• Submitted Tue, 06/16/2009 – 9:15am.Dave Lindorff

If you want to fix the disaster that is called the American healthcare system, the first thing to do is to clearly point out what its major failings are, and there are two of these.

The first is cost.  America is the most expensive or one of the most expensive places in the world to get sick or injured. The corollary of that is that it is one of the best places to make a killing if you are in the medical business, whether as a doctor, a hospital company, a pharmaceutical firm, or a nursing home owner.

The second is access.  One in six Americans — a total of 50 million people at latest count — have no way to pay for that care. Too young for Medicare, too “well off” for Medicaid, but too poor to buy private health insurance or too sick to be admitted into a plan, or employed by a company that doesn’t provide health benefits, these people get no medical care until they get so sick that they are brought into a hospital emergency room where they get treated (often too late) at public expense, or at the hospital’s expense, with the cost shifted onto taxpayers or onto insured patients’ premiums.

Any reform of this atrocious “system” must address these two major failings or it is no reform at all.

And that’s where all the various versions of Obamacare fall flat.

Simply put, you cannot solve either of these problems by leaving the payment system for medical care in the hands of the private insurance industry, since the whole paradigm of insurance is to make money by keeping high-risk people out of the insured pool, and by keeping reimbursements and coverage for premium payers as low as possible.

Having a so-called “public option” plan working in competition with private insurance plans will not solve this problem. Either the public option will become like the private options — trimming benefits and rejecting some applicants — or it will become a dumping ground for all the high-cost, high-risk people that the private sector insurance industry doesn’t want.  At that point, the public plan will become a huge cost burden on the taxpayer, who will begin demanding that it cut back in the benefits it provides, taking us right back to where we started.

The fact that the Obama Administration and the Democratic Congress are both raising the issue of the high cost of health care “reform,” and are talking about ways to raise revenues to pay for it tells us all we need to know about the alleged “reform” schemes they are contemplating. They are doomed and, even if implemented, will not work.

Real reform of the American health care system would not cost money. It would save money.

There is a level of dishonesty in what passes for the debate over health care “reform” in both Congress and the media that is stunning in its brazenness and/or venality.

Of course, real reform would cost more in government spending.  But that is because real reform would remove the cost of medical care from both employers and from workers (who over the last 20 years have been shouldering an increasing share of their own medical care).  And that shift would mean more profits for U.S. companies, which would free up more money for wages, and it would mean less money deducted from paychecks, meaning higher incomes for workers.

If President Obama had any political courage at all, he’d simply get on TV and say this: I will create a plan that will cover everyone, lift the burden of paying for healthcare from individuals and employers, and have the government pay for it all. You the taxpayer will pay for this plan with higher taxes, but you will no longer have any significant medical bills, you will no longer have health insurance premiums deducted from your paycheck, your employer will no longer be paying for employee medical coverage, and you will never have to worry about losing health benefits again, even if you are laid off. (Incidentally, eliminating employer-funded health insurance would go a long way towards allowing workers to fight to have unions, and to strike for contracts, by ending the threat that they would lose their benefits.)

Of course, to do that the president would have to be talking about what is variously known as national health care or a single-payer plan, in which the government is the insurer of health care for all.

This option isn’t even being discussed in this so-called debate. As I’ve written earlier, even though there is an excellent single-payer system in place that has been running for a third of a century just to the north in Canada — a system where patients have absolute freedom to choose their doctor, get instant access to a hospital and to expert specialist care in emergencies, and have a healthier society by every statistical measure — all at a fraction of the staggering cost of healthcare in the U.S., not one Canadian expert working in that system has been invited down to discuss its workings with the White House or with members of Congress.

There has been a lot of negative propaganda spread about Canada’s single-payer system, by right-wing, business-funded “no-think” tanks, and by medical industry lobbies from the American Medical Association to the pharmaceutical industry, but no government committee or agency has bothered, or dared, to bring in Canadian experts to respond to and debunk that propaganda.  The corporate liars talk about waiting lists and lack of access to CAT-scan or MRI machines. But all we really need to know about the Canadian, and other similar single-payer systems, is that nowhere that they have been instituted have they been later terminated, even when, as in Canada, right-wing governments have been elected to power.  The public, whether in Canada, or France, or England, or Taiwan or elsewhere, loves their public health insurance system, whatever flaws or problems with underfunding those systems may have at certain times.  Trying to eliminate such systems would be political suicide for a conservative government, as even arch-free-marketer British Prime Minister Margaret Thatcher, who never met a government activity that she didn’t want to privatize, learned.

Right now, with half of all Americans reportedly fearing that they could lose their jobs, and with one in five Americans reportedly either unemployed, or involuntarily working part-time, we have a situation where a majority of Americans either have no health insurance, have lost their health insurance, or are in danger of losing their employer-funded health insurance.  It is a unique moment when a bold president and Congress could act to end private health insurance and establish a public single-payer insurance plan to insure and provide access to affordable medical care to all Americans.

Instead of this, we are being offered half measures or no measures at all by leaders who are shamelessly in hock to the health care industry or who are afraid of its power.

In 1993, the Clintons had a similar opportunity to grab the health care industry by the neck, strangle it, and produce a single-payer alternative. They blew that chance by trying to keep the health care greed-heads happy. Now, almost a generation later, we have another shot at it, and Obama and his Democratic Congress are doing the same thing again.  There is a strong likelihood that they will fail, like the Clintons before them. If they succeed in coming up with some kind of hybrid public-private Frankenstein of a system that includes a public insurance option, it will simply delay the inevitable disaster, as medical costs, already 20 percent of GDP — the highest share of any economy in the world — continue to soar, and as the cost of the public plan, which will inevitably become a dumping ground for high-cost patients, becomes politically untenable. In the end, we will have even more expensive and inaccessible healthcare than we have today.

It doesn’t have to be this way, but only if Americans rip their eyes away from their crisp new digital-image TV screens and start demanding real health care reform will we get honest reform.  A good place to begin would be to start writing and phoning your local media outlets to ask why they are not reporting on single-payer, and in particular on the single-payer bill sponsored by Rep. John Conyers (D-MI), which is being silently blocked and killed by his colleagues in the Democratic congressional leadership and by the White House. A good place to begin would also be to start calling your elected representatives to demand that they support Rep. Conyers’ single-payer bill.

DAVE LINDORFF is a Philadelphia-based journalist. His is author of the critically acclaimed book “Marketplace Medicine: The Rise of the For-Profit Hospital Companies” (Bantam Books, 1992). His latest book is “The Case for Impeachment” (St. Martin’s Press, 2006). His work can be found at www.thiscantbehappening.net.

US paid reward to Lockerbie witness, Abdelbaset al-Megrahi papers claim

Scottish detectives discussed secret payments of up to $3m made to witness and his brother, documents claim

BACKGROUND:  On 21 December 1988, a terrorist bomb exploded on board Pan Am flight 103, destroying the aircraft over the Scottish town of Lockerbie and killing 270 people. Anglo-American authorities soon accused Libya of being behind the terrorist act, fingering a Libyan, Abdelbaset al-Megrahi, as the key man behind the plot.

Reconstructed fuselage of doomed plane.

The claims about the payments were revealed in a dossier of evidence that was intended to be used in an appeal by Abdelbaset al-Megrahi, the Libyan convicted of murdering 270 people in the bombing of Pan Am flight 103 in 1988.

“I continue to protest my innocence – how could I fail to do so?,” he said. “I have no desire to add to the upset of many people I know are profoundly affected by what happened in Lockerbie. My intention is only for the truth to be made known.”

Weekend Edition
September 25-7, 2009

Reflections on the Degradation of Politics and the Ecosystem

Is Obama a Socialist?

By ROBERT JENSEN  // [print_link]

Corrupt GOP pols like Eric Cantor cynically spread the confusing lies that agitate a clueless population.

For months, leftists have been pointing out the absurdity of the claim that Barack Obama is a socialist. But no matter how laughable, the claim keeps popping up, most recently in the form of the Republican Party chairman’s warning of “a socialist power grab” by Democrats.

Within the past year, Republican Sen. Jim DeMint of South Carolina has called Obama “the world’s best salesman of socialism.” Conservative economist Donald J. Boudreaux of George Mason University has acknowledged that Obama isn’t really a socialist, but warns that the “socialism lite” of such politicians “is as specious as is classic socialism.”

Silly as all this may be, it does provide an opportunity to continue talking about the promise and the limits of socialism in a moment when the economic and ecological crises are so serious. So, let’s start with the basics.

Obama has never argued for such principles, and in fact consistently argues against them, as do virtually all politicians who are visible in mainstream U.S. politics. This is hardly surprising, given the degree to which our society is dominated by corporations, the primary institution through which capitalism operates.

Obama is not only not a socialist, he’s not even a particularly progressive capitalist. He is part of the neo-liberal camp that has undermined the limited social-democratic character of the New Deal consensus, which dominated in the United States up until the so-called “Reagan revolution.” While Obama’s stimulus plan was Keynesian in nature, there is nothing in administration policy to suggest he is planning to move to the left in any significant way. The crisis in the financial system provided such an opportunity, but Obama didn’t take it and instead continued the transfer of wealth to banks and other financial institutions begun by Bush. Looking at his economic advisers, this is hardly surprising. Naming neo-liberal Wall Street boys such as Timothy Geithner as secretary of the treasury and Lawrence Summers as director of the National Economic Council was a clear signal to corporate America that the Democrats would support the existing distribution of power and wealth. And that’s where his loyalty has remained.

In reaction to the issues of the day, a socialist would fight to nationalize the banks, create a national health system, and end imperialist occupations in Iraq and Afghanistan. That the right wing can accuse Obama of being a socialist when he does none of those things is one indication of how impoverished and dramatically skewed to the right our politics has become. In most of the civilized world, discussions of policies based in socialist principles are part of the political discourse, while here they are bracketed out of any serious debate. In a recent conversation with an Indonesian journalist, I did my best to explain all this, but she remained perplexed. How can people take seriously the claim that he’s socialist, and why does applying that label to a policy brand it irrelevant? I shrugged. “Welcome to the United States,” I said, “a country that doesn’t know much about the world or its own history.”

Business leaders saw this as a threat and responded with private and state violence. The Red Scare of the 19-teens and ‘20s tried to wipe out these movements, with considerable success. But radical movements rose again during the Great Depression, eventually winning the right to organize. In the boom times after WWII, management was willing to buy off labor (for a short time, it turned out) with a larger slice of the pie in a rapidly expanding economy, and in the midst of Cold War hysteria the radical elements of the mainstream labor movement were purged. But radical ideas remain, nurtured by small groups and individuals around the country.

To demand that we continue on this path is to embrace a kind of collective death wish. So, while I endorse socialist principles, I don’t call myself a socialist, to mark a break with the politics associated with industrial model that shapes our world. I am a radical feminist anti-capitalist who opposes white supremacy and imperialism, with a central commitment to creating a sustainable human presence on the planet. I don’t know any single term to describe those of us with such politics.

I do know that the Republican Party is not interested in this kind of politics, and neither is the Democratic Party. Both are part of a dying politics in a dying culture that, if not radically changed, will result in a dead planet, at least in terms of a human presence.

So, socialism alone isn’t the answer. In addition to telling the truth about the failures of capitalism we have to recognize the failures of the industrial model underlying traditional notions of socialism. We have to take seriously the deep patriarchal roots of all this and the tenacity of white supremacy. We have to condemn imperialism, whether the older colonial style or the contemporary American version, as immoral and criminal. We have to face the chilling facts about the degree to which humans have degraded the capacity of the ecosystem to sustain our own lives.

I end with Scripture not because I think everyone should look to my particular brand of radical, non-orthodox Christianity for inspiration, but because I think the task before us demands more than new policies. To face this moment in history requires a courage that, for me, is bolstered by tapping into the deepest wisdom in our collective history, including that found in various religious traditions. We have to ask ourselves what it means to be human in this moment, a question that is deeply political and at the same time beyond politics.

At the core of these traditions is the call for humility about the limits of human knowledge and a passionate commitment to justice, both central to finding within ourselves the strength to pass through that narrow gate.

My advice to any of you who want to be part of a decent future: Find that strength wherever you find it, and step up to the narrow gate.

rjensen@uts.cc.utexas.edu and his articles can be found online at http://uts.cc.utexas.edu/~rjensen/index.html.