Thursday, January 10, 2008

Health is a "civil right"

"What European countries definitely haven’t done is dismantle their strong social safety nets. Universal health care is a given. So are a variety of programs that support families in trouble, helping protect Europeans from the extreme poverty all too common in this country.(...) the next time a politician tries to scare you with the European bogeyman, bear this in mind: Europe’s economy is actually doing O.K. these days, despite a level of taxing and spending beyond the wildest ambitions of American progressives."
Paul Krugman - NYT
David Seaton's News Links
Health is a civil right, like the right to life or the right to vote.

I live in Europe, where we have socialized medicine. This means that the major hospitals are owned by the state. During at least half the day most doctors, even eminent specialists, are state employees. Medicines, even the most expensive, are heavily subsidized or totally free. Here the suffering of poor people in America without medical care, or the anxiety of the American middle class worrying about losing their jobs and thus losing their coverage is unthinkable. I read the "plans" the different American political "leaders" have to solve this suffering and humiliation and they remind me of the cynical and patronizing "separate but equal" justifications of the Jim Crow south.

The more I explore this painful and festering sore of scores of millions of Americans of all colors without adequate medical care, the more I am reminded of the political climate before the civil rights battles of the 50s and 60s. What seems totally missing, however, is the Martin Luther King or the Malcolm X to give it shape and words. Polar bears and glaciers have their Al Gore, but who is to lead a citizen's revolt against pain, sickness, humiliation and death?

You could say that the idea of some 40,000,000 Americans many of them of color, condemned to death and disease is even worse than the injustice of segregation, but the comparison is one of hope. The civil rights movement's successes means that even within the American system profound change is possible when enough people stand up and say, "this far, no farther." It can be done, it's been done before.

For someone who has no memory of what America was like before the civil rights movement, let me explain as quickly and brutally as I can what America would be like today if that movement had never existed:

  • Colin Powell would be a retired army sergeant.
  • Barack Obama's mother would be a pariah.
  • Barack Obama would be somebody's butler.
  • Clarance Thomas would be working in somebody's yard.
  • Condoleezza Rice would be teaching in a segregated grammar school.
  • Oprah Winfrey would be cleaning some white lady's house.
That America is so different today, that the lives of the above mentioned have turned out so differently, was not engineered by benevolent politicians, it was a conquest of the American people in the streets. It was all about marches, sit ins and riots. It cost pain, blood, jail time and lives. Cities burned and soldier's patrolled the streets, men were lynched. It was a movement. The politicians came trailing after making laws to recognize the facts created on the ground.

The result is that the America of today is barely recognizable to someone born into the America that was before. This means that things can be changed by people who won't accept "no" for an answer.

But make no mistake, this battle could be even harder and crueler. The battle against prejudice and discrimination was only really about customs and habits, it was fought in the context of the cold war where the Soviet Union used the plight of black people in the USA to its advantage in Europe and the Third World. Law makers knew that social inertia was the only real obstacle to dramatically improving America's self-image and its image around the world as a champion of freedom. It was simply good for business. For America's rich and the powerful little was really changed by allowing African-Americans full civil rights.

The battle for the right to health, however is about money, lots of money: higher taxes for the rich, much higher... like in Sweden. And the limits beyond which the wealthy of America will not go
in defense of their money, has yet to be discovered.

The money invested in the ideology necessary to fight socialized medicine in America is also limitless. This ideological task force that the oligarchy has deployed has even made the very words "
socialized medicine" taboo. Thus the successful system of countries like Britain, Canada, France and Germany is made to sound like something inefficient and subversive.

Politicians require huge amounts of money to get elected and those who sign the big checks don't want to pay the taxes necessary to pay for a health system similar to Europe's. I don't think anything meaningful will ever occur led by the men and women who owe their existence to our present system of campaign financing.

To get something like this done only a movement will suffice and I doubt if even a million uninsured children marching on Washington would be enough to melt the hearts of those weaned on a diet of Ayn Rand. It might take a general strike, the shutting down of America's huge transport system for a few days,
to bring it off.

This more than any other is work for grassroots activists and organizers: free health care for all is the true catalyst for change in the USA. Those who begin to organize this from the ground up are today's equivalent of the Freedom Riders that opened up the American south and ennobled an entire generation. DS

Paul Krugman: The Comeback Continent - NYT
Abstract: Why should Americans care about Europe’s economy? Well, for one thing, it’s big. The G.D.P. of the European Union is roughly comparable to that of the United States; the euro is almost as important a global currency as the dollar; and the governance of the world financial system is, for practical purposes, equally shared by the European Central Bank and the Federal Reserve. But there’s another thing: it’s important to get the facts about Europe’s economy right because the alleged woes of that economy play an important role in American political discourse, usually as an excuse for the insecurities and injustices of our own society. For example, does Hillary Clinton have a plan to cover the millions of Americans who lack health insurance? “She takes her inspiration from European bureaucracies,” sneers Mitt Romney. Or are top U.S. executives grossly overpaid? According to a Times report, Michael Jensen, a professor emeritus at Harvard’s Graduate School of Business whose theories helped pave the way for gigantic paychecks, considers executive excess “an acceptable price to pay for an American economy that he believes has outstripped Japan and Europe in growth and prosperity.” In fact, however, tales of a moribund Europe are greatly exaggerated.(...) Since 2000, employment has actually grown a bit faster in Europe than in the United States — and since Europe has a lower rate of population growth, this has translated into a substantial rise in the percentage of working-age Europeans with jobs, even as America’s employment-population ratio has declined. In particular, in the prime working years, from 25 to 54, the big gap between European and U.S. employment rates that existed a decade ago has been largely eliminated. If you think Europe is a place where lots of able-bodied adults just sit at home collecting welfare checks, think again. Meanwhile, Europe’s Internet lag is a thing of the past. The dial-up Internet of the 1990s was dominated by the United States. But as dial-up has given way to broadband, Europe has more than kept up. The number of broadband connections per 100 people in the 15 countries that were members of the European Union before it was enlarged in 2004, is slightly higher than in the U.S. — and Europe’s connections are both substantially faster and substantially cheaper than ours. I don’t want to exaggerate the good news. Europe continues to have many economic problems. But who doesn’t? The fact is that Europe’s economy looks a lot better now — both in absolute terms and compared with our economy — than it did a decade ago. What’s behind Europe’s comeback? It’s a complicated story, probably involving a combination of deregulation (which has expanded job opportunities) and smart regulation. One of the keys to Europe’s broadband success is that unlike U.S. regulators, many European governments have promoted competition, preventing phone and cable companies from monopolizing broadband access. What European countries definitely haven’t done is dismantle their strong social safety nets. Universal health care is a given. So are a variety of programs that support families in trouble, helping protect Europeans from the extreme poverty all too common in this country. All of this costs money — even though European countries spend far less on health care than we do — and European taxes are very high by U.S. standards.(...) According to the anti-government ideology that dominates much U.S. political discussion, low taxes and a weak social safety net are essential to prosperity. Try to make the lives of Americans even slightly more secure, we’re told, and the economy will shrivel up — the same way it supposedly has in Europe. But the next time a politician tries to scare you with the European bogeyman, bear this in mind: Europe’s economy is actually doing O.K. these days, despite a level of taxing and spending beyond the wildest ambitions of American progressives. READ IT ALL


antonymous said...

This is also going to another inevitable development. When looking at Europe, every country got a different version of "socialized medicine" as they all arrived at it in different ways. The struggle in the US is mainly about getting people to recognize their potential. Unfortunately the whole Anglo system is very much predicated by an almost total loss of community and even communication among people. A healthy protest culture like in France simply doesn't exist in Anglo countries where obedience toward the "authorities" is much more entrenched as an attitude.

David Seaton's Newslinks said...

I use the civil rights battles as an example precisely because it was a successful "people's struggle".

Anonymous said...

Civil rights was indisputably a moral imperative. That said, I think it's also beyond dispute that the world would be a much nicer place if Colin Powell reportedly of My Lai fame was a retired army sergeant and Condoleezza "smoking mushrooms" Rice was teaching in a grammar school.

Having a ample experience in the world of medical research, and having discussed this very topic with a confidant of a Nobel Prize laureate in medicine, who privately was disgusted by what passes for medical research, I'll say that the very last thing America needs is a complete government takeover of healthcare. There is NO dispute that such a step would allow the many disadvantaged access to more and better care. But there are huge hidden costs. The most pernicious, far and away, is that you wind up entrusting medical research to bureaucracies that as sure as night follows day set out to preserve their institutional prerogatives at the cost of their clients. If Europeans or Americans understood how bad the problem already is today, there would be riots. I firmly believe that depriving the FDA of its ability to make binding decisions - and thereby keep innovation out of the market (all too often for political and financial reasons) - and only allowing the FDA to make nonbinding recommendations would probably increase the life expectancy of your average American by 5 if not 10 years.

Ron Paul has his flaws, and may even sound a bit extreme in his desire to abolish as opposed to neuter the FDA, but by God, he does understand how destructive giving a single bureaucracy in far away DeeCee the right to deprive Americans of healthcare freedom is.

The problem with the United States is that the rich have managed to subvert the system to such an extent that the poor don't stand a chance; the problems go far beyond healthcare; pretending its only a healthcare issue will only compound the misery.

David Seaton's Newslinks said...

I really don't care that much about brilliant researchers finding amazing new cures for odd diseases: what I would like to see is good preventive medicine, frequent visits to GPs, prenatal care etc, etc, for "all".

Everybody has a doctor to treat them and all the medicines they need even if that means some loss of quality somewhere, which I don't think it really does. It certainly doesn't where I live.

potpourri_for_sixteen_hundred said...

Nobody said anything about "brilliant researchers finding amazing new cures for odd diseases."

I was alluding to brilliant researchers finding cures for common disease that either cause disability or death, and not being able to get through the medical industrial complex.

It was foolish of me, however, to not bear in mind that the state can provide a minimum level of care to those who need it, and still allow everyone to get unregulated care.

To some extent, we're both on the same page: the right to purchase the best possible and most appropriate treatment is a civil right, and shouldn't be able to be revoked by the federal government.

David Seaton's Newslinks said...

Take note that socialized medicine is not a charity operation for the poor.
In a socialized system private medicine takes a back seat. Obviously nobody gets a nose job on national health, but the public hospitals are first in line for resources. It is really about equality. It means that a rich person doesn't get better care than a poor person.

Anonymous said...

" It means that a rich person doesn't get better care than a poor person."

Is this really true? Don't the rich have enough money to buy additional care?

David Seaton's Newslinks said...

In Spain what it may mean is that the rich person can pay to have an individual room instead of a two bedder. A case where private plans may be popular is maternity, but for big stuff. This does not mean better quality medicine. My wife was operated on free of charge on the public system, by one of the top specialists in Europe.

In Spain when a patient in the private hospitals develops complications they put them immediately in an ambulance and take them to a public hospital, because the public hospitals have better equipment and more doctors on call.

This is really difficult for Americans to understand. They've got the bit about "Liberty", but not the part about, "Equality" or "Fraternity".

Note that the Spanish constitution guarantees the right to health and work and the right to organize and strike along with free speech, etc, however it doesn't guarantee the right to bear arms. I guess you can't have everything.

David Seaton's Newslinks said...

Typo correction:
People don't go to private medicine for really big stuff. Varicose veins, liposuction and nose jobs are done mostly, but not exclusively in private hospital. If a psychiatrist recommended plastic surgery, it could be done on the public system.

stunted said...

Another terrific post. I now live in the U.S. after 20 years in France, where I benefitted several times from the health care system in place over there. The innate suspicion of government regulation in America is breathtaking. The idea that government is bad and the private sector good, or at least better has taken on the weight of unquestioned fact. This allows racist nutcases like Ron Paul to be taken seriously as long as he squeaks about getting "the government" off the back of the "common man." All of the presidential candidates who even do address the health care issue are leaving private insurance companies in charge as providers, simply forcing those without health insurance to sign on to some existing private policy and this they call universal health care. It will take a huge shift in perception to get people in the streets to demand change and I think you are so right that it will demand great personal sacrifice. I just don't know that Americans will ever be ready to say "This far and no further" on this issue.

antonymous said...

re Ron Paul, I think he's something like (in medical terms) an abscess on the body politique ;) Some deep sickness opens up these pusbags..

And David is right, socialised medicine is always a mix between private and govt but each euro country has a different implementation. If only there were enough 'muricans to get their head around the fact how much their govt is spending on "defense" (privatised, haha) these are obscene amounts compared to what free basic treatments would cost.

Gary Sweeten said...

America could pay for health care if we did not spend billions to defend Europe so they can spend their money on themselves.

I have consulted with state hospitals and saw the waste, long lines and poor medicine there. All systems need help and change.

David Seaton's Newslinks said...

I agree that the United States should devote more money to the public health system and less to the military-industrial complex. I really don't think it would make an ounce of difference to Europe's security if we did.

And really if you study and compare statistics like longevity and infant mortality, you'll see that the medicine practiced in Europe is far superior to that practiced in the USA. Of course the social medicine in Europe could be improved, but the most important thing is that it exists. Health is a civil right to which all should have access and not a business.

Anonymous said...

Europe has actually been doing well over two decades--despite the supposedly "crushing" burden of taxes: