In the years and decades following the 2nd World War essentially all the industrialized democracies reached the conclusion, in agreement with the Universal Declaration, that all their citizens have the right to health care; that no one should be denied medical care because of an inability to pay for it. Thus, the norm amongst the Western democracies is a system of national health programs that enrolls all citizens, and that excludes no one because of economic circumstances. The details vary as to how such systems are implemented and paid for, but they all reflect the universal right to health care expressed in the UN Declaration. While polling indicates that a comfortable majority of Americans favor such a national health program that covers all citizens, the United States remains the extremist, alone among the Western democracies in having a for-profit health care system. Indeed, upwards of 60 million Americans have no health insurance, and perhaps as many as 100 million are under-insured, and vulnerable to catastrophic financial ruin if they should become seriously ill. If democratic government is supposed to reflect the will of the people, then how can this be?
I'm one of the lucky ones. Through my employer I have access to what would probably be considered a "good" health insurance plan. I recently had my most significant encounter with the US health care system. My five year old son had to have open-heart surgery to correct a congenital heart defect. He received fantastic care from all the doctors and nurses, and is doing great, but I couldn't help but think what a parent without health coverage would have to go through if their child were in a similar circumstance. But even with a "good" insurance plan, one is expected to make out of pocket payments at virtually every visit to a doctor or care giver. A visit to my primary care physician now requires a $25 co-payment, for example.
The present fight over health care reform reveals much about the sorry state of American democracy. Indeed, it highlights the fact that the institutions, such as the Congress, which are supposed to be instruments of the public good, are in fact controlled by powerful, private economic interests. Perhaps nothing exemplifies the endemic corruption in Congress around the health care issue as the key position that Senate Finance Committee Chairman Max Baucus (D-Montana) occupies within the process. Baucus is well known as a beneficiary of extensive campaign largesse in the form of millions of dollars from the health care and pharmaceutical industries. Any legislation significantly effecting health care reform will have to go straight through his committee. If this is not a conflict of interest, then the term has no meaning. In my field it would be as if one had the ability to peer review ones own scientific papers. Only in the US Congress could such circumstances be passed off as business as usual.
Even if reform can elude the entrenched corporate interests that routinely prowl Capitol Hill, then there is still no shortage of conservative ideological buffoonery to overcome. Witness the following contributions from two "luminaries" of the House Republican caucus during recent floor debate on health care, courtesy of the folks at Democracy Now!;
REP. STEVE KING (R-Iowa): Here’s another place where they think they’re going to save. They’re going to save money by rationing care, getting you in a long line. Places like Canada, United Kingdom and Europe, people die when they’re in line.
REP. LOUIS GOHMERT (R-Texas): Well, if you go to the socialized medicine countries, you find about 20 percent worse results. You get it? One in five people have to die because they went to socialized medicine! Now, I’ve got three daughters and a wife. I would hate to think that, among five women, one of them is going to die because we go to socialized care, and we have to have these long lists.
These comments reveal a number of outright lies and fabrications that the health care industry lobby and the Right in general likes to promulgate about health care reform. So, let's dispense with a number of these right now.
1) The "rationing" myth. This one is so ludicrous it's almost funny. The argument goes along the lines of Representative King's statements above. By going to a "socialized" system the government will decide who gets care and who doesn't, and you'll have to wait in long lines to see your doctor, and worse yet, there might even be a government bureaucrat making health care decisions! Often the argument is accompanied with comparisons to other country's
systems, with Canada and France often being used to illicit the desired fear response. This one is pure falsehood. The truth is that there are no "long lines" in countries with "socialized" medicine. People see their doctors in much the same way as with private insurance plans in the US. Indeed, polling shows that citizens of France and Canada have higher satisfaction rates with their health care systems than in the United States. As is often the case with deceitful right-wing propaganda, the truth is usually the opposite of the claim, and in this case even more so. The truth is that rationing is endemic to the private, for profit system in the US, not to "socialized" systems. Talk about rationing, how about excluding 1/5 of the population! Now that's serious rationing. Moreover, how do you think that private insurance providers make profits? They make money by rationing care! Indeed, amongst the industrialized democracies, the only nation where bureaucrats are routinely making health care decisions is in the for profit system in the United States. Here, insurance company bureaucrats make life and death decisions about who gets care and who doesn't. The truth is that only doctors make such decisions in countries like Canada.
2) The "we have the best health care system in the world" myth. This one is encapsulated in Representative Gohmert's ridiculous statement. Apparently Gohmert's ignorance of math is only eclipsed by his ignorance of the health care systems of other nations. Here again the truth is the exact opposite of the claim. The truth is that countries with "socialized" medicine actually get better health care, and unfortunately, the United States ranks well below most of the Western democracies with national health programs in many indicators of public health. As one example, the US ranks below Cuba and Cyprus in infant mortality, just ahead of Croatia. This is not to say that good health care can not be obtained in the US, indeed, America does have some of the best medical institutions in the world, but it is precisely the way that the care is rationed, ultimately only to those who can pay, that is so destructive. Because of the prohibitive costs many people defer preventive care and thus when they are treated it is at more advanced stages of disease, which is more costly to treat and results in poorer outcomes. Not surprisingly, the lack of health care, and its deleterious effects on public health, falls disproportionately on the poor.
3) The "slippery slope to socialism" myth. This one is also a rip. Anytime you hear some wing-nut frothing at the mouth against health care reform you can be sure that soon to follow is the charge that soon we'll all be wearing red and singing The Internationale. Of course the truth is rather different. Indeed, much of the US health care system is already "socialized." Two large examples include the Medicare program, which is essentially national health insurance for those over 65, and the Veterans Administration's programs providing health care to veterans. Indeed, Medicare is a good example, and one the private insurance companies greatly fear. The government administers the Medicare program with a 3-4% overhead, this compares with a more typical 25% (or worse) value for private plans. Here we see exactly why private insurance companies are desperate to keep public plans off the table. When you take the profit, the multi-million dollar corporate compensation packages, and the corporate jets out of the health care business, and just care for people, then it becomes impossible for the private insurers to compete.
While President Obama and most Democrats seem sincere in there desire to pass legislation that will provide coverage to all Americans, it also seems clear that their inclination is to try and do this by tinkering with the existing private insurance system. They may succeed in extending coverage to more people, but this path is almost certainly doomed to failure in terms of curbing costs. Other countries have already figured this out. How long will it take for America to wake up and finally fulfill the promise of health care for all enunciated in the Universal Declaration of Human Rights? Until the corporate control of Congress is lessened, then I fear the wait is not yet over.
