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THE HEALTHCARE BATTLE IN THE UNITED STATES CONGRESS

by David Osborn, MH, L.Ac
Tuesday, August 8, 2017

Why Is Securing Quality Healthcare for Americans So Difficult?

The Political and Economic Picture

Of all the major industrialized nations of the world today, the United States is probably the only nation that does not guarantee healthcare to all its citizens.  We spend more than any other advanced nation on healthcare, yet have worse outcomes for all the money we spend.  In spite of the astronomical prices we pay for all aspects of healthcare in America, there are millions of people who are uninsured or underinsured, and obesity, diabetes, heart disease and other chronic and debilitating conditions run rampant and unchecked.  In my travels, the foreign nationals I encounter constantly wonder why the United States has not been able to adequately tackle what they see as nothing more than the basic accounting and management problems presented by the task of providing sufficient healthcare to all.  For sure, the roots of America’s current healthcare crisis reach deep into the American psyche, into a primitive, unreasoning fear of what many see as the specter of socialized medicine or a “government takeover of healthcare” a propaganda line that was promoted by Ronald Reagan and others back in the ‘60s.

Healthcare is like a political football that keeps getting tossed back and forth on the shifting tides of America’s political fortunes.  We had a pretty good public healthcare system in the Affordable Care Act, also known as Obamacare during the previous administration, but now that the Republican Party is in control of the presidency as well as both houses of congress, they seem to be hell bent on destroying Obamacare.  The only reason why they have not been able to repeal the ACA (Affordable Care Act) is due to the massive, vehement protests of ordinary citizens who would face dire health consequences if the ACA were to be repealed.  In spite of all the Republican rhetoric and cynical double-speak about “the nightmare that is Obamacare”, the simple fact is that Obamacare has indeed saved lives.  The so-called alternative healthcare plan that the Republicans are trying to slap together, in a desperate effort to get something – anything – passed, which they have named the American Health Care Act (AHCA) has only about a 17% approval rating among American voters.  So why are the Republicans so persistent in the face of what would seem to be surefire political suicide?

Traditionally, the Republicans are the party of big business interests and the economic elite, whereas the Democrats have traditionally been the party of the working class.  In recent years, however, a flood of corporate money into our political system has corrupted both parties and made them more beholden to the corporations and the super-rich than they have traditionally been, affecting the Democratic party as well as the Republicans.  The Republican-led “Reagan revolution” of the 1980’s introduced the idea of “trickle-down economics” – that giving more money to the super-rich and the economic elites would enrich the whole economy as the corporate executives would then invest that money back into their business enterprises.  But in one form or another, over a thirty-plus year period, “trickle-down” has failed to work, and the reason for this is not hard to figure out for any intelligent person who is willing to do some sincere, objective reflection:  If the aggregate consumer demand for the goods and/or services that the corporations provide is not there, simply investing money to expand operations and create jobs will not pay off.

This leads us to the economic truth that consumer demand, which is supplied by the middle and working class, is the real engine that drives economic growth.  Put another way, give a rich person some extra money – which they don’t really need – and they will do one of three things: lavish spending on luxury items, stashing that money in an offshore or tax exempt bank account, or wagering it on the stock market casino in risky investments of questionable worth.  But give a middle or working class person some extra money and they will pump it right back into the economy by buying needed goods and services.  These economic realities may run counter to traditional conservative values like self reliance and the Protestant work ethic, but what works, works, and sooner or later these realities must be accepted if we are really serious about fixing our economy.  In other words, to heal our economy, and our healthcare system, which is roughly one-sixth of it, we must take money from where it is not needed and put it where it is needed – back into the hands of ordinary consumers to drive economic growth.

Due to terrible Supreme Court decisions like Citizens United, the floodgates of corporate money have been opened, and this “dark money” has had a corrupting influence on both major political parties.  But since the Republican party has traditionally been the party of big business and the economic elite, they are the ones who are most corrupted by, and beholden to, the super rich and the big corporations.  And so, the Republicans hardly seem to do very much anymore, legislatively speaking, unless there is some big tax break or giveaway to the corporations or the super rich involved.  This so-called “American Health Care Act” that they are trying to ram through congress is actually a pseudo- “health care” act – it’s actually a bill that, at its core, decimates and makes massive cuts in the Medicaid program, which is probably the single largest healthcare provider to poor and working class Americans, and gives that money in massive tax cuts to the corporations and the super rich.  And no matter how they try to dress it up, no matter what kinds of changes they may make to it to make it more politically palatable, this basic core they will not change.  It’s really a tax cut bill masquerading as “healthcare”.

Obamacare was funded mainly through a small or modest increase in taxes on corporations and the super rich – and now the top 1% and the big Republican political donors want their money back.  As proof of this underlying agenda, Republican leaders speak of the urgent need to repeal and replace Obamacare so they can get on to other pressing business – the first item of which is what is euphemistically called “tax reform”.  So one way or another, through this pseudo “healthcare” bill, or more openly via “tax reform”, the super rich and the Republican political donors fully intend to get their money back, and the people be damned.  In reference to the current healthcare crisis, a recent political cartoon highlighted the main difference between Reagan era Republicans and today’s Trump Republicans:  The Reagan Republicans were into coming up with all kinds of convoluted explanations as to why “trickle-down” economics would benefit everyone, whereas today’s Trump era Republicans are much more cynical and direct, saying, “I’m cool with you dying” to the lower classes.  The nonpartisan Congressional Budget Office estimates that at least 16 million people would lose their health insurance under the current Republican plan, and of those, at least several thousand will probably die.  This makes healthcare a more visceral, “hot button” issue than anything else in American political life.

From Reason to Religion: Am I My Brother’s Keeper?

There is a deep, irrational fear of “socialism”, “socialized medicine” and “a government takeover of healthcare” in the American psyche; perhaps it is a relic of the McCarthy era communist witch hunts, perhaps it is due to the rugged, independent American frontier mentality or the pioneer spirit – or a combination of all the above.  So, whenever a group of legislators gets together with a sincere desire to improve the healthcare lot of the American people, as they did in the previous administration with Obamacare, or the Affordable Care Act, there arise irrational fears in the American psyche.  During the Obamacare fight, conservative politicians were constantly invoking the specter of government-run “death panels”, being completely oblivious to the fact that there were actual death panels in the existing healthcare system in the form of health insurance company officials who continuously denied health insurance coverage to those with pre-existing conditions.  “Don’t pull the plug on grandma!” they would cry out.  These irrational fears have robbed them of the mental clarity needed to figure out that the whole idea of insurance, in which risks and liabilities are spread out among the masses, and in which the many take care of the unfortunate few, is basically a socialistic concept.

The Affordable Care Act was a good start in reforming America’s healthcare system, but it didn’t go nearly far enough.  Some of the worst abuses of the private, for-profit health insurance companies were eliminated, like denying coverage to those with pre-existing conditions, but it still left those same private, for-profit health insurance companies in charge of our healthcare system, without any competition from the government – the foxes were still guarding the health care henhouse, so to speak.  Obama and democratic legislators in congress refused to even give a single payer healthcare system or a public option to provide competition to the private, for-profit health insurance companies, and so keep costs down, a fair hearing.  Solving America’s healthcare crisis is essentially very, very easy.  We already have a government-run healthcare system for those aged 65 or older called Medicare, and even as it is, it has run remarkably well, and is one of the most liked government programs for elderly and retired folks.  Now, any third grader with halfway decent math and computational skills could see that making Medicare available to all and having a larger risk pool, with younger and healthier individuals paying into the system as well as older people, could only put Medicare on a sounder actuarial footing.  Just one thing stands in the way of this eminently simple solution – the incredible financial might and political power of America’s private, for-profit health insurance companies.

Whether it’s insurance or religion, the socialistic concept of taking collective care of the less fortunate finds a universal voice and advocacy.  Quite early on in the Bible, in Genesis 4: 9, “bad brother” Cain asks God, who is inquiring about his brother Abel, “Am I my brother’s keeper?”  And prominent theologians have argued that the whole rest of the Bible is God’s long, drawn-out answer in the affirmative.  The whole Christian message definitely culminates in the life and ministry of Jesus Christ, who went around the Holy Land giving free healthcare to everyone who asked for it.  “As ye have done to the least of my brethren, ye have done also unto me”, says Jesus in the gospel of Matthew; in other words, the basic moral and ethical yardstick by which a society and a nation can be judged lies in how it treats the least and the poorest among them.  This is diametrically opposed to the cynical, cold-hearted “I’m cool with you dying” stance of the cartoonist’s depiction of Trump era Republicans.  In one way or another, all the world’s great religious traditions answer Cain’s question to God in the affirmative.

Many states in the US have a law mandating that all drivers obtain car insurance – then what’s wrong with a mandate that all obtain health insurance coverage, since what is being covered is our physical or bodily vehicle, which is much more precious to us than any car?  Nevertheless, insuring one’s health is much more complex, and involves some difficult and thorny ethical issues.  More than the differences that exist between different makes and models of cars, individual differences among people and their health are much greater, and definitely no one size fits all.  And so, the factor of individual freedom and choice enters into the equation.  President Washington’s personal physician, Benjamin Rush, who was a signer of the Declaration of Independence, advocated for the inclusion of medical freedom, or freedom in healthcare, as a fundamental human right, but sadly, this was not given explicit mention or voice in our nation’s founding documents.  Although I may be a “bleeding heart liberal” on many other issues, I am most independent and in favor of individual freedom of choice when it comes to healthcare, and do not favor a blanket mandate of treatment procedures by the government.  Above all, I believe that an individual must be free to follow his or her conscience in matters of healthcare, just as with religion, and must also be free to choose the way of natural healing.

In the second part of my blog on the important and vital topic of healthcare, I will share and discuss my personal views and vision for an ideal healthcare system for America – and where the natural healing option and traditional healing systems like Greek Medicine fit into the picture.

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