With the "Obamacare" bill now before the Supreme Court, the rhetoric is heating up. I like to read the comments on various news articles to get a feel for the sentiment on both sides of the argument, but in this case I will confess that my mind is already made up on the healthcare issue. It has been my considered opinion for decades, after I had carefully thought it over and looked at various opinions and realities, that any nation worth its salt should, if it has the resources, do for its citizens three things: ensure that nobody goes hungry, that the sick are treated and that education is not hindered by poverty. And I don't think that any substantive argument exists to show that the United States does not have the resources to do all three.
The current "Obamacare" bill, or the Affordable Care Act, is a carefully crafted centrist bill designed to mollify President Obama's constituents concerned about universal healthcare, and to pacify the conservatives who believe that universal healthcare would necessarily mean that the lower 50% who allegedly pay no taxes would become grifters helping themselves to enormous slices of free healthcare while pretending to be broke. In truth, it does neither. It is not a universal healthcare bill, in that it requires even people who cannot necessarily afford it to buy coverage, based on arbitrary income guidelines. What a specified income gets you can vary considerably from one county to the next, let alone various regions of the country. Secondly, it is not the free-market system that the conservatives insist upon, for the simple reason that it compels the buyer. Both sides want to see this fail, to re-start the debate and get what they want.
I, too, want this to fail, because I see this as a cave-in to the insurance companies, who will add enormously to their profits, and because it will cause additional hardship to those already suffering in a declining America. The United States is already spending approximately one-fifth of its GDP on medical care, and about a third of that is on Medicare/Medicaid. The insurance companies collect about three-fifths of all health-care related expenses as premiums, and unfortunately, the substantial profits which they make are also lumped in as "healthcare costs" in this debate. Contrary to popular perception, Medicaid costs are not incurred by the indigent elderly. These are mostly for very poor families(quite a number of whom actually vote Republican), and temporarily indigent people. As for the procedures typically attributed to the elderly, such as hip and knee replacements, I am seeing more and more of these being done for relatively young people, in their 40s and 50s, and some even in their 30s. So accusing any one group of patients/insured for disproportionately and indiscriminately using services is somewhat ill-informed.
I've observed, over the last three decades, a slide in the conservative mindset to a very selfish outlook. While the poor have never really been the focus of right-wing sympathy, at least one could argue that conservatives still had real national loyalty that worked to the benefit of the poor. Even that has eroded to almost nothing now. The argument on the conservative side pretty much runs to "Let the free market work". I submit that it has been the free market working thus far- except for the Medicare/Medicaid programs, and it has been found wanting, much as using wolves to guard flocks of sheep. True free markets are akin to anarchy, and it benefits individuals at the cost of the well-being of society. That's why we have anti-trust and anti-racketeering laws.
It is not just Medicare/Medicaid which has driven up the costs of healthcare, but equally the general healthcare system, a substantial measure of which are the insurance companies' ever-rising premiums. When numbers are bandied about on healthcare spending, as a percentage of GDP or per capita, it includes premiums. Another major factor is how Big Pharma is ripping off the American consumer. In no other country in the world are pharmaceuticals as expensive as in the US, and the rationale for that is that American pharmaceutical companies(which are no more "American" than any other MNC) need to recoup the enormous amounts they allegedly spend(and more of it overseas now than ever before) on developing each drug, and they successfully lobby both to keep out generics and competitive products as well as to overprice their product. My question, then, is this: why do Americans have to pay up the cost of developing medical drugs while the rest of the world gets the same drugs at far lower prices? And what happens to the alleged concern for the operation of the "free market"?
One commenter on an NYT story on today's SC proceedings says, "Send the bill to the person who uses the service and not the taxpayer, just as utility bills or credit card bills are send[sic] to the user of those services." Perhaps he doesn't realize that virtually nobody pays directly for medical services, as most are covered under some sort of insurance plan, and insurance is actually socialist, in the sense that risk is shared. If that commenter had to pay out of pocket for catastrophic care for himself or a family member, I'm pretty sure he would be handily bankrupted. The same goes for other forms of insurance, such as automobile or home insurance. How many people who have lost homes to tornadoes, earthquakes, fires and floods would be able to rebuild if it weren't for the millions of others with firmly standing homes who are paying into an insurance pool? And yet nobody asks that the whole insurance business be repealed, and that people should pay as needed and according to their ability.
The same silly argument, of "free markets", is being bandied about regarding the public school system. The argument, which I've heard and refuted for years, goes: why should I have to pay school taxes when I have no kids in school? Why should I pay school taxes when I send my child to a private school? The reality is that school taxes do a lot more than just send your kid to school. It subsidizes the education of other kids when your kid is done, just as others did when you were going to school. If you happen to be fortunate enough to have been so successful as to send your child to a private school for $60,000 a year, it doesn't take away the fact that, most likely, your own education was subsidized by others who had no children in school and you should thank them for their magnanimity. School taxes are also a form or insurance, insuring that all children in the school district can go to school regardless of their parents' income. And, not least of all, a good school district props up your home's value.
Conservatives swear by religion, and most US conservatives profess Christianity. The distinguishing feature of Jesus' teachings is empathy for those less fortunate. This should be the hallmark of the conservative movement. Unfortunately, it is the least of it. Universal healthcare is not some Robin Hood scheme. It is not different than any other form of socialism that many don't complain about: police, fire brigades, public schools, freeways, public water bodies, public libraries, public parks, the military(yes, that's socialist too, because it protects you and your property from foreign raiders without you paying as you go), and on and on. Most of the volunteer firefighters I've met are from lower-income families, as are most of our fighting men and women. You and your forefathers have benefited from these and many more, with others subsidizing your costs before you were able to afford them. Now that you no longer need these subsidies, it's your turn to help others out. Go on, be an American again!
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