The European countries acting on behalf of Greece’s creditors are bullies. Americans are saps. And a group of sane doctors may get the right result for all the wrong reasons.
As is the bully’s practice, the more the Greeks concede, the more the bullies demand. To this point the bullying has worked (for the bullies) but now the country’s managers are in fear for their political lives, at least, so the country looks as likely to default on its debts as to accept the latest turn of the screw.
That’s Greece, which has a long tradition of strikes and other actions aimed at stopping the prosecution of economic and social and physical warfare against the population, whether inflicted from within or without. And it has taken five years of recession and increasingly draconian “austerity” assaults on the citizens and their economy to bring them out into the streets in numbers and with intent sufficient to genuinely scare government officials.
Greece will ultimately default on its debt payments because the more the country gets squeezed, the less able it is to spend money on debt. This is pretty obvious. It’s as if a credit card company had the power to continually lower your income and simultaneously force you to spend less on food, shelter and other essentials in order to maintain your payments to them. When you get to the point of homelessness and starvation, you’re liable to say “Well fuck this” and stop paying them. And perhaps walk downtown to put a rock through their window.
Despite that tradition of what the US military might call “highly kinetic responses” to political and economic events, it wasn’t until this past week that the protests attracted enough people to hint at popular revolt. How much longer will it take the considerably less participatory US audience to turn fearsome? The Occupy movement and the Wisconsin heroics notwithstanding, the mathematics of passivity suggest that the answer is approximately four evers.
Bad as they are, economic conditions are not as awful here for most people as in some other developed countries, and of course Americans have in some respects considerably less to lose than their counterparts elsewhere who are being tenderized with the austerity mallet. Our social safety net was born tattered and erected piecemeal and serves only the desperate, leaving the merely needy to fend for themselves until they’re drowning.
Medicaid, for instance, provides different benefits in California than it does in Missouri than it does in North Dakota, and to people of varying degrees of impoverishment. The new health insurance “reform” program has gaps and exceptions that will paradoxically leave people who earn middle class incomes worse off, in many cases, than those who make less and consequently qualify for more generous government subsidies. Hardly anyone knows all the permutations of the safety net, and a great many people think it’s far more substantial than it actually is.
In other countries, safety net programs are uniform and more broadly applied, and of course health care is a guaranteed social insurance program rather than the US system of welfare for those at the bottom of the heap and a haphazard public-private mishmash for those doing a bit better.
Social insurance programs in the US—Medicare, Social Security, unemployment insurance and the like—are also less robust, more exclusive and less well understood than in other countries, and in consequence are more vulnerable to attack.
The short version is that Americans by and large don’t know the difference between social insurance and welfare, they don’t know how the various programs function, the programs themselves are often both feeble and unequally applied—making them ideal vehicles for exploiting resentment by people who need help and don’t get it against those who need help and do get it—and inadequately defended, if not openly attacked, by politicians of the “liberal” political party. And on top of that, the institutional press often appear incapable of accurate reporting on the subjects. Consequently, Americans are divided, ill-informed and increasingly less adamant about safeguarding and strengthening the programs that we have.
A group of doctors, including two of those who Democrat Max Baucus had thrown in jail during the health insurance reform hearings, have filed a brief in the Supreme Court case addressing whether or not the individual mandate, the Affordable Care Act provision aimed at forcing Americans to buy crappy (and competition-free!) private-sector insurance, should be declared unconstitutional.
“It is not necessary to force Americans to buy private health insurance to achieve universal coverage,” said Russell Mokhiber of Single Payer Action. “There is a proven alternative that Congress didn’t seriously consider, and that alternative is a single payer national health insurance system.”
“Congress could have taken seriously evidence presented by these single payer medical doctors that a single payer system is the only way to both control costs and cover everyone,” Mokhiber said. “Instead, Senator Max Baucus (D-Montana), chair of the Senate Finance Committee which drafted the law that became the ACA, had two of those doctors – Dr. Margaret Flowers and Dr. Carol Paris – arrested and thrown in jail. Those doctors are now two of the 50 who have signed onto this brief challenging the Constitutionality of the ACA.”
“If the US Congress had considered an evidence-based approach to health reform instead of writing a bill that funnels more wealth to insurance companies that deny and restrict care, it would have been a no brainer to adopt a single payer health system much like our own Medicare,” said Dr. Margaret Flowers. “We are already spending enough on health care in this country to provide high quality universal comprehensive lifelong health care. All the data point to a single payer system as the only way to accomplish this and control health care costs.”
The only absolute certainty in the case is that if the Supreme Court does bounce the mandate, it won’t be because Congress didn’t consider a single-payer plan. Nowhere in the Constitution is good faith required of elected officials.
Dr. Flowers is right, of course; the US spends as much government money per capita on its fragmented health care programs as do most countries with universal care systems, and then we spend the same amount again through individual and employer payments to private-sector companies—all with results that fall short of those in countries that provide universal care, including every developed nation and some less so. And of course the best health care system in the country, with the lowest administrative overhead, best outcomes and highest patient satisfaction is the the Veterans Administration network: the one run along identical lines to England’s completely socialized, completely government-owned and -operated National Health System. And all despite persistent attempts by Republicans and some Democrats to starve the system because of their hostility toward what its success represents.
None of that is likely to matter to the court or to the large majority of those in Congress who despise single-payer on ideological or cash-related grounds (or both). To this point it hasn’t mattered to the press, either. No institutional press outlets have picked up the filing of the brief, and of course the press did an abysmal job of reporting on the single-payer alternative during the manufacture of the Affordable Care Act. Despite the completely unambiguous data supporting the superiority of a single-payer system (indeed, any developed country system, from England’s socialized medicine to Germany’s public-private hybrid) over ours, the press for the most part addressed it only in terms of the theater of protests and arrests and not on substance; when the president excluded single-payer from consideration in his public and private negotiations with Congress, insurers and pharmaceutical firms, the press apparently took that to apply to themselves as well as the participants in crafting the legislation.
Possibly the brief will ultimately attract some attention; possibly anyone reading this could send the press release along to the health care reporter at your local fish-wrapper. As I have repeatedly, with great patience and restraint, told people who think that single-payer is out of the question, the way to get people talking about it is to talk about it.
Meanwhile, more Americans seem to have become benumbed rather than bestirred in the years since financial speculators and crooks looted the economy and then the treasury. Not surprising, as the inside men on the jobs—two successive presidential administrations and many in Congress—have worked steadily to defuse anger against the perps and muddy the waters as to exactly who did what, at the same time as they’ve worked to normalize high levels of long-term unemployment and to lower long-term expectations of what the economy and the government can do for us.
Missing something you never had (and maybe never heard of), as in a sane health care system, is an abstraction too far for people who are being systematically anesthetized against responding sensibly—which is to say, aggressively and against the actual malefactors—to the theft of what they did have. The Greeks, although no more monolithic than are Americans and perhaps not all that much less susceptible to divide-and-conquer tactics, are nevertheless keenly aware of what they had and what they’re losing and who’s taking it all away. And yet they’re still not stringing the agents of their destruction up from street lamps (although they have apparently destroyed many street lamps and almost all of the traffic signals in Athens).
That leaves me with a lot less hope for the near-term future of protest in the US than I had a few months ago, when the success of Occupy at injecting the fever of economic injustice into the political blood stream of the country despite determined efforts to marginalize the protesters and ignore their (quite clear, thank you very much) message had me thinking that the number of Americans able to shake off the exhaustion of their circumstances and rouse themselves to action might be headed toward self-perpetuating growth.
Now, I think we’re mostly just hunkering down and abandoning ourselves to the prospect of being more or less delicately flayed forever, with the degree of delicacy to be determined at the polls later this year. Maybe next Depression, we’ll be less confused.