, we might return to our homeland for more than a visit.

Marsha Coupé, a former Sacramentan, is an entrepreneur living in Kent, England. Reach her at MCoupe@CoupeWoman.com.