Healthcare and the quest for majority rule

The healthcare debate, for all its pomp and circumstance, exemplifies the inherent incompatibility of capitalism and democracy as ‘money versus wellness’ heads into the final round of what has been a knock-down, drag-out fight ever since the days of Clinton.

While democrats jockey for position on a potential public option, republicans deny that anything is broken, reflecting a swath of American society suffering from acute cultural narcissism. The conservative right has been able to virtually halt progress on healthcare reform with an argument loosely grounded in their party’s defense of “free-market economics”. Having already failed to produce results by President Obama’s August deadline, democrats struggle to unify on message in what should have been a bipartisan effort against corporate tyranny, the heart of the healthcare industry beast.

Only in a nation helplessly addicted to self-congratulations can you assert that the American healthcare system is the best in the world while keeping a straight face. In an attempt at proving this otherwise baseless claim, right-wing pundits repeat the truism that foreigners often fly here from all around the world in search of the best medical care on earth. Sure, wealthy patients can readily find access to the best American healthcare money can buy, but in question is the accessibility of quality care for the vast majority of American families.

The uniquely American evolution of employer-based health insurance has resulted in soaring administrative costs for these giant insurance companies, prone to poor corporate structuring and top-heavy mismanagement. While these providers clamor on about the unfairness of a government-run competitor, the age-old tradition of denying coverage has reached new heights of broken contracts and ethical misconduct. These insurers claim the need to tighten policy restrictions in response to sharp systemic increases in medical costs. U.S. hospital systems then point to the insurance providers and their perpetual practice of non-payment for their own need to raise prices. Then, the pharmaceutical industry chimes in with its self-justified overcharging of American consumers since profits from international prescription drug sales simply do not generate enough capital to sustain the rising expense of research and development. These costs, in turn, add to the already inflated insurance costs, and the spiraling cycle is born, self-perpetuating: an infinite cacophony of blame and expenditure.

The American system of doctor-patient care, while predictably the most expensive on earth, has become shamefully mediocre when compared with other superpowers. The U.S. ranked 37th according to the World Health Organization’s global analysis of healthcare systems conducted in 2000. France, often mocked for its nationalized universal healthcare, has its single-payer system ranked first. With the United States far out-pacing its economic rivals worldwide, allowing tens of millions of its own citizens to struggle without even basic health coverage is a far cry from the American Way once held sacred by the patriotic mass majority.

After World War II, France was joined by the United Kingdom, Canada, Australia and the Netherlands, installing government-run healthcare systems, providing everyone the necessary medical care they needed, plain and simple. This collective and natural progression for Western democracies to embrace “socialized medicine” had much to do with the devastating effects the war itself had on national economies. The whole of Europe was simultaneously faced with hundreds of millions of unemployed people, many injured or sick in a post-war setting of unrivaled human suffering.

With governments acting as “middle-man”, these sovereign countries were able to negotiate costs on behalf of their citizens. During the 64 years since WWII, those same governments haven’t had to endure the price gouging that American citizens contend with regarding prescription medications, primary care visits, hospitalization, rehabilitation, physical therapy, psychiatric care, etc. The very notion of a middle man siphoning one-third of every dollar spent on healthcare is an abysmal waste of spending that should have every fiscally conservative American sick to their stomach.

Purchasing power is immediately disabled in the U.S, and costs are subject to unconstrained inflation for the sake of unfettered privatization. With an unemployment rate hovering around 10%, the affordability of healthcare for tens of millions of Americans currently out of work equates to a fiscal nightmare for all parties involved. Because our government does not step in and negotiate costs on the front-end (as with the single-payer program), it then has to sacrifice even more local, state and federal tax dollars attempting to provide safety nets for the unfortunate droves of jobless Americans.

We The People have been decidedly unwavering when it comes to the concept of universal healthcare since polls on the topic were first introduced. The sense that this is some newly empowered push by Marxists is beyond reproach. Cries of “socialism” have laced the rhetoric of tea party protests, and president Obama has falsely been accused of being a radical leftist.

The fact remains: Obama has been painfully moderate on nearly every issue the Democrat party stands for, and clearly seeks to align himself with centrist policies during his presidency. It is in this same vein that the president has pushed so vehemently for what has come to be known as “ObamaCare”.

In hindsight, perhaps if the president had initially taken a more liberal stance in calling for a single-payer system of universal healthcare, he could have negotiated himself into the compromising position of a mere “public option”, which may or may not get the ultimate congressional nod at this point.

If the public option is successfully defeated from the Senate bill, Obama will have to chalk up a loss that will factor heavily in his bid for re-election, but the failure will not be his alone. It will be a failure of our entire system of governance. Before long, our slow devolution into “corpocracy” will be academic. The unending quest for capital gains continues to prevent true democracy from coming to fruition when private investors are left to steer our collective efforts of legislative health reform. All this has more to do with the need for “lobbyist reform”, since fixing the healthcare system would be a far easier task were it not for special interest groups and their persistent obstruction of legislative justice.

Another example brought to light by the World Health Organization was the Total Health Expenditures report resulting from a five-year international study conducted from 2000 to 2005. Calculating the percentage of gross domestic product being used for the purposes of medical treatment in all its forms, the U.S. came in second place spending over 15% of its GDP on healthcare.

We can pretty much claim top dog on that one, as first place went to the Marshall Islands, whose population happens to be less than the number of Philadelphians jammed into the Linc on any given Sunday. This trajectory of super-spending for a C-average health system is unsustainable, at the family budget level as with federal tax coffers.

Ironically, conservative policy wonks cite "over-spending" and "bureaucratic mismanagement" as what they oppose about the bill currently on the floor of the Senate. Given that these ideas are exactly what the health system is up against, one would expect some fresh ideas from a Republican party self-designed on fiscal conservatism.

Unfortunately, defeating Obama over healthcare reform has become the driving force of right-wing political theory of late. This was summed up in July by Senator Jim DeMint (R-SC) who told one reporter, "if we're able to stop him on this, it will be his Waterloo. It will break him."

The elephant in the room continues to be "cost control" (or lack thereof), putting the “hell” in healthcare. Having long since discarded all talks pertaining to the single-payer model, the last beacon of hope for upsetting the meteoric rise of healthcare costs lies with the cantankerous public option.

Struggling to breathe on the Senate operating table, the public option itself may now be a victim of rationing, in need of immediate end-of-life counseling. The very backbone of the House bill is now “subject to change”, as Republicans and conservative democrats rally around the divisive issues of federally-funded abortions and illegal immigrants being allowed to buy into the exchange cooperative.

Meanwhile, Senate Majority Leader Harry Reid (D-NV) appears to be signaling an alternative to the public option, hoping to ensure the 60-vote filibuster-proof majority that democrats are so determined they can accomplish. In so doing, Reid threatens to further dilute what has already become a watered-down version of universal healthcare, a distant echo of socialized medicine.

While 51 votes will get the bill passed back to the House for approval, Reid and the DNC rightfully fear an absolute stoppage of play on the floor of the Senate if the bill is forced into debate-status. Knowing that 60 has become a magic number of sorts, moderate Senators find themselves at the heart of the debate, such as Joe Lieberman (I-CT) and Olympia Snowe (R-ME). Both have rallied against the public option: Snowe insisting states could opt out of the program when the bill was being considered by the Gang of 6 last month; Lieberman promising to oppose any final version of the Senate bill that includes a public option in any form.

In response, Reid has asked democrats to come together behind his proposal of a private, non-profit company to be run by the federal Office for Personnel Management, similar to the health plans now in use by federal employees. Additionally, an expansion of Medicare would allow for Americans to receive benefits at 55, shaving ten years off of today’s minimum age of eligibility. There will still be an exchange where self-employed, unemployed and small business workers can pool their resources, allowing for competitive group discount to filter through to those uninsured by a large corporate employer. Abortions will not be covered, unless in the event of rape, incest or a threat to the life of the mother, by anyone electing to benefit from this impending reform package.

Most importantly, the bipartisan consensus is solid against the further denial of coverage due to a patient’s pre-existing medical conditions. This practice had skyrocketed over the last few years, while 60% of all personal bankruptcies in the U.S. are due to a patient’s inability to pay medical bills.

The U.S. economy can no longer absorb the status quo of an American healthcare system that continuously widens the gap of cost/benefit analysis. With the ailing economy on the forefront of everyone’s mind these days, both bills promise to remain deficit-neutral.

Decades of polling reveal a consistent majority of Americans standing firmly on the side of universal healthcare dating back to World War II. Whether or not that same majority will get to witness democracy in action remains to be seen, but one thing is certain: the insidious defects of our American system of government will make themselves known in the coming weeks. As is too often the case, the politicization of an otherwise simple act of democracy has conflagrated into a healthcare debacle fraught with obstructionist propaganda.

The American pastime of partisan pugilism will attempt the further mutation of what-could-have-been history in the making. Now is the time for Congress to stand-up against party-line bickering, advance on the insurance conglomerates, strike dead the very concept of “coverage denial” and bring industry-wide costs well within reason, by any legislative means necessary.