Monday, October 19, 2009

ARCHIVE: The Revolution will not be medicalized: The real reason we don’t have single-payer universal health care

by Kellia Ramares
[This essay was originally published on Cyrano’s Journal Online on July 9, 2009]
THERE SHOULD NOT EVEN BE A DEBATE OVER SINGLE PAYER.  All of the objections to it are a bunch of baloney.

Waiting times: I remember my dying grandmother stooped over her cane in agony while waiting hours for Montefiore Hospital, a prestigious private hospital in the Bronx, to find a bed for her – in 1964. And insurance wasn’t an issue; they just didn’t have the space. Surely everyone who has been delayed or denied approval for care from an insurance company knows the waiting time issue is a red herring. Maybe doctors would have more time for their patients if they didn’t spend hours dealing with insurance companies.
Freedom of choice: Yeah, you can have any doctor you want, so long as he or she is in your insurance network. If the doctor is out of network, you pay through the nose. Some freedom!
The government can’t afford it: Well, if we shifted our priorities away from bailing out banksters and waging wars, we could afford it easily. Why is it that we can throw trillions of dollars at bailouts and bombs but we can’t afford health care for all?
Socialized medicine: This argument is the biggest hoot. First of all, so what if single payer were socialized medicine? If you want to talk about efficiency, as the people against single payer are wont to do, then let’s talk about the inefficiency of having the capitalist system, which was designed to provide goods and services, based on profitability, attempting to provide services for everyone, based on need. The process doesn’t work well because capitalism was never designed to provide for everyone based on their needs. Trying to shame, cajole, sue or entice it to work that way only results in inefficiency at best and injustice at worst.
Several years ago, I saw a newspaper photo of a black women in a Third World country; she was wrapped in a white sheet and sitting in a wheel barrow on the street. She had been put out of the hospital she had been in because she could no longer afford to pay for her care. In the United States, we would rightly consider such treatment barbaric, and then hypocritically hide our own barbarism in myriad bureaucratic maneuvers to deny a patient access to the hospital in the first place.
Secondly, we shouldn’t react as if we don’t already have socialized services in America. We have plenty of them: police and fire services, street lights, libraries and public schools to name a few. If they aren’t working as well as they should, at least part of the blame can go to the anti-tax attitudes of the last thirty years, which have led to underfunding. So single-payer health care would not be the first time we had a public service available to all, funded by the taxpayer i.e. socialism.
Lastly, single payer wouldn’t really be socialized medicine under a Medicare-for-all type of program. Only payment for services would be socialized. The actual rendering of health care would remain private. The practices and facilities that are private now would not become government-owned and run.
The Real Reason
The focus on all of these issues hides the real reason why single payer has been stymied. The real reason is that a “Medicare-for-all” system would put the private health insurers out of business. Corporatists and their bought politicians cannot allow the insurers to be run out of business because it would set a dangerous (to them) precedent of having a society decide that certain types of industries heretofore wearing the respectable label of “legitimate business” do not have an automatic right to exist.
If that happens, then what comes next? As food activist Michael Pollan, author of The Omnivore’s Dilemma and In Defense of Food, points out, many of our health problems in America have their sources in food. For example, a triple-chocolate cake sent to me as a gift last December contained, according to its ingredient list, silicone and propylene glycol, the latter a substance also used as a solvent and as anti-freeze. Ingesting those kinds of substances cannot be healthy if one is not a car. Will a society that has the temerity to abolish health insurance companies then totally revolutionize its food system to run the purveyors of artificial and toxic “edible food-like substances,” to use Pollan’s term, out of business? (Monsanto, watch out!)
Once we break free of the notion that any particular industry is entitled to existence, will we then to finally repeal corporate personhood, stating what should be the obvious: that corporations are things that human beings have created to aid in performing certain functions. They are not our masters who have rights that can trump those of flesh and blood people. Single-payer health care could be the snowball that could start the avalanche that flattens and buries corporatism.
Imagine such a thing because I can assure you that the corporatists have. And the thought makes them sweat. It’s is not simply a matter of lost near-term profits. It’s a matter of control — permanent control — over our lives, money and choices.
The “public option” sell-out of single payer is allegedly a form of competition for the private insurance industry. Under capitalist theory, industry works more efficiently, innovation is fostered, and consumers have more choices when competition is promoted. But what do you want to bet that the “public option” will draw the poorest and sickest people, i.e., those who under the current system are deemed uninsurable, or who can’t afford what insurance they could get, leaving the prime customers, i.e., the young, healthy and well-off people who will make fewer claims, to the private companies. The public option will be underfunded in these “hard times”, and the mainstream media will sniff everywhere for stories of how people on public insurance had to wait for their care (to reinforce the “private good – government bad” brainwashing), while stories of private insurance companies delaying or denying care will be buried, sometimes along with the patients.
The only true health care reform is universal single-payer health care. Health insurance is a scam! Public option is a sham!
Kéllia Ramares, 54, a freelance journalist in Oakland, CA, is and has been uninsured most of her adult life. She has worked a variety of temporary, part-time and freelance jobs that did not offer insurance. She asks: Why should your access to health care depend on what kind of job you have? She can be reached at