Thursday, August 6, 2009

Healthcare, Wealthcare

In 1980, the top 1% of Americans owned 9% of the USA's wealth. By 2007, the top 1% owned 20% of this country's wealth (see Robert Reisch, Supercapitalism). The Reagan revolution succeeded in this massive redistribution of wealth. During this same time, union membership dropped, real wages have stagnated, and millions have lost health insurance. Culminating in the bank bailouts, we have privatized profits by socializing financial loss. No one is screaming "reverse socialism" about this trend. In fact, capitalism itself remains unquestioned in this country. There are no socialist or Marxist commentators. Despite its massive failure and gross inadequacies, there is no debate about this country's fundamental economic structure. This isn't an anomaly: the plutocrats or corporatists of this country have always been artful in controlling the masses.

Now we have the healthcare debate. At least 47 million Americans have no insurance, no one knows how many millions are underinsured, and people who have insurance through their jobs can easily lose this coverage. Medical expenses are the leading cause of bankruptcy in this country. Recently, an elderly relative of mine tearfully worried that her family wouldn't love her anymore because of a secret. It broke my heart to see her crying, and I couldn't believe this gentle soul could have done anything that she was ashamed of confessing. She had to declare bankruptcy at age 85. She was unable to continue paying on her second husband's medical costs. Her husband had died at age 65, and never had Medicare. They had no idea how inadequate their insurance was. She spent all her retirement savings on hospital bills, and worked until age 80. Her vision failed, she had to stop working, and was forced to declare bankruptcy. The most painful thing about this secret burden was her shame about it. She never told her family why she wasn't able to retire sooner.

A disabled friend of mine has Medicare due to illness. His medical costs are about $12,000 a month for medication alone. He confided that all told, his bills came to $250,000 last year for surgeries plus medicine. "Am I worth that much?" he asked me. I know many people with catastrophic or chronic illness who have to stop working so they can qualify for Medicaid. For whatever reason, single payer insurance is not even discussed in politics any more. We are the country that spends twice what other countries spend on medical costs, yet we have millions who can't get healthcare. An estimated 18,000 people die every year because they are unable to access medical treatment before it's too late. We have the highest rate of infant mortality of any industrial nation.

As I told my elderly relative, and as I told my friend who doesn't think he's worth spending that much on, the system is rigged. Healthy people, and the insured, may not understand this. Fortunately, most sensible people do understand this inequity. Yet insurance companies and big Pharma are spending $1.4 million per day on defeating any reform of the healthcare system. Teabaggers and other goons are disrupting town hall meetings with Democratic politicians. Rush, Beck, Hannity, the insurance companies, have all mobilized pathetic people to act against their own economic interest.

Once again, the top 1% has mobilized the masses to act in favor of the plutocrats. As Thomas Frank observed in What's the Matter with Kansas, conservatives are artful in deploying people to fight against their own self interest. In the 1850's, Frank notes, only about 1% of Southerners owned slaves. This one per cent rallied people to fight a war of secession on their behalf. Are Americans stupid, or are we insane? Some speculate by eliminating spending on public education, the rich are able to keep people dumb enough to fight oil wars on their behalf. In California, Schwarzenegger is slashing both education and healthcare, perhaps hoping to keep the masses sickly as well as stupid.

Will there be meaningful healthcare reform? Will people learn to act on their own behalf, instead of on behalf of the uber-rich? Will anyone question the privilege of the wealthy? I wish I could be more hopeful.

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