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Misanthropic healthcare: the U.S. model

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Headlined to H2 3/7/12

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Both left-wing activists and right-wing conservatives have a tendency to defer to near mythical idealogical principles that formed the core of the United States.  But the "founding fathers" and "American ideals" that these continual references point to are such broad and scattered concepts that their employment serves only the most shallow rhetorical purpose. The idea that at the conclusion of the Constitutional Convention, the general population was in such noble accord with the spoon-fed magnanimity of the original planners is ignorant at best and idiotic at worst.

We can examine assertions made by James Madison during the Secret Debates of the Federal Convention of 1787.  He understood that "the man who is possessed of wealth, who lolls on his sofa, or rolls in his carriage, cannot judge of the wants or feelings of the day laborer" and that "if electons were open to all classes of people, the property of the landed proprietors would be insecure."  He went on to argue for a Senate that would "protect the minority of the opulent against the majority" which was overwhelmingly made up of "day laborers" which, today, cannot be uttered without mention of the condition of blacks and latinos.  (1)

The point is that it has always been a struggle between Haves and Have-nots. The Haves want the freedom to consolidate their power and the Have-nots want the freedom to eat, educate their children, and survive. An attempt to accuse me of hyperbole would be, in contrast to my previous indictment, ignorant at best, but fraudulent at worst.  In 1981, 8% of American families filing for bankruptcy listed medical bills as the primary reason.  In 2007, this number jumped to 62% according to a study published by Harvard researcher David Himmelstein, M.D. (2). We have to keep in mind the subsequent financial collapse and burst of the housing bubble since then.  The question that needs to be asked is for what racial/socioeconomic groups are medical expenses so costly that they lead to bankruptcy?

Another Himmelstein study in 2009 connected the lack of health insurance to 45,000 U.S. deaths per year.  Basically, you're more likely to die when you're uninsured--40% more likely, to be accurate (3).  Well that makes sense if you subscribe to basic principles of logic.  And I'm also reasonably certain that you don't have access to life, liberty, and the pursuit of happiness when you're dead, but I could just be brainwashed by the elite agenda of the liberal media.  Logic aside, this becomes a moral issue when you consider that 50 million Americans--a cautious estimate--are uninsured according to a recent Census Bureau report.  Furthermore, 21% of blacks and 31% of hispanics are uninsured compared to 11.7% of whites (4).  Uninsured means being without health insurance which is a radically different concept from being without a flat-screen TV or a Range Rover.  It is unfortunate that we have to be constantly reminded of this so as to wash away the infectious sermons of free-market demagogues.

Numbers like these don't immediately conjure "genocide."  But let's take a look at the Rome Statute of the International Criminal Court which defines the " crime of apartheid " as " inhumane acts"committed in the context of an institutionalized regime of systematic oppression and domination by one racial group over any other racial group or groups and committed with the intention of maintaining that regime " (5).  We cannot call the U.S. example a crime against humanity, but this definition is an enlightening one especially when we look at "Health care as an instrument of Apartheid policy in South Africa" which was published by Oxford University Press in 1986.  It was written by Max Price, a medical doctor that is currently the vice-chancellor and principal of the University of Cape Town in South Africa.  He recognized that health policies in South Africa were "instruments of the state in achieving Apartheid goals."  Price asserted that "health services aid in the reproduction of of the Black labour force according to White economic needs" and that "the provision of health care for Blacks"is geared towards the urban population as the supplier of a large and increasingly skilled Black workforce, rather than the Black population at large."  He concluded that the Apartheid regime's health policy was aimed towards "reproducing the conditions of capitalist accumulation and maintaining White supremacy" (6).  The analogy to the United States is illustrated by the relationship of dominant managers and financiers with the dispossessed and disenfranchised laborers and wage earners.  When you commodify healthcare, the obvious outcome is that the rich will have more of it.  Life and vitality and thus franchise become unequally distributed.  Like gravity, this imbalance propagates itself.

But how do we complete the analogy to "reproduction of the Black labour force according to White economic needs"?  We just have to examine the sudden and recent entrance of "universal health coverage" into political discourse.  We might be fooled into thinking that it reflects a recent change in popular opinion brought about by the financial collapse and a more progressive mindset.  But the truth is that government-sponsored medical coverage has been a prominent public concern for three decades (7) (8).  What changed?  Why did it take so long for democracy to take effect?  Well that's a loaded question because it never did.  It was sharply rising pharmaceutical costs making it financially difficult for auto manufacturers such as General Motors to provide health coverage for their employees.  And when a juggernaut such as the American auto industry cries for help, Washington listens (9) (10).  When poor laborers need healthcare, it isn't a big deal.  When corporations can no long afford those laborers, then it's a big deal.



Healthcare in a democracy by Healthcare for America

We need to remain vigilant against comparisons between healthcare and other market goods because those two are ultimately what government and Big Pharma want you to equate.  The idea that wealth affords one luxury consumer items is not--I don't think--a pressing concern for the general population. It is one thing to enjoy the comforts of back-yard suburbia and the safety of police protection while inviting the scorn of those yet to climb the socioeconomic ladder to middle class comforts.  It is another when you're a guest at upscale inpatient hospital facilities such 11 West at Mt. Sinai Medical Center in New York that are available only to the most premium patients that require lobster dinners, imported linens, marble baths, and butler assistance while at the sickbed (11).  Health services have a more visceral and intangible appeal to human beings than material items.  This is not the same as nastily waving a Macbook Air in the face of some poor inner-city kid still going to the public library.  It is a perversion of international standards of human dignity.  It's depressing.  And it's American.

(1)  http://avalon.law.yale.edu/18th_century/yates.asp

(2)  http://www.ncbi.nlm.nih.gov/pubmed/19501347

(3)  http://pnhp.org/excessdeaths/health-insurance-and-mortality-in-US-adults.pdf

(4)  http://aspe.hhs.gov/health/reports/2011/CPSHealthIns2011/ib.shtml

(5)  http://untreaty.un.org/cod/icc/statute/romefra.htm

(6)  http://heapol.oxfordjournals.org/content/1/2/158.abstract

(7)  http://www.kff.org/healthreform/upload/7871.pdf

(8)  http://www.fair.org/index.php?page=3633

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