Healthcare in America — Past, Present, and Future

In the ages before money became king, people took care of one another the best they could

Even if they only had herbs, magic fetishes, and rituals, in addition to feeding and bedding the sick. When greater healing powers arose with the ascent of modern medicine, sadly King Money had, by then, taken power, and – from then on – care became rationed by how much a person or family could pay.

When the prospect of public backlash against rising inequality became threatening to the moneyed ruling class some 80 years ago, the New Deal was implemented in our United States to appease the desperate masses. In due course, social security, unemployment insurance, workplace safety laws, the G.I. Bill, and other measures created America’s Golden Age where many dreamed and even lived the dream of homeownership, and where (at least among whites) a single wage earner could take care of a whole family through a single and usually quite secure job, allowing his or her partner to stay home and take care of the kids and maybe some elderly or sick relatives, as well. Anxiety had been defeated. People could expect living wages and a decent life from the cradle to the grave. It was the American life depicted in Hollywood movies and envied across the world — a life where everybody was… just happy.

Even African Americans, many returned freshly from war, had cause for hope to join the new American Dream of prosperity within reach of everybody. The civil rights movement advanced much in that direction. Unfortunately, attempts to return to a health care that covers everybody only got as far as establishing Medicare for the elderly and Medicaid for some members of society who suffer from exceptional handicaps, such as low-income children and the severely disabled. The rest of Americans, unlike people in other industrialized nations, had to put up with private health insurance companies.

While the New Deal allowed a lot of Americans to live more decent lives, the plutocrats had, unfortunately, never been removed from power by the New Deal, and – unable to impose moderation on themselves and blind and indifferent to the economic, political, and social devastation caused by their greedy actions – they soon went on a counter-initiative.

Private health insurance – over the years – became ever more profit-obsessed, employing dirty schemes, like denial of coverage for those with pre-existing conditions, so one could pay into one’s insurance for years or decades, then suffer a medical emergency, lose one’s job as a result, thereby also lose one’s health insurance, and then be blocked from renewing insurance, except if it excluded coverage of the now “pre-existing” condition, as well as any number of the most remotely-related conditions. Any other kind of employment change could trigger this dirty trick, as well. For example, as a university student, I suffered a minor internal disease. After I graduated, my insurance – obtained via the university – ended and the insurance company offered to re-insure me privately for an unpayably high premium and, yet, would have excluded any kind of internal organ coverage in the renewed insurance contract. The system was set up to take in a lot of money, but deny giving back as soon as the need arose.

Visitors from Europe were dumbfounded witnessing uninsured people — a concept totally alien to them.

In 2003, Representative John Conyers (D-MI) introduced the bill H.R. 676, often called “Medicare for All.” The bill had 49 cosponsors in 2015 (38 current) but has never been debated to date. It would expand Medicare to the non-elderly to provide universal coverage, allow all individuals to select their own physicians, and expand Medicare’s 80% coverage of costs to 100%. The bill would create a single-payer system, with Medicare replacing the 1,300 private insurance companies currently plundering us. Based on various estimates, it would reduce net costs by anywhere from $100 billion to $350 billion annually, largely due to catching illnesses early.

With so many of our political “representatives” being in the pockets of health insurance corporations and Big Pharma (and with medical interest groups also doing their part to keep the fees providers can charge at an insanely high premium), “Medicare for All” was allowed to gather dust on the shelf and, in 2010, President Obama signed into law the Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) and nicknamed Obamacare. It ditched the single-payer concept of Medicare for All (as well as the public option, both empty campaign promises of Obama’s), left exorbitant pharmaceutical and medical pricing intact, and shielded the private insurers from public competition — but, at least, it resulted in more insured Americans and put a stop to the heinous pre-existing conditions scheme. To add insult to the injury of still denying us Medicare for All, it also imposed a mandate: people who have no employer-based coverage (for example victims of unemployment) have to privately insure themselves whether they can afford it or not or else suffer a stiff penalty at tax time. Hurray! (I have been in that privileged position. Boy, was I happy.)

Even though the ACA was essentially an adaptation of Republican Governor Mitt Romney’s state health care plan and a pretty good deal for health services plutocrats (especially with that ugly mandate), Republicans promised for the next seven years to repeal “Obamacare.”

Then, recently — after a member of the plutocracy (Donald Trump) bought himself the presidency and lots of “Democratic” seats in Congress (and the states) went to Republicans last November over the late, but wide, realization that the “Democratic” party has stopped being a workers’ party — the repeal attempt was finally made and – last Friday – fizzled in the House of Representatives, at least, for now.

We should be glad it fizzled, for it wasn’t so much a health care bill as a WEALTH care bill. As I wrote last Thursday in an article titled The True Purpose of Trumpcare, the bill primarily was structured to give huge tax cuts to the richest of the rich in our country, while kicking millions of Americans off coverage — 24 million by 2026, with 14 million of them losing coverage by next year. The nasty mandate was to be not exactly abolished, but rather changed into an even weirder one (see the article). As I calculated last Wednesday in another article, the 14 million insurance losses alone would have – by a very conservative estimation – sent a minimum of 13,500 people to an early grave by next year (and hundreds of thousands in the years to follow). Somehow, this consideration rarely figured in the analyses I read and heard from others. I wonder why. Does nobody care about human lives anymore?

That estimate, by the way, does not take into account the many more casualties resulting from Medicaid cuts, defunding Medicare, and the fact that most people losing their insurance under Trumpcare would be old people, by nature much more likely than others to die from loss of health care access. It would have been a massacre, a massacre for profit, and it still may be, if it’s resurrected.

So, where should we go from here? Well, Medicare for All, of course! In 1995, Taiwan surveyed other countries to see which health program was the best upon which to model its own national program and it fixed upon our Medicare system as the most cost-effective model. Taiwan now has a national health care plan based on our Medicare. Polls show that the majority of Americans would like to have the same. The only thing keeping us from implementing Medicare for All is the greed of Big Pharma and the health insurance industry. It is high time that we shift the focus of our nation’s policies from stuffing the 1%’s offshore bank accounts (in places like the Cayman Islands) to thinking of the 99% who do the actual work in our country and are struggling to survive.

There is an hour-long documentary (and a much shorter excerpt from the same, just 2 minutes 40 seconds), explaining why Medicare for All would be not only so much more ethical and a great relief for Americans, but also a great relief for American business, currently burdened with having to provide overpriced health care for employees (instead of being able to just focus on business), and also a great relief for doctors who could stop jumping through endless hoops with private insurers in order to get paid. Doctors would be enabled to focus on patient care instead.

Our inefficient, unaccountable, overpriced, profit-driven health care system is an albatross around our business sector’s neck, a point I used to make long before it became popular to promote universal health care. It is, in fact, only the profiteers within the health care market who see profit in this awful system of ours. They leech off everyone, including their fellow plutocrats in other industries. In the meantime, they make many of us working class people suffer and die. Europeans look upon us with incredulity and our Canadian neighbors look upon us with pity from the bottoms of their hearts.

Domestic critics deplore Medicare for All as a “government takeover of health insurance.” People who haven’t been brainwashed by decades of plutocrat propaganda realize it would be no different than government-run parks, police, fire departments, or military defense — all things best handled by a government accountable to the people, rather than by profit-seeking leeches, whose goal always is to take as much money as possible and deliver as little as possible in return.

The goal of health care shouldn’t be to inflate corporate profits. The goal of health care should be to provide health care to people. It’s in the name: CARE. You can’t do a good job with that if you prioritize money over the well-being of people.

It’s really a no-brainer. We need to push for wide support of H.R. 676 as the best solution. A variant would seem to be Bernie Sander’s Medicare for All proposal. It took a progressive candidate (Bernie Sanders) speaking out on the issues which move us all, to get the idea squarely on the table of our public discourse. Now we must keep pushing for it until we get it.


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