Worldview Blog

For the first time, I watched Michael Moore's famous documentary 'Sicko' on the American health care system, and it left me feeling disturbed and depressed. It's really about the USA and how the supposed Light of the World has degenerated into a voracious and inhumane money machine, rewarding the richest few with grotesque profits, while treating millions of ordinary people like garbage. I once would have been embarrassed to speak in such 'radical' and 'left-wing' language, since I had absorbed the prevailing propaganda about 'socialism', like most other Americans. But largely thanks to the internet, I have learned a great deal about reality in our country, rarely revealed in the corporate media. Our nation as a whole is sick indeed, all because the power of money has short-circuited our democracy and given us a government of the rich, by the rich and for the rich. It is utterly scandalous.

What is the problem? Regarding health care, it is not just the 40 million uninsured. It is that even middle class people with insurance can be wiped out, because they are refused treatment by their insurance companies, based on one deceitful trick or another. For instance, an insurance company can deny you coverage in the first place, for any reason whatsoever, such as being sick or being likely to get sick! Then, once you have insurance, you never know what fine print can be used or misused to deny you treatment, even for common diseases. Or they may find some trivial 'pre-existing condition' you failed to declare because you forgot. Or they may declare your therapy to be 'experimental', and so on and so on. And the costs of medicine are exorbitant! Most people have no idea what even simple treatments might cost, largely because the system is rigged with patents and other legal devices. Since only a minority are sick at any given time, there is no uproar. But even if there were, I doubt it would matter, with our money-bought politicians giving us so little real choice.

The alleged horrors of 'socialized' medicine

I know what you are thinking. We have all been programmed to think the same thing, namely, that 'socialized' medicine in other countries means interminable waiting lines, in dirty, smelly hospitals, to receive inadequate treatment, from drunken and incompetent doctors. And I used to think that one needed to do the equivalent of several doctorates to get to the bottom of it. This is not true. There are some basic facts that tell it all. America spends the most per person on health care of all major industrialized nations and gets the least return. Our mortality rate trails behind those no-good socialist countries in Europe and to our north. Why are we the only major industrialized nation without universal health care? That is the question we should be asking. And, contrary to the propaganda, our European friends are doing no worse than we are overall. Indeed, their middle class seems to be doing rather better, based on anecdotes from Moore's movies.

Ah, anecdotes! That is the fatal weakness in Moore's film, you say. It's nothing but anecdotes, pasted together by a lefty amateur, presenting a distorted and misleading picture. I don't think so. For one thing, UHC means a government policy, so that anecdotes are indeed representative of the whole. Moreover, even the doctors aren't doing badly at all in the UK, much to my amazement. Can a doctor survive on just one Audi and a mere million-dollar home? Maybe ours can't, but the Eurodoctors have evidently been intimidated by Big Brother into making some severe sacrifices. This documentary convinced me, even if the part on Cuba was a bit naive. That is perhaps the main reason I am writing this post. Before watching the movie, I had dismissed Moore as a bumbling amateur, opening himself and his cause to ridicule, and doing more harm than good for progressive causes. Having seen the movie, I think it is well done indeed, with the right touch of sardonic humor. All Americans should see this. It should be shown in all classrooms, but I guess that would be a 'commie' thing to do. We don't want our innocent children exposed to so much reality. Better to give them 'reality' shows on our idiotic commercial television.

Progressivism and Totalitarianism

Finally, the issue of health care has nailed down the last lingering doubt I may have had about progressive causes. I used to be the typical naive, liberal Democrat, who voted for Clintons while being ignorant of their corrupt nature and dastardly politics of selling out to the rich. It was the Iraq war that got me reading the net. I was vaguely aware of the likes of Chomsky, but felt he must be some extreme, America-hating, nutcase professor, who would become a new Stalin if given half the chance. And I am frankly repelled by the kind of unruly and scruffy youth who sometimes smash windows in anti-war or anti-globalization demonstrations. For some reason, I tended to take them as representative of the 'far-left'. I now realize what a deeply corrupt and brainwashed democracy we have, with sham elections that serve the interests of the mega-corporations and the very rich, no matter who wins. Yet even the poor and middle-class who are being screwed by the system continue to spout Republican platitudes about 'free markets', 'personal responsibility', 'big government', and all the other cliches used to keep the ignorant and uninformed in their place.

Not that I want any kind of totalitarianism! I just want a real democracy with a decent spread in the wealth. The binary choice presented to us by our money-bought pundits and intellectuals is the biggest lie of all. Just look at Europe and Canada. Democracy arose in the first place as people became educated and ceased to be ignorant peasants. Unfortunately, the United States seems to be slipping back into that medieval state, and the exorbitant cost of education isn't helping. (Guess what else they have in those commie-socialist countries. Free or affordable education!) Our corporate masters know what they are doing. They couldn't care less about democracy or the Enlightenment. They simply have a voracious appetite for wealth and wish to make themselves the new aristocracy. And for that, they benefit most when we are cowered, discouraged, uneducated and brainwashed peasants, unable to fight back. This has been going on for many years, with our ever growing militarism sucking up precious resources. Then it took a sharp turn for the worse, with those prostitutes the Clintons, whose ambition and corruption destroyed what was left of a genuine Democratic party. Can we be saved? Can Obama do it? Does he really want to? Does he understand? Do enough Americans? Moore's film will help. It deserves a Nobel peace prize way more that Gore's silly global warming diversion.

Some valid conservative concerns

UPDATE (02 Mar 08): I do share some of the conservative concerns about UHC. Perhaps the most important is that it has to be paid for. I am well aware that we have a staggering debt, due largely to cancerous militarism and reckless tax breaks for corporations. My solution? You guessed it: slash the militarism and the corporate welfare. Anyway, as I said before, money isn't really the problem. We already spend more per capita than other advanced nations, yet we get less return and have higher mortality rates. The question is how we spend the money and who gets screwed. Many studies claim that we could save a huge amount on red tape by eliminating the insurance bureaucracy, much of which is devoted to denying insurance. The basic problem is that life-and-death matters should not be run strictly according to a ruthless profit principle, if we are to be a humane society.

Of course, any government program can become corrupt, if the politicians are corrupt. An example is the recently-passed prescription drug bill for seniors. An expensive new entitlement was created, in which the drug companies are allowed to set the price, with barriers against foreign competition. Of course this travesty of the free market was welcomed by the drug companies! It is a classic example of corporate welfare and corruption posing as 'free enterprise'. Any reasonable UHC program is predicated on some basic political discipline, which the Canadians and the Europeans seem to have. Perhaps the conservatives are right that UHC cannot work under our system of money-bought politicians! Unfortunately, it is these very conservatives who consider it a fundamental right to buy up politicians, under the guise of 'freedom of speech'.

Then there is the strain of libertarian thought which claims that it is 'totalitarian' to include everybody under a single mandated insurance umbrella. But here is why we must. The young will not buy insurance, since they feel healthy. The unemployed may not be able to buy insurance. The whole point of insurance is to spread the risk and cost around in a pool covering all of society. It seems to be working in Europe and Canada, despite all the propaganda. Moore found plenty of middle-class Canadians and Europeans who are quite satisfied with their system, and we may add many Asians as well. According to my experience, the right-wing horror stories about nonexistent healthcare in UHC nations tend to be pulled out of thin air. Moore actually did some real live research, even if it was 'anecdotal'. Note that I have no problem with allowing the rich to buy extra private insurance or healthcare above the basic blanket, but perhaps this will harm UHC in ways I do not yet understand.

Conservatives in America also exploit a deeply-rooted feeling of self-reliance in our population, which is probably an offshoot of the Protestant ethic. Rhetoric about 'personal responsibility' appeals to the heartfelt convictions of many ordinary folks who are not rich or who are even poor. It is tied up with feelings of honor, as well as with the resentment felt by hard-working people, who are led to believe that any benefit they are not receiving at the moment is at their expense. However, illness strikes the industrious and indolent alike, and it is simply foolish to suppose that one might not someday be a victim of disaster with no means to cope. We all need insurance, and in the special life-and-death realm of healthcare, this needs to cover everybody in order to work. As Moore points out, we already have 'socialism' in the form of roads, police, firemen, schools, parks, the military, and other public benefits we take for granted in a civilized society. Healthcare carved out its special status, because a lot of money went into a very powerful public relations campaign. Never underestimate the power of propaganda, even in a democratic society.

Single-payer vs. managed care

UPDATE (02 Mar 08): Ooops! A whole issue I have failed to discuss is how much the government should actually manage the health care system. UHC need not entail close government control of day-to-day operations, which might be anathema to doctors and other health care professionals. This is a complicated subject, which I will simply sidestep for now, but I am sure that reasonable people can understand that universal health insurance is not necessarily the same as government control. We should at least have universal insurance. How far to go beyond that is a matter for democracy to decide.

By the way, take a look at the map in this Wikipedia article. Just look at how many nations have some form of universal healthcare! All of the wealthy nations, other than the US, and many of the developing nations. We have only Africa and China for company. Shame on us! What is the matter with this crazy country? We spend as much on the military as the rest of the world combined, and we invade nations on flimsy pretexts, but we don't have UHC. We are a freak nation, a bizarre anomaly, a moral mutation, where the power of money over politics has perverted the foundations of society. Shame on us! All because of evil Republican brainwashing, in combination with Democratic cowardice. Our bipartisan establishment is a moral cancer. Obama, can you hear the desperate cries of an enslaved nation? Or are you just another narcissistic traitor, like that loathsome Bill Clinton? And it's not just us! We may be dragging the whole world down, as the rich in other nations try to seduce their people into following the fine American 'example'? Screw you, Thatcher, Blair and Sarkozy!

Horror stories from the UK and Canada

UPDATE (02 Mar 08): The Heritage Foundation has an article on the horrors of the UK and Canadian systems, where patients sometimes have to wait for operations, or where drugs are rationed by not being authorized. Regarding the waiting, you can be sure you will be waiting a long time in the US — until you die! — if you are denied insurance and can't cough up the bucks. The rich can always get care; the rest will surely benefit with UHC compared to the alternative. As for new drugs, there are stories surfacing of how the drug companies are bribing doctors and regulatory agencies to push dubious and expensive new drugs. This drives up costs for everybody but benefits only the companies. Then there is the expensive care that results from not having the preventative care practiced by UHC nations. And frankly, there must be some rationing for the dying, although we dare not discuss it. We prefer to let personal wealth play God and determine whether we cling a few more months or years to life at exponentially increasing expense. And remember, every dollar we save on the military is a dollar for public benefit. There are hundreds of billions of such dollars potentially available! We are threatened by no government, only by ragtag bands of terrorists, which is a police and intelligence problem that doesn't require insanely expensive gold-plated weaponry. How curious that all the propaganda against UHC comes from conservative thinktanks devoted to war and to making the filthy rich as filthy rich as possible. That tells you something about their credibility right there!

We Need a Medical-Industrial Complex

UPDATE (20 Apr 08): One often hears that 'socialized' medicine will lead to unrestrained costs, as a new 'entitlement' become a 'third rail' of politics that is invulnerable to the benefits of market discipline. Even decent antiwar libertarians will voice such opinions, due to their ideological hostility to 'big government'.

First of all, a single-payer system need not be 'big government' in the sense of a bloated bureaucracy. Rather, if done properly, the public will benefit from substantial administrative cost savings, estimated at about 15%, compared to private insurance. As mentioned already, politics could be removed with a bit of discipline, in the sense that no providers are given preferential treatment. One doesn't read in the press that Medicare is favoring some medical companies over others. Rather, they seem to be lavished with corporate welfare, in that bidding is curtailed, at least in the case of drug companies. (I am thinking of the recent and infamous Prescription Drug Benefit for seniors, in which the government is not allowed to use its buying clout to lower prices. I assume that the rest of Medicare is probably similar.)

Furthermore, one can argue that a democratic government will always be 'large', i.e. spend a lot of money, as politicians compete for votes. That's just human reality, so we should plan accordingly. Right now, we have a massive military-industrial complex, that seems impregnable, due to all the jobs created, in addition to the river of campaign contributions flowing to politicians. This leads to endless war. Wouldn't it be so much better to have a medical-industrial complex? Our bloated military is equal to the rest of the world's combined. It could be slashed and tons of money transferred to medicine. That might create new corruption, but a less deadly kind than the military. Indeed, it would be a life-saving kind of corruption!

And as we have seen already, the US already spends more per capita on healthcare than any other industrialized nation, but it is the only one without some form of universal health insurance. So there is already plenty of money in the system. With the extra pentagon money, we could probably raise the salaries of most doctors and nurses, as well as cover everybody. If we assume that a democratic government is always going to want to spend boatloads of money on some 'complex' or another, let it be medicine, or, in general, butter rather than guns. The Muslims aren't going to invade us, and neither are the new enemies we are trying so hard to create in China and Russia.

Wikipedia: Universal Health Care

American Medical Student Association: Universal Health Care

Maggie Mahar: Money-Driven Medicine

UK, Canadian experience shows folly of socialized medicine

Alternet: The Cholesterol Con — Where Were the Doctors?

Bruce Fein: UHC like Roman bread and circuses

Joe Bageant: Deer Hunting with Jesus (excerpt)

Alternet: 10 Myths About Canadian Health Care, Busted

Paul Krugman: Only Hillary can achieve UHC

Paul Navarro: The Next Failure of Health Care Reform

Jacques Distler: Blog article on 'Sicko'

Electric Politics: Dr. Steffie Woolhandler on healthcare (audio)

Electric Politics: Dr. David Himmelstein on healthcare (audio)

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