BRAMA, October 20, 2010, 9:00 AM ET
Op-ed
Healthcare Insurance Reform Rubs Partygoers the Wrong Way
By Boris Danik
A historic healthcare legislation was signed into law by President Barack Obama on March 23. It will provide insurance coverage to tens of millions of uninsured Americans.
Enactment of this law enraged the rightwing political spectrum. All Republican legislators voted against it.
The new healthcare insurance law will be implemented gradually over four years. On September 23, 2010 several of its provisions went into effect.
Insurance companies can no longer cancel insurance for people who get sick, which has been done sometimes under the guise of technicalities.
They can no longer deny insurance to children with pre-existing conditions.
There is no longer a cap on lifetime payments. And young people under age 26 can be carried under their parents' health insurance, regardless of marital status or residence.
Is anything wrong with these provisions so far? It is all wrong, say Republican Party spokesmen, from Representative John A. Boehner, Republican Party House leader and on down. This law is un-American. It limits our freedom. And on it goes. Republican leaders now promise to repeal "Obama healthcare".
Recent polls show that only 39 percent of Americans support this healthcare reform, while 42 percent oppose it. There have been organized demonstrations and numerous mob scenes against it. Their anti-Obama fervor became a quick incubation stimulant for the sudden rise of the Tea Party movement.
Why so many Americans dislike this healthcare reform? Stripped of the ideological fig leaf, the winners in America's class wars (and those who feel like winners) are, in effect, telling the 50 million uninsured Americans to become invisible or go to the emergency room.
Healthcare insurance for the poor and chronically ill requires taxpayer subsidies. Households with annual income over $250,000 will be paying an additional 4 percent tax on their investment income and a small increase in payroll tax. Many Americans find ways to say that the poor are mooching off the system as is. Charity yes, socialism no. That's the American way. For our class, people like us.
The same people don't mind red-ink military spending in excess of defense needs – roughly one-half of the world's total military bill.
But "us" may not always be lucky. If you are among winners who have employer-paid healthcare insurance (as many Americans do), but then lose your job, you also lose insurance and join the ranks of Les Miserables at the rate of about 9000 a day. Extension of insurance is unaffordable without having an income. It is even worse for people with fairly common psychiatric impairments, like depression, which multiply with unemployment blues. Without insurance, emergency room visits send them not to a psychiatrist's office, but typically to a state mental hospital, usually a horrible 18th century relic for the insane. They will not be inclined to repeat that experience.
And what about the economy effect in the upcoming Congressional contest?
Even though nearly everybody knows that it was the eight years of the White House Republican tenure that ran the economy into a ditch, President Obama is blamed for not staging miracles to make it whole in a jiffy. Similarly, he is inheriting the blame for the Afghanistan mess.
But the GOP expects to win at the polls more from class wars between healthcare insurance haves and have-nots than from low turnout by Democrats. The GOP gets Tea Party vote, as it did in liberal Massachusetts last fall, winning the Senate seat of the late Edward Kennedy.
Even though the Tea Party activists are clasping hands with Sarah Palin, who had some embarrassing moments when responding to substantive questions during the 2008 campaign, the Tea Party demography is not exactly one of a rightwing fringe. According to a New York Times (April 15, 2010) survey, its supporters are better educated, wealthier, and more conservative than most Americans. Their tea is the perceived self-interest and comfort .
Their anti-reform overdrive and vehemence is baffling because they, like most people who now have healthcare insurance, will not be significantly affected by the new law. The shared psychology of anti-Obama agitation and the conservative yarn that propel that overdrive cannot be rationally explained.
Healthcare dominates midterm campaigning, writes the Financial Times (October 6).
The GOP (Republican Grand Old Party) is preparing to capitalize in the November elections on the divisive public mood of social egotism and rambunctious reloading of latent activism against "socialism and government spending". This is played out as a patriotic engagement, a second American revolution – sometimes with more than a touch of racial twist.
What a contrast to former President John F. Kennedy's "Ask not what your country can do for you. Ask what you can do for your country".
From a common decency point of view, President Obama's healthcare reform is a quantum improvement over the existing system. However, the existing two basic old defects remain. One is the connection to workplace as the provider of insurance, which weakened US cost-competitiveness vs. foreign producers. It also gives US employers an incentive to lay off workers during a recession, rather than have a shorter work week at reduced pay, as in countries such as Germany. The other defect is the presence of middlemen in the form of for-profit private insurance companies.
A rational reform choice would be the adoption of European-type single-payer, tax-funded healthcare insurance – which is being resisted in the USA with a nationalistic zeal and programmed indignation at any critique of the pursuit of profit in sickness..
The permanent campaign to discredit in the eyes of American public the tax-funded healthcare existing in Western Europe and Canada relies on disinformation from Conservative think-tanks, slanted talk-shows, and the US Chamber of Commerce. Part of the flummery is a vocabulary of scary buzzwords, such as "government takeover of medicine", "assault on freedom", "socialized medicine", even though the physicians in those countries have private practice, as they do in the US.
Also, most Americans are unaware that the US Medicare (healthcare insurance for the aged over 65) is similar to the European healthcare model, except for skimpier coverage and copayments in Medicare (as in virtually all healthcare in America).
During the Bush administration, the Republicans unsuccessfully tried to privatize Medicare. But they were able to create a Trojan horse option, called Medicare Advantage. That option relegates paperwork processing to private insurance companies instead of using inexpensive vendors as in the original Medicare. It is more costly to the government than the original Medicare, because of, you guessed it, the skimmed-off percentage for company profit and some sugar-coating for the insured, to boost that option over the original Medicare. The Obama reform is curbing this "advantage", among other measures. It also discourages excessive treatments practiced in the commercial setting of American medical-industrial complex, which spends nearly one-half of Medicare funds in the last six months of the patients' lives.
Remarkably, the Medicare, shortly before it became law in 1965, had been denounced as a Communist conspiracy by Ronald Reagan, future US president, who at that time was promoting the agenda of the American Medical Association.
Denied a single-payer solution, Obama's healthcare reform brings instead a requirement (until now a voluntary choice) for all employers with over 30 employees to provide healthcare insurance for their workers, with some tax incentives.
This requirement is scorned by detractors – rather than recognized as a consequence of turning down a government-funded solution.
The end of year 2010 is also the scheduled date of expiration of George Bush's tax cuts for the top income bracket (which was the major cause of budgetary train-wreck). Some of America's oligarchs, infuriated by its slipping-away and also by Obama's "socialist" healthcare reform, are threatening to emigrate with their treasures in tow.
Emigrate where? According to Forbes magazine – whose publisher, Steve Forbes, is famous for his passionate advocacy to replace US graduated income tax by a flat tax – there are some pleasant quality-of-life places on the planet. The magazine names ten most desirable cities: Vienna in Austria, Munich and two more in Germany, Vancouver in Canada, Sydney in Australia, one in New Zealand and two more in Europe.
All of them are in countries with tax-funded healthcare insurance (rated among the best in the world) and steeply-graduated income tax.
Forbes magazine also names New Zealand, Australia and Norway – all of them with ample Socialist governance tradition – as the best countries to do business.
Dr. Boris Danik
North Caldwell, NJ
October 11, 2010
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