Posted on 07/19/2017 8:41:57 AM PDT by Incorrigible
For now, at least, the health-care fight in the US is over. The Senate bill replacing president Barack Obama's Affordable Care Act has collapsed after two more Republican senators withdrew their support, leaving the ruling party without a majority. Senate majority leader Mitch McConnell is proposing to repeal Obamacare entirely, with a two-year delay so his party can negotiate a new bill, but several Republicans oppose that too.
That leaves the US with Obamacare, whose signal achievement was to cut by 20 million (pdf) the number of Americans without health insurance; the Republican plan would have entirely reversed those gains. But Obamacare still leaves nearly 30 million people not covered and, as Republicans complain, burdens middle-class Americans with higher insurance premiums and the government with higher subsidies.
So why does the US, the only industrialized nation without universal health coverage, also have not only the highest health-care spending in the world - both in absolute terms and as a share of GDP - but also one of the highest levels of government spending on health care per person? And how did it come to be this way?
The answer is that the lack of universal coverage and high costs are intimately linked ”both economically and historically.
Single-payer health-care (in which the government pays for universal coverage, typically through taxes) helps keep costs down for two reasons: It means that the government can regulate and negotiate the price of drugs and medical services, and it eliminates the need for a vast private health-insurance bureaucracy.
Currently, the US spends two to three times as much per capita on health care as most industrialized countries.
Of this burden, an estimated two thirds falls on the government's shoulders, when one accounts for entitlements (Medicare and Medicaid), the cost of health insurance for government workers, and tax credits that subsidize private insurance plans for other people. "Most Americans have publicly funded health care," either in full or in part,says David Himmelstein, professor of public health at CUNY and author of the estimate. ""The government spends much more than other countries, but it's an opaque system." The government's role is mostly to subsidize the astronomical costs set by the for-profit market.
Many Americans think their system is expensive because it's very good. They are wrong: The US ranks 28th, below almost all other rich countries, when it comes to the quality of its healthcare assessed by UN parameters (pdf, p. 13).
When did the country diverge from other industrialized nations and, rather than offering universal health coverage, built up a system that relied on private insurance?
It wasn't one moment, says Karen Palmer, professor of health science at Simon Fraser University, but rather, ""a series of decisions, turning points, and cascading events." Though until World War I there had been some attempts by socially liberal governments to follow the examples of Germany and others, they were met with opposition from doctors, insurance companies, businesses, and even some conservative labor organizations, which considered state-sponsored health care paternalistic and unnecessary. Labor unions also worried that it would weaken their own bargaining power, says Palmer, as they were otherwise responsible for getting their members social services.
But the root of the current system, Palmer says, can be found in World War II. In 1943 president Franklin D. Roosevelt imposed an effective freeze on labor wages, and companies started offering health and pension benefits as a way to retain workers instead. This was the beginning of employer-sponsored healthcare, though there was no government mandate to offer it (except in Hawaii). Unions began negotiating the benefits as part of what they could obtain for workers. The rest of the population wasn't covered, but it meant the unions didn't put pressure on the government to create a public health system.
Another turning point, Palmer says, was an exceptionally successful campaign by Clem Whitaker and Leone Baxter, the founders of Campaigns, Inc."”"the first political consulting firm in the history of the world," as The New Yorker's Jill Lepore described it (paywall). On behalf of the California Medical Association, the two opposed California governor Earl Warren's 1944 plan to introduce compulsory health insurance in the state, paid for through Social Security. Lepore explains that their slogan, ""political medicine is bad medicine," was used to lobby newspapers (with which they had advertising relations) and the population against government intervention in matters of health. They reminded people that what they called ""socialized medicine" was a German invention"”it came from the same country American soldiers were fighting abroad.
According to Lepore, after successfully halting the reform in California, Campaigns, Inc. used a similar strategy - this time on behalf of the American Medical Association - to block president Truman's 1949 proposal of a public health plan. Their campaign, which included riding anti-communist sentiment to terrorize people against the specter of "socialized medicine" and "convincing the people [...] of the superior advantages of private medicine, as practiced in America, over the State-dominated medical systems of other countries" successfully turned popular support against Truman's plan.
This rejection of universal health coverage as a form of "collectivization" or "bolshevization," says Theodore Brown, professor of public health and policy at the University of Rochester, had begun several decades before. In the 1910s, right-wing politicians, medical professionals, and representatives of the medical industry opposed attempts to broaden national health coverage on the grounds that it was a Soviet-inspired concept"”an objection that gained force after the Russian revolution.
That sentiment, Brown believes, is still alive. Despite knowing well that a single-payer healthcare system is the only sustainable long-term solution for creating broader coverage without skyrocketing prices, he says, even advocates of single-payer like Nobel Prize-winning economist Paul Krugman consider it (paywall) politically unfeasible.
The result is that American doctors and the medical industry benefit from a system that pays them significantly more than doctors elsewhere - although, taking into account the cost of medical studies in the US, their standard of living isn't necessarily that much higher.
Contrast this with Britain, which in 1948, as the country was patching itself up from World War II, introduced the National Health Service (NHS). The reform wasproposed during the war, and was based on the principle that health care for salaried workers and their dependents needed to be provided by the state, as it wasn't coming from businesses. This request, led by the Labour party, found an ally in the UK's need to guarantee the survival of a number of voluntary hospitals that had been opened during the war and risked failing without government support.
Throughout, however, "if there is one overarching explanation" for why the US doesn't have universal health care, "it is that there hasn't been a labor party in the US that represents the working class," Himmelstein says. Palmer agrees: "It is the core value of the labor party to bring social solidarity."
The Democratic party has ties with unions and includes those who believe in European-style welfare policies. But it always had a strong pro-business soul which prevented it from focusing primarily on the needs of the working class. One reason no true labor party has emerged is that no large portion of US society considers itself "working class." As Bruce Vladeck, a researcher with Mount Sinai Medical Center, noted in a 2003 paper in the American Journal of Public Health, "in the United States, everyone selfidentifies as middle class." Therefore, the labor movement isn't large enough to demand welfare reforms such as universal health coverage.
Further, Brown says, the labor movement is fragmented, containing a range of views on both healthcare and on other issues. The wide-scale demonization of socialist ideas took place within the labor movement, too, which progressively moved toward the center.
Even in the progressive eras of presidents Kennedy and Carter, while there were some attempts to pass universal health care, none was successful. They were blocked by the American middle class's association of public programs with charity, as well the by-then powerful insurance and medical lobbies dedicated to opposing not-for-profit care.
Inequality and segregation have also played a role. The lack of universal health-care coverage tends to be hardest on racial minorities who, being more likely to be poor, are more likely to be on welfare. The Atlantic's Vann Newkirk notes that the the battle for black civil rights and access to health care have historically been close; the introduction in 1965 of Medicare and Medicaid (government insurance for the poor and the elderly, respectively) struck a powerful blow against segregation, since it channeled federal funds to hospitals and thus, under the Civil Rights Act passed a year earlier, banned them from discriminating on the grounds of race.
However, African Americans are still the most likely to be uninsured. According to the Kaiser Family Foundation, as of 2015, 12% of the black population and 17% of Hispanics were uninsured, compared to 8% of whites.
Despite the evidence that a single-payer system would be a more efficient and cheaper choice, introducing it in the US is not a serious option. Trying to dismantle the current system would be a mammoth task. For one thing, it would cost a great many jobs: Health- and life-insurance companies employ some 800,000 people, with yet more employed by the medical industry just to deal with insurance companies. Though the savings from eliminating them could be invested in retraining those people for other professions, it would be difficult for any party to convince voters that it's a necessary step.
And with a market worth more than $3 trillion, drug firms, medical providers, and health technology companies have an incentive to maintain a system that lets them set prices instead of negotiating with a single government payer. Both the GOP and the Democratic party are under the influence of the medical-industrial complex: In 2016, hospitals and nursing homes contributed over $95 million to electoral campaigns in the US, and the pharmaceutical sector gave nearly $250 million.
The popularity of Bernie Sanders and his single-payer health care model during the 2016 Democratic primaries, however, is a signal that more Americans are open to the idea. Certainly more than in 1993, when Hillary Clinton, then first lady, was heavily criticized for her attempt to push a universal coverage plan.
Gallup's polls suggest that after a few years of skepticism Americans are again warming up to the ideathat health care should be a government responsibility. But the power of anti-socialist rhetoric is such that people's views vary a great deal depending on how the question is asked, Palmer points out. When asked (in April 2017) by YouGovwhether they'd want to expand ""Medicare for all" (pdf), 60% answered positively; when asked (in June 2017) about introducing "single-payer" health care (pdf), only 44% agreed.
The two questions are "essentially the same from a policy perspective," commented Don McCanne, senior fellow at Physicians for a National Health Program. "But the layman hears the first question as being the expansion of Medicare to cover everyon... whereas the second question is about single payer, government, and taxes."
The Republicans' failure to pass their health-care law seems to confirm a prediction made early in the Trump administration: that once people had had a taste of increased health-care security with Obamacare, they wouldn't easily forget it. "One of the unintended consequences of [the Republican reform],"says Palmer, "is that people are feeling more threatened." But universal care? That's still a big leap.
I would argue that many don't feel any additional security with Obamacare, especially if they weren't paying anything to begin with; i.e., those on Medicaid.
For those that ARE paying for their healthcare, I would say we feel less secure, knowing that they're paying an ever-increasing amount for care, and in many cases they question whether or not they should see a doctor at all. "Is that pain something serious?" they wonder. "Is that migraine normal, or just something I can take some pain reliever to handle?"
In a single-payer system, people will have a sense of security, knowing the government will give them all the healthcare they need...until the government doesn't. The word "ration" won't ever be mentioned in their doctor's offices, but they will happen.
I forgot to mention this above, cause the article doesn’t get into it - medical research. No one in the world comes close to matching us in terms of research into procedures, drugs, etc.
The only possible exception to this is Israel, who has universal health care with good research. But I would hazard a guess that more works only because they’re small, very homogenous, and don’t have the same ideals of freedom/individuality as we do.
Nothing about Israel makes sense. It does function in many ways as a family, which is far different from the typical functioning of a nation-state.
If your idea of speaking delicately and kindly is being an asshole I’d say you need to rethink your approach.
As a side note to this thread from related threads …
As patriots read the following material, please bear this in mind. Smart crooks long ago figured out that getting themselves elected to federal office to make unconstitutional tax appropriation laws to fill their pockets is a much easier way to make a living than robbing banks.
Speaking of US healthcare history, patriots are reminded that the states have never expressly constitutionally delegated to the feds the specific power to regulate, tax and spend for INTRAstate healthcare purposes. (Neither have the states constitutionally authorized most other domestic social spending programs that the corrupt feds are now running.) This is because the Founding States had given the care of the people uniquely to the states, not the feds, evidenced by the 10th Amendment. (This is also evidenced by the excerpts at the bottom of this post.)
Sadly, voters have only themselves to blame for the unconstitutionally big federal government on their backs imo.
More specifically, corrupt federal politicians seized the opportunity provided by the ill-conceived 17th Amendment (17A) to get themselves elected. Politicians used 17A to exploit citizens by “promising” low-information voters federal social spending programs, programs that the feds never had the constitutional authority to establish.
And since such voters had evidently never been taught about federal government’s constitutionally limited powers, misguided citizens swallowed the bait on such promises, unthinking using their voting power to unconstitutionally expand the federal government’s powers by electing such politicians — scam city; caveat emptor.
And with the exception of the US Mail Service (1.8.7), even though the states otherwise uniquely have the 10th Amendment-protected power to establish the social spending programs that the feds are now illegally running, the states cannot afford to run their own programs. This because the feds have been effectively stealing state revenues by means of unconstitutional federal taxes, taxes which the feds use to run their unconstitutional spending programs.
In fact, when low-information state lawmakers, and likewise constitutionally-challenged state officials, brag about winning federal grants for budget-starved state social spending services, food stamp and welfare programs great examples, not only can it be argued that state officials are actually recovering state revenues stolen by the feds when they receive “federal” funding for these services, but also consider this.
The corrupt feds typically use such funding to unconstitutionally expand the fed’s powers by requiring the states to comply with unconstitutional federal regulations in order to receive such funding.
Again, big-time scamming by a corrupt, unconstitutionally big federal government.
Are we having fun yet? :^P
Drain the swamp! Drain the swamp!
Since corrupt Congress is the biggest part of the swamp imo, it is actually up to patriots to drain the swamp in the 2018 elections, patriots supporting Trump by electing as many new members of Congress as they can who will support Trump.
In the meanwhile, patriots need to make sure that there are plenty of Trump-supporting candidates on the primary ballots.
Patriots need to qualify candidates by asking them why the Founding States made the Constitution’s Section 8 of Article I; to limit (cripple) the federal government’s powers.
Patriots also need to make sure that candidates are knowledgeable of the authoritative clarifications of the federal government’s limited powers listed below. They are excerpts from the writings of Thomas Jefferson, previous generations of state sovereignty-respecting Supreme Court justice, and Rep. John Bingham, a constitutional lawmaker. These excerpts should help patriots to better understand big-time corruption in the federal government.
Regarding Obama’s justices bluffing that the Obamacare insurance mandate is constitutional for example, consider the fifth entry in the list from Paul v. Virginia. In that case the Court clarified that the scope of Congress’s Commerce Clause powers does not include regulating contracts, including insurance contracts, regardless if the parties negotiating the insurance contract are domiciled in different states.
"Our citizens have wisely formed themselves into one nation as to others and several States as among themselves. To the united nation belong our external and mutual relations; to each State, severally, the care of our persons [emphasis added], our property, our reputation and religious freedom.” —Thomas Jefferson: To Rhode Island Assembly, 1801.
"Congress is not empowered to tax for those purposes which are within the exclusive province of the States.” —Justice John Marshall, Gibbons v. Ogden, 1824.
"Inspection laws, quarantine laws, health laws of every description [emphasis added], as well as laws for regulating the internal commerce of a state and those which respect turnpike roads, ferries, &c., are component parts of this mass.” —Justice Barbour, New York v. Miln., 1837.
”... the care of the property, the liberty, and the life of the citizen, under the solemn sanction of an oath imposed by your Federal Constitution, is in the States, and not in the Federal Government [emphases added].” —Rep. John Bingham, Congressional Globe, 1866. (See about middle of 3rd column.)
"4. The issuing of a policy of insurance is not a transaction of commerce within the meaning of the latter of the two clauses, even though the parties be domiciled in different States, but is a simple contract [emphases added] of indemnity against loss.” —Paul v. Virginia, 1869. (The corrupt feds have no Commerce Clause (1.8.3) power to regulate insurance.)
"Direct control of medical practice in the states is obviously [emphases added] beyond the power of Congress.” —Linder v. United States
"From the accepted doctrine that the United States is a government of delegated powers, it follows that those not expressly granted, or reasonably to be implied from such as are conferred, are reserved to the states, or to the people. To forestall any suggestion to the contrary, the Tenth Amendment was adopted. The same proposition, otherwise stated, is that powers not granted are prohibited [emphasis added]. …” —United States v. Butler, 1936.
Patriots also need to make sure that federal candidates on the 2018 primary ballots, unlike the current RINO-controlled Congress, will be willing to use Congress’s 14th Amendment power to strengthen constitutionally enumerated rights when states abridge those rights, strengthening 1st Amendment-protected religious expression for example, when misguided, pro-LGBT states enforce Christian-hating policies.
What I meant was we have a unique Constitution based upon God-given natural rights and liberty. Does anyone else, for example, have the equivalent of our 2A for the purpose of resisting tyranny?
I don’t believe anyone else really does.
If there are some that even come close to what we have been blessed with, then I stand corrected.
And also Israel (like a lot of countries) gets big foreign aid from us. They can afford to divert money into non-mil stuff when they are subsidized on the mil side
Wow! You should submit that as an article to one of the popular conservative news websites!
The author of this drivel seems to be unaware of the Veterans Administration, a marvel of “single-payer” sloth and corruption.
Because she’s on the verge of figuring it out on her own. Why interfere with that process?
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