AT LENGTH-Contrary to the Tea Party right wingers’ hyperbole these days, the Affordable Care Act, a.k.a. Obamacare is hardly socialized medicine!
It is, however, one of those unholy compromises that nobody really likes but is the only thing that would secure a majority of votes. Let me back up a bit and explain this.
This current health care act is based on the model created by the right-wing Heritage Foundation and was first implemented in Massachusetts under the governorship of Mitt Romney. If you recall, he was President Obama's Republican opponent in the last election. This model is not a single-payer system like most of the other modern social democracies in the world.
Canada, France, Germany, Britain and Italy all have a health care system that provides universal coverage--even for tourists visiting their countries. What this really is, is a form of government subsidized health insurance that regulates how healthcare is delivered and who has access to it.
On one level, the Affordable Care Act mandates that some 30 million Americans who couldn't get health insurance or in some cases didn't want it, now have to have it. On another level this is a huge bone given to an industry that doesn't actually deliver health care but makes money from dispensing payments to those who do.
In other words, this is not socialized medicine! It's doesn’t even come close. But the Teabaggers and other right-wing ideologues like to scream that it is. Medicare, the much more popular form of socialized insurance, is closer to the national health care model but it is still insurance,” not a delivery system.
The compromise that Obamacare made was in the granting of government subsidies to insurance companies in exchange for increasing number of insureds. A weak alternative to real national health care. The Democrats, eager to put something, anything, in place to cover millions of uninsured citizens, agreed to this corporate give-away, mainly because every Democratic President since Franklin Roosevelt has failed to pass national health care. So the Dems have now embraced this as their own, imperfect solution, rolled out with all of its flaws, warts and computer malfunctions, hoping that it can be fixed later. Is there a doctor in the house?
The condition of this patient is that we have a mostly privatized health care system and those who profit the most don't want it changed. Increasingly, those who actually end up providing the services understand this shortcoming, particularly when they don't get paid. Private hospitals, doctors and other health professionals all see a need to get paid for patient care and frequently don't, either because the patient has no insurance and can't pay or they get stiffed by the insurance company, like what is happening with the ILWU’s benefit administrator, Zenith.
The simplest solution would have been for Congress to simply expand Medicare to anyone who wanted or needed it on a voluntary basis, and pay for it with an additional deduction on every payroll stub or as an annual income tax payment. But that would have made too much sense for our conflicted Congress.
However, to answer the conservative critics who are going to jump out of their chairs upon reading this editorial– we already have a hybrid socialize medical system. What do you suppose the National Institute of Health is? Who do you think pays for the Center for Disease Control, or your county health department or the Veterans Hospitals? There’s already a hodge-podge of publicly funded health services all across our nation. There has been for decades. What is dysfunctional is this for-profit model of health care that can charge whatever the market will bear, forever increasing profits.
It would make far more sense to fund a system of local clinics and recreate hospital districts, and then staff them with medical students. Medical students, in exchange for free or discounted tuition, would be obligated to practice in clinics and hospitals for a certain number of years to pay back the investment.
A truly progressive position on health care would be a publicly owned, publicly funded system that would resemble our public school system– there would be a clinic in every neighborhood, a hospital in every town and all you have to do is show up to be treated.
Is public education a “socialized” education system? Yes, it is and we've lived with it for more than 100 years. Is it the best? No. But everybody has access to it, and it sets a minimum standard of mastery. And if you don't like the public option, you can always go to a private school. That's the way health care should be in America.
What we are getting with Obamacare is a halfway measure that is hard to defend, doesn't go far enough, but is far better than the nothing that the Republicans are now arguing for. The problem is that we have politicians trying to cure a system that should be left up to doctors and nurses.
(James Preston Allen is the publisher of Random Lengths where this article was first posted.)
-cw
CityWatch
Vol 11 Issue 90
Pub: Nov 8, 2013