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Fortunately, I was at work today and missed much of the bruhaha about the Supreme Court’s decision to entirely uphold the Health Insurance Corporation Enrichment Act(aka Affordable Care Act aka Obamacare aka Romneycare), and to strike down one of the few incrementally progressive things about it, which was mandatory Medicaid expansion. I heard enough on the way home on NPR, once I got home on the CBS Evening News, and read enough right here on FDL in the last few minutes.
The debate over “health care reform” is not even about health care itself. It’s over health care insurance. That’s a completely different thing. The key question is this: Is health care a fundamental human right in the biggest and wealthiest country that humanity has ever produced or not? For me, the answer is a simple YES. Period.
There are plenty who disagree with me and say so. But if you think health care is a right, as I do, then you must recognize that this whole debate over Obamacare completely avoids my question. Obamacare’s not about providing truly affordable and quality health care to all Americans, it’s about requiring all Americans to either be poor enough to qualify for Medicaid, which is woefully underfunded, purchase private for-profit health insurance(which still has no cost controls), or pay a fine(or a tax, as SCOTUS put it), to the federal government. So, as others have pointed out(hat-tip to Obey), if you’re too “rich” for Medicaid but too poor to buy private health insurance you get fined by the IRS.
How is any of that health care? It’s not. And how did we get to this screwed up situation in the first place? Well, there’s a simple answer: Capitalism.
Capitalism is all about making a profit. That’s it. Health care is all about treating sick and/or injured people and maintaining people’s health. That’s it. You can’t have both, not for everyone. Not even for most people, and as far as I am concerned even if the system worked for most people that’s still not good enough because quality health care is a right. America has tried to do so and has failed miserably.
You want health care for everyone? Then HAVE health care for everyone. There are several different ways to do it, but not one is capitalist. Not one. You have to ditch the profit motive to have truly universal health care. And you won’t hear that in our corporate media or from our corporate politicians.
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Great minds think alike. For more detail on the bigger picture, see Alan Maki’s post:
http://my.firedoglake.com/alanmaki/2012/06/28/supreme-court-rules-in-favor-of-the-health-insurance-and-pharmaceutical-industry-bailout-and-profit-maximization-act-of-2010/
and crown thy good with brotherhood from sea to shining sea …
“The debate over “health care reform” is not even about health care itself. It’s over health care insurance.”
Exactly. That point has been made at FDL repeatedly, not today so much, but in general.
Missing is that insurance is only as good as the providers who will accept it and that most assuredly includes Medicaid.
If you want an insurance system that guarantees affordable coverage for everybody, then providers HAVE to accept it. You can’t do that in a truly capitalist health industry, either.
I wasn’t trying to belabor a point, BTW, just pointing out you won’t hear anything like this on the M$M. And maybe to torpedo a few cheerleaders.
“Affordable” does not even belong in this debate simply because “primary health care” is the most important aspect of health care.
Primary health care is the most important aspect of health care for everyone because it is both preventive medicine and detects problems that might be corrected if caught in time. Plus, often, it makes other medical procedures less expensive if everyone has access to primary health care.
Primary health care is cheaper to provide people with than public education or water/sewer systems and no-fee primary public health care centers should be as conveniently located as the local public elementary schools.
Tax-payers already subsidize all health care in this country in one way or another whether through research on pharmaceuticals, colleges and universities that train doctors, researchers and scientists; the subsidization takes place through tax-abatements and all kinds of tax write-offs. All the public infrastructure associated with hospitals and medical clinics paid for by tax-payers.
The entire medical establishment profits directly from tax-payer subsidies in one way or another.
All these people from doctors on up who profit from the private for-profit health care system talk about “democracy” but they refuse to put their rotten, immoral profit-driven health care system up for public debate alongside a National Public Health Care System.
One need only watch as every sector of the health care system “lobbies” the politicians for what they want.
Doctors who are having problems collecting their outrageous fees as they have to stand in line behind pharmaceutical companies, hospitals and health supply companies to wait for their payments from the bankruptcy courts are now clamoring for a “medicare for all” system provided “private delivery” remains central to their demands… so, these doctors now want the government to pay their outrageous fees which they consider to be “affordable.” And this is where the problem begins as it works its way up throughout the entire health care industry/establishment.
I would advise everyone to spend a day in U.S. Bankruptcy Courts to see first-hand how all of this works. It is really very sickening.
I would like to provide a link to what people have to go through with medical expenses as they struggle to save their families and their homes.
This is a real life experience— one of many similar— we fought on Minnesota’s Iron Range— the Appalachia of the North:
http://foreclosuremoratoriumnow.blogspot.com/
OK, fine, PRIMARY health care, then. Though then I could ask you to define “primary,” but I quibble.
As for bankruptcy, I once had to file bankruptcy for the simple fact that I could not afford to pay $50,000 for my then-wife’s medical bills, so I’ve already been there and done that.
Don’t be too hard on all the doctors, though. Many people go into medicine out of the genuine desire to help others, but when they are saddled with a 100 grand or so of student loans to pay off they are easily sucked into the capitalist health industry and charge as much as they can to try to get out of their own debt. In short, many are trapped by the system into working for the system, and both banks and health insurance companies make money off of them and their labor.
Of course, I think education should be a right, too, but that’s another issue.
I have no health insurance.
What I have is an elaborate and costly bet that I won’t loose my home if I should become sick.
This bet costs me 12,090.00 a year.
I pay $7254.00 and my employer pays $4836.00.
On top of which, I have a $5,000.00 deductible.
A doctors visit which used to cost me a $30.00 co-pay, now costs about $350.00.
So basically, I don’t go to the doctor, which is the intent of the ‘plan’, but if I do get very sick, I probably won’t loose my house.
So I got that goin’ for me.
Well stated Alan. Concur completely. Recommending this.
At this point anyone who remains blind at will or due to being politically lazy about what Barack Obama is doing as POTUS deserves four more years of Barack Obama in the WH. To which soon comes the wails of “oh but Mitt Romney will be worse” or ” but the SCOTUS picks will be bad with Romney”. Like Barack Obama is not doing what Mitt Romney would have done as POTUS since 2009. This Obama WH / DINO / INC./D Party sponsored piece of junk called ACA is just that — junk.
It keeps the money conveyor(s) in place for AHIP and PhARMA and will help keep the Big Five**( see below ) American For Profit Health Insurers where they want to be — at the gate collecting our money for admission to this American healthcare carnival they have been putting on since WW2.
As Alan so very well puts it in his MyFDL diary above the conflict between capitalism/profits and human dignity/well being is not going away with this ACA being put in place. Barack Obama let AHIP/PhARMA pay to play during 2009/2010 to keep or get what they wanted from WashingtonDC. Barack Obama and the DINO INC. Party deserve all the credit for this being so as he was the one American in the Oval Office and the DINOS were the AHIP/PhARMA enablers who could have called BS. POTUS Obama did not.The DINOS did not.
This ACA charade was/is the warm-up for the coming Obama/DINO INC. gutting of SS/MC post Obama’s November 2012 winning of the WH again. Again — those who vote for Barack Obama deserve what Obama most assuredly will be giving them.
At some point the bad politics just become so stinked up that the whole rotted mess collapses into itself. Too many Americans still are too willing to put up with the stench coming from the D INC. and R INC. UNiParty tag teams. Medicare For All or VA For All were two already working,proven USG real health care alternatives to more of the AHIP pillage/plunder we Americans think is “healthcare” when it is “health insurance done for profit” which is not about doing equal access healthcare but about profits.
Barack Obama is not stupid nor is Mitt Romney. They know what they are doing. The rest of us Americans? This so called “win” for ACA is anything but a win for most of us unless you are a happy One Percenter or never get sick or need healthcare or are so far into the American Underground Economy that whatever the USG does is not touching you anyway.
Thanks Alan Maki for doing what you do. Stay with it.
** Big Five AHIP members — WellPoint,Cigna,Aetna,Humana,United Healthcare
Primary health care is essentially what you get when you go to the family doctor, a “med center,” “urgent care,” the “eye doctor” for an exam and for glasses, a dentist, a pre-natal clinic, etc.
I agree with you about the medical education aspect which I think is part of the whole scam involving health care.
I’m not slamming doctors as people but rather as a profession which is part of the corrupt health care system.
There are lots of very good doctors in this country but the problem is they get dragged into a rotten system and I don’t see too many in a hurry to become engaged in real change.
My point wasn’t to make a blanket attack on doctors nor to ignore the good they do. But, I do think we need to point out that the entire health care system is so thoroughly rotten from top to bottom.
I don’t feel in the least apologetic for what I have to say about doctors because doctors are very engaged in politics… perhaps more so than any other profession and they impart their mostly reactionary views on a daily basis to their staffs and patients.
I was once waiting to talk to United States Senator Donald Riegle about health care. His office door opened and standing in the door was a family doctor. I heard him say to Riegle, “I was more comfortable with you as a Republican and was sorry to learn you switched to the Democrats. Riegle responded, “Doc, we still share the same views. I need you to help me. You get to talk to a lot more people on a very personal level than I do. You have their confidence. I need you to help make sure our health care system remains the best health care system in the world.”
A few weeks later, Riegle ordered U.S. Federal Marshals to remove me from a public hearing on health care because what I might say might cause disruptions.
Ironically, as a result of Federal Marshals throwing me over tables and chairs the nightly news focused on the message I was going to deliver about the need for a National Public Health Care System while only a room full of people heard the American Medical Association lobbyist tout U.S. health care as “affordable” and “the best in the world.”
Never mind the cost of health care and the problems with the quality of health care at the specialized and hospital levels… if you don’t have a regular doctor or dentist, good luck trying to get a doctor or dentist off the golf course when you are in pain… especially if you don’t have an insurance the doctor or dentist knows they can profit handsomely from.
Doctors and dentists routinely refuse to treat people if they know certain insurance companies pay their claims slowly and there is no way Obamacare will correct this. And… as insurance premiums continue to soar under Obamacare with insurance companies paying out slower and refusing to pay the higher and higher fees doctors are demanding we are going to be seeing doctors and insurance companies fighting one another over the profits and once again, we the people will suffer.
This is where this rotten system of greed leads and for sure the American Medical Association— which I have yet to hear in any public forum any doctor condemn for its thoroughly reactionary views— speaks loudly and clearly for all doctors.
Even the PNHP refuses to challenge “private delivery” of health care because they know they would lose 95% of their support from doctors and professors in the health care field.
Liberals, progressives and leftists were wrong to allow PNHP to dominate the campaign for health care reform because even those like Margaret Flowers refuse to support:
1. Public financing.
2. Public management and administration.
AND…
3. Public delivery of health care.
In fact, when people are given the opportunity to support one or another health care system— among ALL options— they will choose the National Public Health Care System:
- no fees of premiums.
- comprehensive.
- all-inclusive.
With primary health care paid for with a pay-roll tax on workers and employers just like Social Security and the government will just have to stop funding these dirty wars and tax the hell out of the rich to pay for hospitalization and all specialized health care.
We simply can’t afford the high cost of Wall Street’s for-profit driven health care any more than we can afford Wall Street’s highly profitable wars— and guess what? The extremely rich who have made their most money from health care and wars are going to have to be taxed until they squeal like the pigs they are.
I have yet to hear anyone explain why we shouldn’t operate a health care system in the same way as public education.
Is there any reason a primary care physician should be making more than a public school teacher or why a surgeon should make more than the professors training them?
Who put these doctors so high up on a pedestal and made them better than the rest of us? The American Medical Association— the same group opposed to the best health care system that will meet our needs: a National Public Health Care System.
“Is there any reason a primary care physician should be making more than a public school teacher or why a surgeon should make more than the professors training them?”
1) Yeah, to become a primary care physician, you need to go to medical school for 4 years, which is $200k+ plus residency time. That and to be honest, not everyone is cut out to be a doctor, the standards are very high. Teacher? Less tuition money required and lets be honest here, the standards to become a teacher aren’t very high.
2) Its not necessarily true that surgeons make more than their professors. Often times, their professors have private practices themselves and I don’t think university pay is all that shabby for medical professors.
Ohio Barbarian — not sure how this happened but a comment I thought I was placing on Alan Maki’s current MyFDL same topic diary thread somehow landed in the comments thread to your equally very good MyFDL same topic diary. Hence the dislocated in context use of Alan Maki’s name in my comment on your comments thread.
I am multi-tasking so was away from the computer for a bit and had just returned now to scan FDL again. At first I was nonplussed as to where my comment was. Now have found it. :-)
Scratches head ……..had not even been drinking any Canadian Club…yet.
I do want to apologise for this. No slight was intended. As it is you and I often seem to share pov’s and are on the same page politics wise here at FDL (I think?) so at least my comment is not where it will be readily savaged as it might be at some addresses here at FDL… Now I will go over to Alan Maki’s comments thread and do a fix there.
Liked your MYFDL diary Ohio Barbarian equally well… this ACA SCOTUS decision was well staged Kabuki. Anyone who thought AHIP/PhARMA did not want the Mandated ACA component was a willing dupe of the R vs. D FlimFlam UniParty tag team play this ACA fully is.
Please. Can we stop using the term “mainstream media”? They are anything but mainstream. They are the media for the 1%. I will rather use the term “lamestream media” – kudos to Sarah Palin for once for the term. Though we might differ on the reason behind the term.
I agree with you post Barbarian. Unfortunately I do not see this happening until the vast majority of this planet is forced back into another dark ages and the back of privilege is completely broken once and for all.
Like I have stated, the education is part of the entire health care scam.
The American Medical Association has been involved in a a system of “rationing” doctors for years to keep high costs (high profits)surging upwards.
Doctors in Canada make far less than their U.S.counterparts and doctors in Cuba seem to be very satisfied making about the same as a teacher.
Open up the medical schools to working class youth instead of the wealthy privileged few and we will find many young people willing and eager to serve humanity as doctors instead of dropping bombs on people in other countries who are simply fighting to be free from imperialist domination.
I would be willing to bet tens of thousands of working class youth would much rather be serving humanity as primary care physicians at $50K a year instead of invading and occupying other countries.
It will be a great day when we see billboards and posters in this country proclaiming “Uncle Sam wants you to join his army of doctors to keep people well and fight diseases.”
In Canada working class youth can afford the cost of a medical education and Quebec students are fighting to keep university and college tuition down.
How many working class youth here in the united States get medical degrees to become primary care physicians let alone surgeons? As you have pointed out the cost is prohibitive.
A big part of what is wrong with health care in this country is most doctors don’t know what it is like from their own personal experiences to have to go without healthcare because they can’t afford it. As a result, we don’t even get any empathy from these doctors.
Great points, Alan.
Especially about physician pay vs. teacher pay. I think in some Nordic countries, they are actually on par with each other. I think the same applies in Japan, as well.
Standards are higher for a doctor and doctors do indeed go more in debt which justifies a greater salary. To say, however, “the standards to become a teacher aren’t very high” is just utter bullshit. Why do conservatives and liberals agree on the need to dump on teachers? To teach even in grade school requires first a Bachelors degree followed by “post-grad” education and expenses. If one is “lucky” enough to get and keep a teaching job one faces constantly being dumped upon with additional tasks by those who have never taught, having promises for higher pay in return for higher education broken, and paying for class supplies. If he thinks it is so easy and the standards are not very high, someguy66 is welcome to try and become a teacher.
Hey Ohio, great to see you posting again. It’s been awhile. I’ve been pretty invisible myself… lots of non-writing things going on.
Your “Health Insurance Corporation Enrichment Act” had me looking for other names. For example, how about the Help Elite Insurers Sustain Themselves (H.E.I.S.T.) or the Health Insurance Profit Empire (H.I.P.E.).
Health care, and even health insurance, is not just a right; it is, or should be, the very essence of government and society. A healthy society should be built on the idea of shared risk and shared benefits. If we allow private ensurers to profit from our desire to act humanely towards one another, we all lose. There should be no profit to be made from sharing the risk of ill health. Insurance should be a function for government. Capitalism exploits our humanity; socialism endows it.
It’s easy to view discussions of health care in the narrow frame of providers, insurance companies and the other elements of the formal health care infrastructure. The broader picture, however, sees the connection between dis-ease and the stressful, malnourished, worked-to-death, chemically-laden, gmo’d lives we lead. Capitalism’s evil pervades far more than just the medical world. It spews its poison into seducing too many of us away from living in a healthy manner. Want fries with that? It poisons our air and our water and our food. It turns us into no-free-time work slaves.
What motivates today’s power elite? Is it to use government to build a more health-oriented infrastructure? Is it to help our fellow citizens become the healthiest in the world? Of course not. It’s all about greed and profit for some and all about a let-them-eat-cake for the rest.
Recommended.
Very bad logic, sir. You simply make the case that both teachers and doctors should be held to very high standards and have an affordable high standard education, such as is done for teachers in Finland, for instance. How do the Finns manage? Oh, I guess they gave up on ruling the world, silly Finns.
The care doctors are able to give to their patients or the education teachers furnish their students should not be part of the profit/derivative scandal that is Wall Street today, in which only the high rollers win. This country is very sick, but it is beginning to realize that tummyache might just be something more serious. And where are the physicians for that? Not in either crony capitalistic political party hogging the podiums, that is evident. No, the stratosphere’s just fine for both of them.
As OhioBarbarian points out, this is American capitalism today, in which everything, even health, is a commodity and can be sliced and diced and offered on the market. To the point where more and more people lose homes, jobs, healthcare, education because it has all evaporated into the stratospheric jet stream where the 1% cavort and gamble.
Perfectly fine for rich people to gamble. Very sad when poor people do and lose their life’s savings in an instant. And criminal when the rich reach down into the pockets of the poor to feed their insanity. That’s anti-social. That’s mis-anthropic. That’s even a threat to human survival on the planet. And the misbegotten health insurance plan Obama gave birth to as the shining product of his presidency is a placebo to preserve the status quo.
Nice Juliana,
I was going to drop the “f” word as in Finland as well. But you did it for me.
Recommended. As with Alan’s recent post OB, I agree with you.
Do also read caleb36′s diary ‘Supreme Disaster.’ There’s a lot here which doesn’t immediately meet the eye.
We are now hearing Obama’s apologists saying because rightwing politicians like Rand Paul and Mitt Romney oppose Obamacare that Obamacare and the U.S. Supreme Court’s ruling upholding it must be good.
Opposition from Rand Paul, Romney and the Republicans aside, this legislation is patently unconstitutional because it forces and coerces people to purchase insurance from PRIVATE FOR-PROFIT insurance companies.
It would be constitutional only if people were being forced to purchase health insurance from a government owned co-op or public enterprise.
This is the bottom line. We should be defending the Constitution not backing out of this fight simply because these right-wingers are opposed for other reasons.
Just because a bunch of right-wing politicians are opposed to something doesn’t make it right— ethically, morally or Constitutionally; nor does their opposition mean that this Obamacare will work, because it won’t.
For starters, does anyone really think that the few good parts of this legislation will be adequately financed? If so, dream on— because right now Barack Obama, the Democrats and the Republicans refuse to adequately fund VA, the Indian Health Service, Medicaid, Medicare and the National Public Health Service as city, county and state health care services and agencies have had their budgets slashed while Planned Parenthood goes severely underfunded.
Obama and these Wall Street politicians aren’t going to adequately fund any health care programs when they have these costly imperialist wars to finance which are so profitable to Wall Street coupon clippers just like what they expect to make with people being forced to buy insurance from them.
War and health care are two rackets managed by the same Wall Street crowd and we pay the bill for both as they profit.
When all is said and done we are getting screwed again.
Plus this most undemocratic, unconstitutional and obscene ruling from the United States Supreme Court intended by Roberts to provide Mitt Romney with never ending ammunition now until election day has opened the door wide to allow the government to force people to purchase many other “social programs” from private for-profit corporations and it places Social Security in jeopardy. If you can be forced to purchase health insurance from private for-profit insurance companies will the next step be forcing people to purchase retirement accounts from these same insurance companies as the Social Security fund is turned over to a consortium of private insurance companies to “manage?”
I know someone who it appears buys auto insurance when he needs his plates renewed and then dumps it. I wonder if it’d be possible to do this around April 15th. Could we have a national petition to get on the ballot “If I’m going to be taxed, can I buy me some Medicare?”