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I think that in the future, the Obama administration may be most remembered for making moderate liberal reforms while massively entrenching corporate power.
We’ve seen it with health care reform, the bank bailout, the recent Citizens United Supreme Court decision, and expect to continue seeing it happen.
It seems to me that the recently passed “health care reform” legislation is mildly positive for some people. It is massively lucrative for pharmaceutical companies, and mostly positive for insurance companies as well. People who can afford insurance but can’t get it should theoretically be able to buy it now, and people who have insurance should not have their coverage abruptly canceled when they need to, y’know, use it.
The “individual mandate” is the most fucked-up part of all this. The bill calls for all Americans who don’t have health insurance to buy it. The “public option” would have made this tolerable; a non-profit, government agency selling you insurance would have been a good fall back for people who can’t afford corporate health insurance. But despite the massive popularity of this idea among American citizens, neither the industry, nor their friends in DC wanted it to become law. So it didn’t.
When this mandate is phased in (2016), people go without insurance will be charged $695 a year, or 2.5% of their income, whichever is higher. However, if health care pundit Ezra Klein is right, the bill actually makes no allowances for enforcement of the mandate. So the reality there is possibly less harmful than I’d thought.
I have been really confused about what the health care bill actually says about abortion. It does sound as though it allows insurance companies to stop covering abortions, which they likely will. So if you’re insured, poor, and need an abortion, this bill shits all over you.
And “confused” doesn’t even begin to describe my take on the “health care exchanges”. We shall see.
Thanks to this bill, pharmaceutical companies can continue to charge ungodly prices for their medicines, more than they charge in any other country on Earth. And while some of these regulations should cut into insurance company profits, the mandate hands them 32 million new customers. Sounds like a bargain to me. Of course, what really happens remains to be seen: devil, details, you know how it goes.
So when your right-wing friends call this “the government takeover of health care”, you really should laugh at them. Almost this whole mess is private. Your employer is writing checks to a big insurance corporation, or you are writing checks to a big insurance corporation. Or you’re too poor, or you’re on Medicare.
(And if they’re really worried about “government-run health care,” they need to start speaking out against the VA. Veterans’ health care is 100% government owned and run: government doctors, government hospitals, government pays the bills. And strangely, public health researchers are finding that the VA gets the highest satisfaction ratings from patients of any type of health care program in the country.)
So this may end up being beneficial to some people. I have, however, heard just the opposite from some informed folks. Jane Hamsher of the progressive FireDogLake blog actually expects the bill to do almost exactly the opposite of what’s been promised, in almost every way.
An insightful book I read recently on the topic of health care (mentioned below) made a very important point. An intelligent public health official (who has helped several national governments set up their health care systems) said that a country needs to decide your health care philosophy first. Everything follows from that. Should everyone have full coverage? Is the free market important? Should everyone have access to every possible treatment? Amazing as it is, I don’t know that I’ve hear any politician in this health care reform debacle even mention a philosophy. About all we’ve heard is that the system needs to be “better”. That’s the only philosophy I can divine, given that the statistics say that this legislation will only cover 32 of the estimated 50 million people with no health insurance.
What is very clear, is that this bill is a massive failure of democracy. Polling data for years has shown Americans favoring a national health care system (“single payer”, Medicare for all, something like that), and a vast majority preferred the “public option” to this bill that eventually got passed. This policies have been popular in this country for many, many years. But, as Noam Chomsky is fond of pointing out, these policies are portrayed as “not politically feasible”. In other words, it was supported by the majority of the population, but opposed by a tiny fraction of Americans who happen to be insanely wealthy and politically connected. We all know that, we all see signs of it regularly, and here is another big ol’ slab of proof. A very popular president with a majority of the seats in both houses of the Congress did not even really attempt to pass a bill that was incredibly popular with the American people. The two obvious reasons are disheartening. Either they are too afraid to take on these powerful interests, or they are on the same side as these powerful interests.
My concluding thoughts: if you actually care about health care and what America should do about it, you really have to read “The Healing of America” by T.R. Reid. It’s a pretty easy read. The author visits about a dozen countries, interviews doctors and patients about their health care system, studies the history and how that system came to be, and then has his own chronic medical condition treated by local doctors there. There are many more options than we’ve been lead to believe, every system has its pros and cons, and every system has its own challenges to face in the near future.
And finally, it’s crazy that this debate about “health care” has so little to do with actual American health. What we’ve been saying all this time is “people should be able to see a doctor and get treatment when they’re sick or injured.” This talk rarely include preventative medicine, where you could see a doctor, who’d give you tips or treatments to avoid future illness or injury. Also not included: our broken industrial food system; pollution of our air and water; stressful work/commute cycles; lack of time for exercise; or conditions caused by drug, tobacco and alcohol use/abuse.
I’ve got plenty to say on the right-wing/Tea Party freak outs regarding health care, but we’ll see when I have time to write about that. Ironically, the only reason I had time to write this is because I took time off of work, because I’ve been sick.