Ernie Haberkern writes on the row over healthcare reform in the USA
In a sense, the right wing tub-thumpers organized by the pharmaceutical and insurance companies through media hysterics like Russ Limbaugh and Sarah Palin, have done Barack Obama a favor. They have drawn attention away from what the administration is really doing by making stupid charges and turning their demonstrations into clown shows. It is easy enough to poke fun at Sarah Palin’s charge that a provision allowing doctors to be paid for advising elderly, ill patients about the possibility of setting up living wills, making clear to their loved ones what they would like done in the event they become incapacitated, amounts to setting up “death panels”. As the Republican Senator from Georgia who introduced the legislation, Jacob Isakson, put it the statement is “nuts”. But, then, what would you expect from Sarah Palin.
Increasingly, however, the liberal center is beginning to voice concerns about where Obama is going. The headline of this article is based on an op-ed piece in The New York Times by Frank Rich titled “Is Obama Punking Us” in which he quotes a real estate broker from Virginia who voted for Obama, Chris Ann Cleland, as saying “I feel like I have been punked!”
The specific issue that set Rich off is the administrations secret deal (well, it was secret until The New York Times and The Los Angeles Times found out about it) in which the pharmaceutical companies were assured that their prices would be protected. As I write this article, officials of the administration like Kathleen Sebelius, Secretary of Health and Human Services, have been saying in interviews that the public option, a government financed insurance program that would compete with private insurers could be dropped as part of a compromise to get the deal through.
Let me suggest that there is something more going on here than more of the same special interest lobbying and liberal collapse in the face of it that have characterized American politics for decades.
There is a real health care crisis. Partly as a result of the aging of the population and partly as a result of increasingly expensive treatments and drugs, the percentage of the GNP devoted to health care is growing. Add to this the gross profits of the drug companies, and the insurance companies who spend enormous amounts trying to avoid making payments, and the possibility of a financial collapse like that of the banking and real estate sectors looks like a real possibility.
And the response of the Obama administration and the Democratic Party is similar.
What is going on is a form of nationalization which preserves and protects the existing private bureaucracies by incorporating them into the state bureaucracy. With no effective democratic control or regulation. It is analogous to the nationalizations carried out by the Atlee labor government after WWII. There, too, the old bureaucracy remained in office only their pay was guaranteed by the state. After all, where else could you find people with the necessary expertise? Some sectarian socialists referred to this process as “the bureaucratic collectivization of capitalism.”
When the town hall tub-thumpers point out the size and complexity of the bills, the Senate bill is over 600 pages and the House bill over 1000 pages, they have a point. No one except the lobbyists and the administration representatives and the carefully selected Congresspersons and Senators knows what has really been agreed to. The tub-thumpers are also right to be worried about the undetermined price too. Where they are wrong is in their assumption that the pharmaceutical and insurance companies are on their side. Leaving aside the fact that these people are exploiting the general population, the present system is unsupportable. They know that and that is why this time around, unlike during Clinton’s administration, the companies are eager to make a deal. It is the only way they can continue to exist. Like the Banks they understand that they need “socialism” and “big government”.to survive. They just want to make sure they get the best deal they can and continue to collect their bonuses.
I don’t see how anyone interested in a democratically responsible, decent, egalitarian health care system can support the Obama proposal. Some of the worst abuses of the system may be alleviated. The insurance companies which now function as “death panels” denying medical treatment, not only to the aged but to young people with, for example, leukemia, may be forced to amend their most outrageous practices but they will preserve their profits and pass on the costs to the taxpayer. Or just add them to the growing deficit. Medicare, which now functions like a half-way decent single payer system, may be absorbed into this new monstrosity. The tub-thumpers again have a point.
So where do we go from here? For now I think the energy and enthusiasm, the momentum, generated by the Obama campaign and victory will be dissipated. But the problem won’t go away and the 60 percent of the population who want public health care will probably become a larger percent. In the US, because of the federal nature of the system, the possibility of fighting for a single payer system at the state and even local level exists.
A crucial role here will be that of the unions. They too face a crisis. When Harry Truman’s attempt to introduce universal health care was defeated in 1948 the response of the unions, led by Walter Reuther and the UAW who had supported Truman, was to make health care for their members and retirees part of their contracts. Aside from the fact that this led to their members being put in the position of a privileged minority, this too is no longer affordable. Among other things it is one of the pressures forcing manufacturers to outsource production overseas or to non-union plants in the US.
The problem won’t go away even assuming there is a revival of the economy.