Early Returns on 2021

No bread? Let them eat ice cream!

W.J. Astore

So far, 2021 is looking much like 2020. Nancy Pelosi is once again Speaker of the House, with progressive leaders like AOC extracting no meaningful concessions for their votes. Jimmy Dore had suggested progressives could use their leverage over Pelosi to force a vote in the House on Medicare for All, but of course the progressives caved and cravenly supported Pelosi, who like Joe Biden is against Medicare for All.

America, you will never get a single-payer, publicly-funded, health care system. If you can’t even get a vote on one during a pandemic that will soon kill 400,000 Americans, you will never get a vote. America’s health care system is a wealth-extraction system that profits off the sick and dying. That system simply will not change because politicians like Pelosi and Biden are bought and paid for. Short of a revolution or a truly progressive third party, Americans will continue to suffer bankruptcy and death due to our for-profit wealth-care system that puts profit before patients.

Trump, meanwhile, is conspiring along with a dozen or so sycophantic senators to contest the election he lost. Trump, who has the virtue of saying the quiet part out loud, pressured the Georgia secretary of state to “find” about 12,000 votes for him so that he could be declared the winner. This circus is the lead story in U.S. media today, as if Trump has finally put his foot in it. But he’ll soon pardon himself, I’d wager, and even if he doesn’t the incoming Biden administration won’t do anything to prosecute him on any charge.

In other news, Americans will have to be satisfied with means-tested $600 checks (don’t spend that all in one place), instead of the $2000 checks that Trump advocated for. Interesting, that princess of virtue, Nancy Pelosi, was perfectly satisfied with $600 checks until Trump demanded $2000. Only then did Pelosi mount a weak effort for the higher figure, which was quickly killed by Scrooge himself, Mitch McConnell. Suck on that, America.

Speaking of Trump failures and revealing moments in Congress, Trump’s veto of the NDAA (the Pentagon budget) was easily overturned, as America’s representatives professed their bipartisan support of “our” troops. I’ll believe in that “support” when Congress finally acts to end America’s disastrous wars overseas. Perhaps on the twelfth of never?

Finally, it was good to hear that Julian Assange will not be extradited to the U.S., though the judge’s ruling in the UK was made on the narrow grounds that the U.S. prison system is so oppressive that Assange would likely commit suicide here, given his current mental state. Of course, the U.S. government doesn’t care that much about prosecuting and imprisoning Assange. Assange, like Chelsea Manning, Reality Winner, and other whistleblowers, has been made an example of. This is all about intimidation of journalists and other potential whistleblowers, and it’s working.

Readers, what’s caught your eye in the opening week of 2021?

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.

American Health Care Is Wealth Care

covid-19-featured-image
Covid-19 is exposing the American health care system’s greatest weakness: its focus on wealth rather than health

W.J. Astore

As millions of Americans lose their jobs due to Covid-19 disruptions, they also lose their health care, which is tied to their jobs.  Only in America is health care contingent on employment.  Efforts to create a national, single-payer, health care system have failed since the Truman administration in the late 1940s.  Americans have been sold on the idea that health care is best administered by “the free market,” which of course is neither free nor much of a market.

The American health care system puts profit over people; in short, it’s wealth care, not health care.  This is simply fact.  Health insurers, pharmaceutical companies, hospitals, are motivated by money.  Indeed, health insurers make money by denying you coverage, not providing it.  They raise co-pays and deductibles to unbearable limits.  Meanwhile, they spend liberally on lobbyists to keep Congress in their pockets, as well as on advertising to persuade Americans that health insurers are always on your side.  Until you file a claim, that is, or need expensive treatment.

Health care should be about health, not wealth, and people, not profit.  Back in 2013, I wrote the following article on health care for Huffington Post.  Of course, the system has only grown worse.  America faces a crisis today, driven by a deadly pandemic.  Isn’t it time to embrace single-payer health care for all?

***

Americans generally, and politicians in particular, proudly proclaim that we live in “the greatest” country. But how should we measure the greatness of a country? I’d suggest that quality of life should be a vitally important measure.

And what is more fundamental to quality of life than ready access to health care? When you’re sick or suffering, you should be able to see a medical specialist. And those costs should be — wait for it — free to you. Because health care is a fundamental human right that transcends money. Put succinctly, the common health is the commonwealth. And we should use the common wealth to pay for the common health.

Here’s the truth: We all face the reality of confiscatory taxation. If you’re like me, you pay all sorts of taxes. Federal, state, and local income taxes. Property taxes. School taxes. Social security. State lotteries are a regressive tax aimed at the poor and the gullible. We pay these taxes, and of course some for health care as well (Medicare/Medicaid), amounting to roughly 30 percent of our income (or higher, depending on your tax bracket, unless you’re super-rich and your money comes from dividends and capital gains, then you pay 15 percent or lower: see Romney, Mitt).

Yet despite this tax burden, medical care for most of us remains costly and is usually connected somehow to employment (assuming you have a good job that provides health care benefits). Even if you have health care through your job, there’s usually a substantial deductible or percentage that you have to pay out-of-pocket.

America, land of the free! But not free health care. Pay up, you moocher! And if you should lose your job or if you’re one of the millions of so-called underinsured … bankruptcy.

Health care is a moral issue, but our leaders see it through a business/free market lens. And this lens leads to enormous moral blind spots. One example: Our colleges and universities are supposed to be enlightened centers of learning. They educate our youth and help to create our future. Higher Ed suggests a higher purpose, one that has a moral center — somewhere.

But can you guess the response of colleges and universities to Obamacare? They’re doing their level best to limit adjunct professors’ hours to fewer than thirty per week. Why? So they won’t be obligated by law to provide health care benefits to these adjuncts.

Adjuncts are already underpaid; some are lucky to make $3000 for each course they teach. Now colleges and universities are basically telling them, “Tough luck, Adjunct John Galt. If you want medical benefits, pay for health insurance yourself. And we’re limiting your hours to ensure that you have to.”

So, if Adjunct John Galt teaches 10 courses a year (probably at two or three institutions of “higher” learning) and makes $30,000, he then faces the sobering reality of dedicating one-third of this sum to purchasing private health insurance. If that isn’t a sign of American greatness, I don’t know what is.

I groan as much as the next guy when I pay my taxes. But I’d groan a lot less if I knew my money was funding free health care for all (including me and mine). Commonwealth for the common health. With no death panels in sight.

A healthy republic that prides itself on “greatness” should place the health of its citizens first. That we don’t is a cause for weeping — and it should be a cause for national soul-searching.

Healthcare in America: No Pony for Us

bonnie3
Wise up, America!  Only the richest little girls get ponies (Scene from “Gone with the Wind”)

W.J. Astore

The comedian and political commentator Jimmy Dore has a great sketch about Americans not getting a pony.  The “pony” in question is taxpayer-funded, single-payer health care.  Only the most naive or gullible or spoiled Americans could possibly believe they deserve such a pony — this is an argument advanced by Democratic sages like Hillary Clinton, among many others, like Nancy Pelosi.  She’s supported today by “sensible centrists” like Joe Biden and “Mayor Pete” Buttigieg, who argue that Medicare for All is wildly impractical and crazily expensive.

As my wife quipped, for “sensible centrists” and their ilk, we don’t get a pony — but we do get to pony up.

Yes, Americans get to pony up — and up — and up, in the form of high insurance costs, deductibles, co-pays, and the like.  And let’s not forget the high cost of life-giving prescriptions, such as insulin, which under our wonderful private systems have soared in price.

Those who attempt to sell Medicare for All in America, like Elizabeth Warren this weekend, are dismissed as delusional.  Take this headline at Reuters: Republicans, Democrats, ‘SNL’ attack Warren’s U.S. ‘Medicare for All’ plan.

Wow!  Everyone is against her — even liberal comedians at Saturday Night Live (SNL).  No pony for us!

Yet, as Jimmy Dore pointed out in his skit, other countries and peoples get ponies.  The Canadians do.  The British do.  The Germans.  The French.  The Italians.  The Japanese.  And so on.

Want a pony, America?  Better move to Finland.  Or Hong Kong.  Or Greece.  Or New Zealand.  Or Tara.  Because you’re not getting a “pony” here.