Medicare for All: Force the Vote

It’s time! Commonwealth for the common health. Medicare for All!

W.J. Astore

The comedian and activist Jimmy Dore has inspired a movement for a vote in the House on Medicare for All early in January 2021. (Here’s Jimmy Dore talking to Cornel West on this issue.) Go to forcethevote.org and sign the petition to put pressure on Progressive Democrats to withhold their vote for Nancy Pelosi for Speaker unless she brings Medicare for All (M4A) to the floor of the House for a vote. If not now, during a global pandemic that has killed more than 300,000 Americans and caused nearly 15 million Americans to lose their employer-based health insurance, when are we going to consider M4A?

I rarely sign petitions. But my wife and I instantly signed this one. Americans supposedly live in the richest country in the world, yet we allegedly can’t afford to fund health care for everyone. It’s absurd. Not only that, it’s a crime against our common humanity. Which of you, if a friend or even a stranger came to you sick and asking for help, would seek to profit off this? Which of you, if a friend or even a stranger came to you seeking a diagnostic test to see if that lump was possibly cancerous, would seek to deny such a test as “not needed” or “not covered”?

It’s obscene that America’s health care system is based on the profit motive and the exploitation of the sick and dying. That it drives families into bankruptcy. That people sometimes die because they’re afraid to go to a doctor or the emergency room because it will cost too much.

Progressives say they want Medicare for All. A majority of registered Republicans and nearly 90% of registered Democrats say they want M4A. Why can’t Nancy Pelosi hold a vote on it? She claims to represent the people. That she even “feeds” them. Why isn’t she working to give the American people health care during a deadly pandemic that may cost as many as 600,000 Americans their lives? Is it because she doesn’t really represent us?

It’s not just about holding a “performative” vote on M4A. It’s about forcing the hand of Congress and seeing who the phonies are. Who wants to deny Americans M4A at this awful time? I’d like to know. I’m sure all Americans would like to know. And if Joe Biden is willing to veto M4A, as he’s said he will, I’d like to see that veto and his rationale for denying Americans the health care they so desperately need.

Again, if not now, when? If Progressives aren’t willing to force a vote on M4A during a deadly pandemic, when there’s deep suffering in America, when will they be willing to act?

We need to force them to act. Sign the petition, call your Member of Congress, and spread the word.

Update (12/26/20): In the comments section below, JPA made a strong argument for institutionalized corruption within America’s privatized medical system. With his permission, I’ve added his comment here so that more people will see it:

When people lump “doctors” into a homogeneous group that is a mistake because “doctors” are no more homogeneous than “cops” or “blacks” or “gays”. Most doctors want to deliver good patient care. Most of these hate the [American medical for-profit] system. However, a significant minority of doctors is quite happy with the current system and oppresses doctors who speak out against it. I work with a lot of healthcare professionals who are driven to depression or suicidal despair because they are trapped in a system which abuses them and their patients.

It is very likely that the tests ordered by the doctors who treated Maine’s brother were mandated to do so by the hospital’s electronic health record (EHR). EHR’s are mandated by law in large healthcare organizations ostensibly to improve patient care. In reality these make patient care more difficult and their real purpose is to run algorithms to determine the way to maximize the billed charges.

Doctors who work in hospitals are employees who are pressured to admit patients, do procedures, and run tests. If they don’t they can be fired, and their contracts usually contain non-compete clauses that prohibit them from working in the area. When someone has a family, and large student loan payments, then one is at the mercy of the employer. Very few people have the courage to stand up to that kind of pressure. Those who do often risk bankruptcy or divorce when the spouse realizes that they are not going to have the lifestyle they planned upon.

Or the hospital labels the physician as “disruptive” and other physicians who act as stooges for the hospital fabricate complaints that get the “disruptive” physician in trouble with their state medical board.

Here are the main things I hear from healthcare providers:

  • It is not possible to practice good medicine in the current environment
  • The pressure to meet corporate demands for revenue generation is contrary to good medical practice
  • Clinical guidelines are set by people/organizations with conflicts of interest
  • Upcoding, excessive testing, unnecessary procedures/screening/testing are expected and demanded
  • For-profit medicine does not work

Individual corruption occurs when a person behaves unethically. That is not the problem in American medicine. The problem in American medicine is institutional corruption.

1) Institutional corruption occurs when the laws, policies, and guidelines of a system are structured to enforce a set of values that is antithetical to the values the system is ethically obligated to express and uphold.

2) Health care professionals are obligated to place a higher value on patient care than on making profit.

3) The laws, policies, and guidelines of the American healthcare system are set up to prioritize making profit over providing patient care.

4) From 1, 2, and 3 above, the American medical system is institutionally corrupt.

This system is supported and maintained by a corrupt system of government. For further reading on this I recommend On Corruption in America by Sarah Cheyes.

Hillary Clinton’s Email Fiasco

Trust me!
Trust me!

W.J. Astore

Once again, Hillary Clinton is in the news for the wrong reason.  She used a private email account while she was Secretary of State, rather than an official government email account.  As a result, not all of her (unclassified) emails are part of the public record. Many may be “lost,” consigned to the dustbin of history, whether by accident or design is hard to say.  In the press conference she then gave to explain herself, she was less than forthcoming.  And it now appears that her email server wasn’t even encrypted for the first three months she served as Secretary of State, meaning her official emails were eminently hackable and readable by foreign governments.

Just another meaningless scandal, right?  No — what this reveals is the arrogance of power. Official rules may apply to “little people” like you and me, but to the Clintons, those rules can be ignored.  They think they can do whatever they want.  It’s a clear double standard, and it’s just one more reason why the prospect of Hillary Clinton as president disturbs me.

I remember when Hillary Clinton served as First Lady and worked on health care reform in the early 1990s.  Her right-hand man was Ira Magaziner.  I’d heard of Magaziner since he had served as an outside consultant to my hometown. According to Wikipedia:

“After Oxford, Magaziner and a group of former Brown students attempted to implement social democratic reforms in the city of Brockton, Massachusetts. These reforms included starting an agricultural cooperative, supporting liberal candidates for city council, strengthening the union movement, and printing a progressive town newspaper. Magaziner soon abandoned the project, after the group recognized that the effects of foreign business competition on the local manufacturing base would undercut their efforts.”

Not as I heard it.  Magaziner thought he could come to Brockton and serve as its “instant expert,” remaking the city in his image without paying much attention to the desires of the locals.  Brockton is working-class, fairly conservative, and tough-minded, proud of its championship boxers (Rocky Marciano and Marvin Hagler).  The people of Brockton were less than enamored with Magaziner and his fellow “experts” telling them what to do and how to do it.  So Magaziner withdrew, mission unaccomplished.

Magaziner then took his know-it-all approach and applied it to health care reform, working hand-in-hand with Hillary Clinton and her team.  They concocted a massive reform of the health care system with no buy-in from major stakeholders.  Arrogant policy wonks, they believed their ideas and reforms were so brilliant and compelling they’d easily win assent from Congress.  Instead, they fell flat on their faces.

Nobody likes being dictated to.  And nobody likes people who make their own rules while dancing on the heads of the little people. Hillary’s latest fiasco once again reminds us of her imperious nature, her arrogance, her lack of political deftness.

She’d make a formidable empress.  But a president?  No thanks.