I 'm inclined to believe the fierce resistance to health-care reform in the United States is the work of a small fringe.

The other possibility is that there's something deep in the psyche of Americans that drives them to defend to the death their right to deny health care to millions of their fellow citizens.

Some have attempted to downplay the scariness of recent protests against President Barack Obama's health reform efforts, noting that a lot of Americans protested George W. Bush as well.

But the anti-Obama protesters are much more extreme – and yet are treated much more respectfully. When Obama spoke in Phoenix last month, about a dozen protesters showed up carrying guns, including one who was interviewed by the national media as he strutted about freely with an assault rifle slung over his shoulder. (Anti-Bush protesters got no such media attention, and would have been arrested – if not shot – had they shown up at presidential rallies bearing assault weapons.)

While the U.S. media gave prime time to gun-toting health reform opponents, they all but ignored a Harvard study, reported last week in the American Journal of Public Health, that found nearly 45,000 people die in the U.S. each year largely because they lack health insurance.

As resistance to U.S. health reform rages on – with its inane, vicious, even racist overtones – the fiasco should remind Canadians of the dangers of allowing our public health-care system to deteriorate.

What makes health reform so elusive in the U.S. is the way its opponents – led by wealthy corporate interests – are able to play Americans off against each other.

Americans are hunkered down in their own little bunkers, watching out just for themselves and their families. Anyone proposing reforms that might result in higher taxes is met with a rifle poked out the top of the bunker.

It's this dynamic – citizens pitted against each other – that has kept Americans at each other's throats over health care for years. It's easy to understand, for instance, why middle class American taxpayers resent paying for medicaid, a public program that provides some coverage for the poor, when these same taxpayers can't afford coverage for themselves and their families.

The only real solution is public health care for all. A Canadian-style plan could save Americans $400 billion a year, Harvard's Dr. David Himmelstein wrote recently in the New England Journal of Medicine.

But Americans are so uninformed about the rest of the world that few even seem aware any Canadian can spend weeks in hospital getting state-of-the-art medical treatment and then walk out the front door without owing a penny. Such is the menace of public health care.

Universal care is extremely popular once it's in place, but it can be hard to overcome resistance to putting it in place, as the current U.S. psychodrama shows. (Canada went through a less traumatic, but still difficult initiation.)

All this should serve as a potent lesson to Canadians about the urgency of protecting our public health-care system. Once it starts to fall apart, the rich bolt from it, arrange for their own care and then object to paying taxes for a system they don't much use.

The importance of avoiding this fate has never been more apparent than now, when the snarling fury of America's current crop of right-wing extremists almost makes one nostalgic for last year's gentler, childlike lunacy of Sarah Palin.

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Linda McQuaig's column appears every other week. lmcquaig@sympatico.ca