Whatever They Can Get Away With

socialism

 

 noun

so·​cial·​ism | \ ˈsō-shə-ˌli-zəm  \

Definition of socialism

1: any of various economic and political theories advocating collective

or governmental ownership and administration of the means of

production and distribution of goods

2a: a system of society or group living in which there is no private property

b: a system or condition of society in which the means of production are

owned and controlled by the state

3: a stage of society in Marxist theory transitional between capitalism 

and communism and distinguished by unequal distribution of goods

and pay according to work done

American doctors aren’t making more, except in certain rarified circles of expertise or where vanity calls. There are still strikes from other healthcare workers, so they don’t seem to think they are making enough. Medicare is falling short, Medicaid isn’t robust and US mortality rates and life expectancy numbers are going the wrong way. The number of medical bankruptcies is rising, and healthcare costs are skyrocketing again.

Still, as we listen to the political rhetoric, where government support of any form of healthcare is labeled as “socialism.” And as those older folks in our constituency know, if you can label a program as “socialist” or “communist,” you can draw direct comparisons to those autocratic and brutal nations who call themselves “socialist” or “communist,” but repress and slaughter their own people who raise a finger in dissent. Folks who bandy that “s” word around probably cannot give you a proper definition. The complete Merriam-Webster definition is given above, and not one word of that definition would seem to apply simply to a system of governmental support for universal healthcare. 

There is a huge difference between “socialism” and “social programs.” If you hate governments doing anything in the way of social programs – stuff like free public primary and secondary schools or Medicare – that’s totally different… but hardly reflective of a modern culture based on a severe division of labor, deep and constant interaction of its citizenry resulting in massive interdependence. Think pioneer woodsman vs someone repairing cars or working in as office tower. Having a vastly undereducated population is generally an indicator of a failed and economically inadequate state.

So, if government support for medical care is not socialist, if doctors are not making the big bucks anymore (but still paying the big tuition costs), why is the GOP – clearly calling the shots – so vehemently against national healthcare? Why are 20 red state attorneys general, with full legal support from the Trump administration, fighting so hard to kill the remaining provisions of the Affordable Care Act (ACA) and telling their voters that any public system of healthcare robs them of choice and quality? Let’s add one work to the equation that will explain it all: profits. Pharmas, even those causing the opioid epidemic, insurance carriers and for-profit hospitals are making money hand-over-fist. Just look at their performance in the stock market, soaring even higher with the GOP gift of a massive but unneeded corporate tax cut. Republicans recruit people vulnerable to sloganeering and meaningless “solutions,” while really fostering profits over everything else.

When the ACA passed Congress in 2010, so many elected members had received so much in the way of campaign contributions from the healthcare industry, that the only to get the law passed was to give in to the pharma lobby – the new healthcare exchanges would not use their size to negotiate lower prescription prices – and the insurance companies. In exchange for lower administrative costs, these insurance carriers would get mandated new customers. In short, “cost control” was not part of the first wave of national healthcare coverage. That would have to wait for phase 2… except the GOP was hell-bent on making sure there was no phase 2 and that they could unravel most of phase one to kill it. 

For a nation that spends more on its military than the next ten highest-military-budget nations combined – and has not won a major war since WWII – to say that we cannot afford a healthcare system that is readily available in the balance of the developed and mostly capitalist-friendly world is the equivalent of saying, “Americans Can’t.” Seriously? How does it work elsewhere? Our system is even inferior to that of South Africa: “South Africa’s system… boasts ready access to treatment, and prices that actually reflect the cost of care, rather than whatever amount healthcare providers think they can get away with.” Los Angeles Times, September 24^th.

“In France, a visit to the doctor typically costs the equivalent of $1.12… A night in a German hospital costs a patient roughly $11… And in the Netherlands — one of the few wealthy nations other than the U.S. where patients face a deductible — insurers usually must cover all medical care after the first 385 euros, roughly $431… Healthcare in the U.S. has long been unique. But few things so starkly set the American system apart as how much patients pay out of pocket for medical care, even if they have insurance.

“‘The U.S. likes to see itself on par with other high-income countries,’ said Jonathan Cylus, a former economist at the Department of Health and Human Services who now studies patient costs internationally at the World Health Organization and European Observatory in London. ‘The truth is, it’s a real outlier.’… Nearly all of America’s global competitors — whether they have government health plans, such as Britain and Canada, or rely on private insurers, such as Germany and the Netherlands — strictly limit out-of-pocket costs.

“So while tens of millions of insured Americans must balance medical bills with spending on food and other basic needs, such trade-offs are largely unthinkable for patients in Western Europe, Japan and Australia, a Times examination of international health insurance systems shows.

“‘We only have to worry about getting well,’ said Pieter Piers, a 57-year-old Dutch engineer who was talking with his family doctor this year about work-related stress in Gorinchem, a walled city in the table-flat farmland of southern Netherlands… ‘If I had to worry about how to pay for it all, I don’t think that would be very helpful for getting better,’ said Piers, one of dozens of patients and physicians worldwide interviewed for this story, including at clinics and hospitals in Germany, Britain and the Netherlands… The Netherlands, like many wealthy countries, mandates that visits with primary care doctors are free so patients won’t be discouraged from seeking care…

“By contrast, as deductibles in job-based health plans in the U.S. have more than tripled in the last decade, half of Americans who have coverage through an employer say they or close family members have put off going to the doctor or filling a prescription because of cost in the last year, according to a nationwide survey conducted for this project by The Times and the nonprofit Kaiser Family Foundation.

“One in six covered workers has had to make a difficult sacrifice in the previous year, including taking on extra work or cutting back on food, clothing or other essentials, the poll found… In the Netherlands, just 1 in 90 households faces catastrophic health spending that competes with necessities such as food and housing, a recent World Health Organization analysis of patient spending in three dozen countries found… In Ireland, Britain, Sweden, France, Germany and Japan, fewer than 1 in 35 households had medical bills that threatened their financial security.

“The financial struggles of American patients have prompted renewed calls by some Democrats for a government-run, single-payer system, or ‘Medicare for all,’ as it is sometimes called.” Los Angeles Times, September 17^th. Germany even funnels its entire government-supported system through private insurance carriers!

“About 27.5 million Americans, or 8.5% of the population, lacked health insurance last year, according to the Census Bureau. That’s up from 7.9% in 2017… The Japanese enjoy the longest average lifespans of anyone in the world (83.7 years). South Korea is No. 11 on the World Health Organization’s life expectancy list. America is a distant No. 31… Citizens of nearly every other developed country live longer than we do and pay less for healthcare. That alone says we could be doing much better.” LA Times. Seriously. 

              I’m Peter Dekom, and while I do not know how you feel about all this, I’m betting that “America can”!