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Imagine for a second if you will, holding a card in your hand, roughly the same dimensions as a credit card, with a chip somewhere in the middle, similar to a sim card used in cell phones. Most of the front portion of this card features a waving flag of the United States of America and reads Medicare Plus in a slick font over that flag with the user’s personal information and ID code on the bottom. Now imagine that this same card is in the wallets of everyone in the US from Anchorage to Miami and Maui to Montauk. This card allows you to walk into any public or private hospital or clinic, and the office of any dentist, optometrist, chiropractor, or acupuncturist anywhere in the entire USA. The visits to medical offices would be as convenient as ever, as the receptionist simply borrows the card for a few minutes to check the data and enter your visit into their system and the card’s memory. Moreover, this card would be behind an ultra innovative program that has contributed to a significant decrease in the monthly amount going towards insurance and also means lower co-pays, drug prices, and routine and emergency care. Would you want this card? I believe most of us would.
Lack of remedies, lack of license to discuss the disease
H. L. Mencken, the early 20th century satirist, famous for his mockery of democracy and pragmatism once observed what he considered a fatal flaw in democracy: “To lack a remedy is to lack the very license to discuss disease.” This is a common frustration for anyone advocating for more debate and discussion, hoping for change instead of the usual watered-down reform. So, the listener says, what’s your solution? What are you going to do? David Greenberg, in an essay last year in the The New York Times, argued that this is precisely the reason why the final chapters of books commenting on society and politics tend to be rather weak, despite what came before.[i] I’ve always noticed that this is where the reader will find a list of actions to take and books to read in order to really make a difference. To try and avoid this potential problem here, let me throw out some links early in the article to get you thinking about how change on this issue may just come about. First, we must recognize that the leaders of this movement—doctors, nurses, lawyers, professors, health advocates, journalists and rabblerousers alike—all seem to work toward the same goal, namely that people get educated on this topic. Margaret Flowers and Kevin Zeese from ItsOurEconomy.us have teamed up with Russell Mokhiber and SinglePayerAction.org for what they consider to be the education and movement-building phase. For this, they regularly tap into the excellent work being done by physicians at groups like Physicians for a National Health Program at www.PNHP.org. This education, they assert, would increase the already high numbers of people interested in a Medicare For All fix and some of those would be passionate enough to bring it to everyone they encounter and everywhere they go.
The language is important of course. In 2009, Nate Silver criticized a poll of doctors that claimed to show widespread opposition to meaningful health care reform, charging that the pollster, in this case Investors Business Daily, was not intending to be objective as indicated by obviously loaded questions and that this has been a common approach to surveys on health care policy in the US.[ii] Furthermore, it has been widely reported that use of terms like Medicare, which are highly regarded by many US voters, increase the percentage of support for extending government health care to all. The Pew Research Center found in a June 2011 poll that 88% of those surveyed believe Medicare was very good (36%) or good (52%) for the country.[iii] I would also propose using terms like middlemen, when describing the private health insurance providers. In my experience, even children can see the problem with a system that rewards middlemen so heavily, especially when those profits come from the suffering of average people. So we should teach children about the issue by asking elementary school teachers to consider preparing lesson plans about the importance of health care and the detrimental role played by middlemen. Obviously, the same should be encouraged for junior high and high school teachers. These lesson plans can then be shared, enhanced and teachers can encourage feedback and discussion through the use of wikis and other educational tools.
It is within the universities and colleges across the US where the most talented young minds should come to understand how bad our system is compared to others, and discuss a broad array of solutions on how to overhaul health care and other areas where serious change is needed now. Seminars and conferences led by students and professors should be occurring regularly and links to other schools should be a natural part of this process. This is in contrast to inviting people for brunch, waffles, smoothies and reflection, a strategy by a group calling itself the Movement Strategy Brunches, noted in a recent article by the anonymous Insider on Counterpunch.[iv] Furthermore, doctors, nurses and patients should discuss this more openly and perhaps those that are seeking solutions on either side can organize more meetings and tell their stories in as many media outlets as possible. Finally, Ralph Nader proposed a system of activists in each of the 435 congressional districts to become actively involved in educating, organizing and fund raising; Nader urged Occupy to adopt this strategy and to set up protests outside of local representatives’ offices in their home districts, as well as outside their DC offices.[v] Can we begin to ask that people within the Occupyreconsider Ralph’s suggestions today?
Bold Ideas and Visions
Neil Degrasse Tsyon, the esteemed scientific voice of reason and bold thinking, has consistently decried the lack of subsidies for NASA and the politicians who have let the space program, widely credited for awakening the national imagination and creative spirit of millions of young Americans in its heyday of the 1960s, recede into irrelevance. Tyson, perhaps one of the greatest scientific minds in the US today, considers this to be the most important issue of our time. Dr. Tyson glorifies the past and argues that earlier dreamers knew that seemingly impossible things were possible. Unfortunately, he also glosses over the connection between space exploration and war. In so doing, he ignores the calamitous disasters that not only the proliferation of nuclear weapons has caused but also the horrific legacy of nuclear power generation and the ongoing shift to robotic technology, i.e. militarized drones, amongst other scientific breakthroughs that raise a host of serious issues (patenting of life, GMOs, powerful computational programs used by Wall Street to trade faster than the speed of light and surveillance breakthroughs).[vi] I am not arguing against funding NASA or the need for science and technology training by any means, rather I am arguing that an equally bold vision for health care and other immediate and impactful government programs might contribute more to the future of the United States of America than dreaming big dreams about walking on Mars.
To his credit, Tyson later pointed out that the economic argument needs to be lifted among all others because no one wants to be poor and if you are suffering economically, you are not likely to be scientifically productive. However, I understand his intent is to create more profit motives for science. Profit motives in the field of medicine and health care spell disaster. Mergers and acquisitions continue unimpeded by concerns for actual well-being and health. For example, WellPoint recently bought out Amerigroup, a Medicaid-focused health insurer, in a $4.9 billion cash deal. This was already “one of Wall Street’s favorite “managed health care” companies…[and it] keeps getting bigger through acquisitions that pay hefty fees to the bankers involved”, according to Nomi Prins. This deal involved the usual suspects, “Goldman Sachs (who advised Amerigroup) and Credit Suisse (who advised WellPoint) retain[ing] their top positions in the global health care deal advisory league table”.[vii] Prins also reports that “the highest-paid [health care] CEO made 94 times the average compensation level of primary care physicians” and this leads to the exorbitant average $15,745 USD per year that a family pays for coverage that typically comes up pitifully short.
Matt Stoller, a former Democratic party heavyweight and self-professed formerly aggressive opponent of 3rd party challenges, recently pointed out that President Obama’s handling of the economy has led to a jaw-dropping recovery of corporate profits surpassing previous records, but “home equity levels have remained static”. This is unprecedented as home equity levels and corporate profits have simply never diverged in this way since World War II.[viii] Add to this historic challenge to working poor and middle-class Americans a skyrocketing health care bill that falls far short of adequate coverage because of the greed of Wall Street. Most importantly, Obamacare does nothing to remedy this problem. Moreover, consider the high incidence of illnesses[ix] that precede home foreclosures and the multitude of studies that show how adversely our health, marriages, and hopes are affected by financial worries.
While writing this article, my two and a half-year old daughter got sick and it was a worrisome experience that also created tension between her parents. Any illness has negative impacts, but those involving a child are even worse. How anyone could seek to profit from such a situation, much less endorse a system designed to thrive on profiting from tragedy, especially if they have children of their own, is beyond most of us. I am not alone in contending that empathy is at least as definitive a human feature as is greed.
A Taiwanese friend recently told me that as a child she was sick and often in and out of the hospital and she remembers the pre-National Health Insurance days well. Among the strongest impressions was a man begging for money to have a doctor see his sick wife and reduced to selling his own blood then and there. Clearly there is no empathy in that kind of system is there? Yet, years later, a decision was made to do something monumental for the people of Taiwan who recently endured over four decades of martial law and were dealing with rapid industrialization and the resultant pollution. Within six months after pushing through the legislation, Taiwan had insured an overwhelming majority of its citizens in the brand new system.[x]Think about that for a second. If the US could get through the brutal political obstacles that Wall Street and its benefactors have erected by January (can’t help but scoff at this impossible dream, can you?), we could have that smart card out to everyone by July 4th!
I think it is obvious that health care is one of the real connective issues in our society because it affects us all. If we look abroad to a system like Taiwan, a late-comer in the national universal health program community, we can see the real possibilities. I am currently paying around $75 US a month (@$900 USD per year) for rather comprehensive coverage for myself and daughter and this allows me to visit the most modern fancy private clinics, in addition to any of the public health institutions (as more locals prefer). This can happen in the US too and we need to start visualizing it and demanding nothing less than an improved version of Medicare for each and every one of us! The myriad debilitating health effects of our economy make this all the more important.
An economy of death and destruction
For those struggling to get by that make up the bulk of the middle class, and the poor, we tend to buy the cheapest food possible, eat too much of it, work multiple jobs and extra hours, lose sleep and are increasingly anxious about our future. This leads to drug and alcohol abuse and the vicious cycle only continues. Writing about the sugar industry and its far-reaching ties in the early 1970s, William Dufty described a system of sickness that has conspired throughout its history to keep us addicted to unhealthy food guaranteed to have ill effects on our health.[xi] Remember that revelation a few years back by the former commissioner of the US FDA that the fast food industry was calculating precise combinations of sugar, fat and salt that would keep people addicted and coming back for more?[xii]
What we have today can appropriately be described as an economy of death and destruction. Profiting on human misery should always be exposed for what it is and many of the industries and products that exist in today’s world (even the iPhone you may be reading this on) are part of this frightening, cold calculus of exploitation.
In deference to Eisenhower’s classic speech on the eve of his departure from the Oval Office, let’s take a look at some recent guns-and-butter-type comparisons. In total, we send an average of around 15.1 million dollars abroad every day for defense purposes, constituting a grand annual total of over 5 and half billion dollars.[xiii] This is in addition to the near 1 trillion dollars we currently spend every year on our military and wars and interventions. These numbers are hard to comprehend, but try this application of numbers to time to gain some perspective: one million seconds is around 11 and a half days, 1 billion seconds is 31 years and several months, and 1 trillion seconds add up to over 31, 709 years. Moreover, consider that around 53% of our health expenditure came from the government in 2010[xiv] and that the central government spent around 3,426 dollars per person in 2008 (WHO)[xv] and there were still 50 million uninsured and enough people to fill a stadium the size of Camden Yards in Baltimore dying due to lack of timely and appropriate coverage. This figure is roughly 4 times the amount Taiwan pays per person to insure every citizen and foreign worker living there with a Medicare plus system (indeed it was designed on the basis of US Medicare as I explained in my last piece).
Let’s not stop there. The publicly reviled bi-partisan farm bill, in its current form known as the Food, Conservation and Energy Act of 2008, according to the New York Times, provides rewards for rich farmers in direct payments amounting to about $5 billion a year (the bill’s total cost was $307 billion) and does little to control food prices, climate change, and address the needs of the world’s hungry, in the US and abroad.[xvi] Subsidies flow to the same oil companies that engage in price gauging after natural disasters, in addition to the various forms of tax breaks and loopholes, and greatly enrich companies that are already the most profitable on the planet. The nuclear industry receives an incredible amount of assistance in a variety of forms from US taxpayers. Senator Bernie Sanders recently pointed out that the 1957 Price-Anderson Act puts taxpayers on the hook for losses that exceed $12.6bn if there is a nuclear plant disaster, so “when government estimates show the cost for such a disaster could reach $720bn in property damage alone, that’s one sweetheart deal for the nuclear industry!”[xvii] It is not only our individual health but the health of communities and ecosystems that are under assault from this economy obsessed with domination and manipulation.
Shame on Obama?
The system we live in is monstrous and most who advocate for third parties are implying that the extent and the continued deepening of depravity in this system is in fact endorsed by both parties and their candidates. Most economists and politicians support and even worship the warped logic of the economy today. Indeed, earlier this week, President Obama stated that climate change would have to take a back seat to the economy only weeks after Hurricane Sandy, saying that if the US “could create jobs, advance growth and make a serious dent in climate change” then that would be something that the whole country could get behind.[xviii] Unfortunately, the economy (read: oligarchs and their corporate wealth) would simply not allow the obvious solution in a Green New Deal to emerge.
Obama, of course, did not create this system or even the worst parts of it, but he has done little if anything to stem the rapidly moving train of death and destruction that we are riding. This current president, celebrated for his intelligence, kind heart, and way with words, had no problem attaching his family name to a program that is woefully inadequate in response to a health care crisis as large as the one currently afflicting the wealthiest country in the history of the world. By endorsing this program, for which he took minimal risks and showed no innovation or courage, he has put the most fiscally responsible, health-conscious, and humanitarian of us in the awkward position of responding.
What should our response be? Should we just give in and move on? Well, we must remember that health care and universal coverage are incredibly connective issues and the more facts that we can get out and the more comparisons we can make to other aspects of our system and other health care systems around the world, the better. A supermajority Democratic voters are largely behind a single-payer system, as I was told by a leader of the movement,[xix]and that the critical ten percent strong support of the citizenry (see my last article) is not so impossible to achieve considering the extent of our desire for real health care reform from which we can all benefit.
Across the spectrum, we are all eager to achieve one major victory that we can celebrate. Noam Chomsky recently said that the two good things about the 2012 election are (1) the worst didn’t happen and (2) they are over.[xx] I would add to this the victory of grassroots movement in response to the drug war, Republican attacks on women, and the homophobic hang-ups across the country. We need look no further than the ballot initiative victories on 64 in Colorado and I-502 in Washington legalizing marijuana, to find examples of those small groups of thoughtful, committed citizens to whom Margaret Meade once referred.
A victory for US citizens in the realm of health care would have major ramifications for the entire system and therefore the entire world. Empathy and action are all we need. Let’s satisfy the desire for those fiscal conservatives among us to be financially responsible by dramatically lowering the amount of taxpayer funds we spend on health care, let’s say to 10% of our GDP by cutting out the incredible waste and corruption, roughly 3.5% more than Taiwan spends, and cover everyone, plus ever more of our needs (alternative health treatments, dental, vision, etc.). It is not unreasonable to imagine this happening. Sometimes, not often enough, humans do collectively stand up for what we believe and make a run on the worst systems and relegate them to the annals of shameful history.
Consider the words of Frederick Douglass, arguably one of the single most important single actors in the history of the United States, in the final phases of planning his escape with his fellow slaves. This exuberant leader aimed to pacify those who were relying on his cunning and inspiration, as he eloquently expressed the fears that must accompany any move that has a chance to make history when he wrote:
“At every gate through which we were to pass, we saw a watchman—at every ferry a guard—on every bridge a sentinel—and in every wood a patrol. We were hemmed in upon every side. Here were the difficulties real or imagined—the good to be sought, and the evil to be shunned. On the one hand, there stood slavery, a stern reality, glaring frightfully upon us,—its robes already crimsoned with the blood of millions, and even now feasting itself greedily upon our own flesh. On the other hand, away back in the distance, under the flickering light of the north star, behind some craggy hill or snow-covered mountain, stood a doubtful freedom—half-frozen—beckoning us to come and share its hospitality.”[xxi]
I think that is where we find ourselves in mid-November of 2012 with an unapologetically cold President Obama 2.0. Sitting back and waiting for the situation to develop on its own should not be an option. There are remedies and we can achieve these ourselves, both H.L. Mencken and Barack Obama’s cynicism be damned!
Adam Chimienti is a teacher and a doctoral student originally from New York. He can be reached at email@example.com
[i] David Greenberg. “Why Last Chapters Disappoint,” The New York Times, 18 March 2011 at http://www.nytimes.com/2011/03/20/books/review/why-last-chapters-disappoint-essay.html?pagewanted=all&_r=2&
[ii] Nate Silver. “IBD/TIPP Doctors Poll Is Not Trustworthy,” Five Thirty Eight Blog 16 September 2009 at http://www.fivethirtyeight.com/2009/09/ibdtipp-doctors-poll-is-not-trustworthy.html and also this post “Public Support for the Public Option,” 20 June 2009 at http://www.fivethirtyeight.com/2009/06/public-support-for-public-option.html
[iv] The Insider. “One Big Progressive Cluster F—k,” Counterpunch 14 November 2012 at http://www.counterpunch.org/2012/11/14/one-big-progressive-cluster-f/
[v] Ralph Nader. “CEOs contemplate the Occupy Movement,” Counterpunch 22 March 2012 at http://www.counterpunch.org/2012/03/22/ceos-contemplate-the-occupy/
[vi] See the transcript of Dr. Tyson’s speech before the Senate Committee athttp://www.haydenplanetarium.org/tyson/read/2012/03/07/past-present-and-future-of-nasa-us-senate-testimony or watch the video of the entire speech and Q & A that followed at https://www.youtube.com/watch?v=9H3vOFPPSXo&feature=related
[vii]Nomi Prins. “Real Danger of Obamacare: Insurance company takeover of health care,” 11 November 2012, at http://www.nationofchange.org/real-danger-obamacare-insurance-company-takeover-health-care-1352648027
[viii] Matt Stoller. “The Progressive Case Against Obama,” Salon.com 27 Ocotber 2012 at http://www.salon.com/2012/10/27/the_progressive_case_against_obama/
[ix]For one example of such a study, see the OECD Observer’s article “Health and the Economy: A Vital Relationship,” from 2004 at http://www.oecdobserver.org/news/archivestory.php/aid/1241/Health_and_the_economy:_A_vital_relationship_.html
[x] Anne Underwood. “Health Care Abroad: Taiwan,” The New York Times Health Section, 3 November 2009 at http://prescriptions.blogs.nytimes.com/author/anne-underwood/
[xi] William Dufty. Sugar Blues New York: Grand Central Life & Style (1975).
[xii] David Kessler. “Obesity: The killer combination of fat, sugar and salt,” Originally published in The Guardian, 16 March 2010 at http://www.informationclearinghouse.info/article24995.htm
[xiii] See the Department of State’s Executive Budget Summary, for FY 2012.
[xiv] See the World Bank Data page at http://data.worldbank.org/indicator/SH.XPD.PCAP/countries.
[xv] See the 2011 World Health Statistics Report Part II Global Health Indicators.
[xvi] Editorial. “A Disgraceful Farm Bill,” The New York Times 16 May 2008 athttp://www.nytimes.com/2008/05/16/opinion/16fri3.html?_r=0
[xvii] Bernie Sanders and Ryan Alexander. “Stop the Nuclear Industry Welfare Program,” The Guardian 13 April 2012 at http://www.guardian.co.uk/commentisfree/cifamerica/2012/apr/13/nuclear-industry-us-welfare
[xviii] Andrew Restuccia. “President Obama says climate change to take a backseat to economy,” Politico, 14 November 2012 at http://www.politico.com/news/stories/1112/83865.html#ixzz2CmBH7tTt
[xix] From an email conversation with a long-time advocate of single payer universal coverage.
[xx] See Democracy Now! on 14 November 2012 at http://www.democracynow.org/2012/11/14/noam_chomsky_on_gaza_and_the
[xxi] Frederick Douglass. Narrative of the Life of Frederick Douglass, an American SlaveDover Publications Inc. (1845).