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Is it desirable to have 46 million uninsured and 25 million under-insured citizens in a country that trumpets democratic traditions noisily on the global scene? Probably not. The protest measures on ‘socialised’ medicine conform to the pattern set by that mistaken American assumption that rugged individualism should carry the day and trump ‘collective’ decisions. This rather hollow, not to mention false rhetoric takes place alongside huge, intrusive bureaucracies that span the country from coast to coast. Big government is here to stay, even as Democrats, Republicans and libertarians dispute its relevance or ignore its existence.
In the United States, individualism is patently neurotic, allowing obscene spectacles of wealth to take place alongside ghastly pictures of poverty. Either way, everyone deserves what they get in this brutal schema. America was, as Gore Vidal observed, Social Darwinian before Charles Darwin tackled evolution. That such naturally ordained pattern of evolution in society will lead to a poor distribution of resources, an overwhelming concentration of wealth and power in the hands of a few, notably in the health industry, is beside the point for the medical free marketeers. They hate competition, the supposed driving force of the market, and make sure it won’t take place.
Health care, for that reason, becomes the battleground where bodies and minds conflict: do we make the state insure the health of its citizens? Who should care that the world’s most powerful nation doesn’t so much employ doctors through its insurance schemes as pharmaceutical representatives barely keen to examine you before banishment through the door heavily medicated? The system is not so much broken as non-existent. Targets, jottings on paper and spreadsheets count. Healthy bodies are simply vile bodies.
Even with some of the current proposals, the idea of competition is not stymied. Public insurance becomes another player in the myriad chaos of sham schemes that count as “private” health care. On that side of the fence, queues still exist, and medical service is often poor. The committees in Congress are, however, not in agreement as to how to spread the burdens. Obama, on this score, has decided to shift the focus back to the Congressional arm of government, rather than chart the scheme of health reform from the White House. The Senate Health Committee has cobbled together some proposal for compulsory health insurance, a scheme underwritten by subsidies for those on low income. Senator Max Baucus’s Finance Committee has proven intransigent over a bill on healthcare reform, though the creation of a “public option” seems out of the question, at least in that quarter. “Blue Dog” Democrat Mike Ross is singing truly Republican hymns against the state at this stage.
The Obama administration has ample ammunition to gather and deliver in its defence of a medical scheme, the president’s speech before a joint session of Congress did not clear the air on the subject. A few stabs were offered at both sides of politics, a few lies put to rest about such matters as medical coverage for illegal immigrants. Getting sick was no basis for going penniless, he seemed to say. There was heckling, some of it fairly aggressive.
An otherwise low profile Rep. Charles “Lord” Boustany (R-La.) after the speech was livid, for himself and the GOP. Again, the pathology of government involvement surfaced, though in Boustany’s case, the sentiment may be personally derived: a fear of intrusive medical panels, given three malpractice lawsuits in the rather risky field of cardiac surgery. “The president had a chance tonight to take government-run health care off the table. Unfortunately he didn’t do it.” Admittedly, the GOP is not entirely averse to some changes – assistance to those who cannot afford a doctor may be provided under a suggested plan. Medical liability reform is on the cards from that side of the aisle as well.
Health is the poisoned chalice of American politics. The time has come to change its contents altogether. Obama’s vision may remain, at this stage, just that. But he must simply reiterate what should have been done from the start. Divvy up the score in the health industry. Spread the obligations and payments. Make government, that immutable evil, work. If competition is what drives America, then play on the theme of competition, something the private health industry is terrified about. That way, Americans might be convinced that an appropriate government service issues from their tax dollar.
BINOY KAMPMARK was a Commonwealth Scholar at Selwyn College, Cambridge. He lectures at RMIT University, Melbourne. Email: firstname.lastname@example.org