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Healthcare – Right or Privilege?

Occupy Wall Street supporters march callIs healthcare a right or a privilege? The answer varies by country. In most of the world it is a right accorded to all residents as part of their social safety net. However, in the United States it is a privilege accorded to the more fortunate – those who have private health insurance, seniors over 65 who have Medicare and Medicaid for a small percentage of low income individuals. For those not falling into one of those categories they are “on their own.” This generally means neglecting medical conditions in the early stages when they are more easily treatable. It often leads to expensive trips to the emergency room when the condition becomes acute and where only the symptoms can be treated without a provision for follow-on care.

Medical bills are the major reason for bankruptcy in the United States. Without health insurance many citizens are forced to pay out of pocket for expensive for-profit medical treatment. This has been exacerbated by the housing crisis. Unscrupulous lenders convinced people to borrow against the equity in their homes. Americans were encouraged to use their home as a piggy bank to pay for accumulating medical bills in the case of long term or serious illnesses. That put people in a position of either minimizing treatment of their medical condition or risk losing their home. In many cases where treatment could no longer be delayed they lost their health and their home. This tragic situation could not happen in any other developed country in the world.

Because the United States depends on profit making private insurance companies to provide healthcare, it has the highest per capital health care costs in the world. Supporters of the for-profit companies claim that in return for the cost we have the best healthcare system in the world. This view is another aspect of the myth of American exceptionalism. The facts based on key international health indicators tell another story. Based on the latest WHO (2010) data, U.S. life expectancy ranks 29th in the world. Healthy life expectancy fares even worse – 34th in the world and infant mortality ranks a grim 158th. These are staggering statistics for the most expensive healthcare system in the world. We are the wealthiest country in the world, yet we let our less affluent citizens go without the care that can preserve their health and save their life.

Under Obamacare, an effort was made to reform some of the most odious aspects of the system. Essentially it was not actually healthcare reform but health insurance reform. Insurance companies were required to cover people with pre-existing conditions and certain aspects of preventative care were covered at no cost to the beneficiary. In return, private insurance coverage became mandatory for all citizens in a system that had no real cost controls. Drugs continue to be expensive under a provision that makes it illegal for Medicare to negotiate for the price of drugs and approximately 30 million people remain uninsured.

While Republicans and insurance lobbyists continue to sing the praises of private insurance and criticize Medicare, the facts tell another story. Not only are most seniors happy with Medicare, but it is actually more cost effective than private insurance. Without having to pay multi-million dollar salaries to top executives, Medicare has an overhead of 1.5 to 2% versus 20-30% for private insurers. In recent “fiscal cliff” negotiations, Republicans and Obama discussed raising the age for Medicare from 65 to 67. That would represent an increase in health care costs during the additional 2 years added to the waiting period for eligibility. In addition, health care companies would be reluctant to accept seniors in that age category, many of whom may have serious health issues.

Instead of raising the eligibility age for Medicare, it should be reduced to 55 when many seniors start to experience chronic health problems. Better yet, we should have a Medicare-for-all or Single Payer system. The administrative structure is already in place. It would be a matter of phasing in the rest of the population over a 1-2 year time frame. That would take the profit out of healthcare and provide universal coverage for all of our citizens.

The insurance lobby is strong and it won’t be easy to remove them as the middle man in the healthcare system. Single payer is not likely to be approved at the federal level in the wake of Citizens United. Our legislators are too dependent on campaign contributions for their political survival. The more likely course is state by state – as was the case in Canada. Tommy Douglas, the premier of the province of Saskatchewan introduced universal health care to his constituents. The system was so popular it was eventually adopted countrywide. In recognition for his contribution to Canada’s quality of life Tommy Douglas was voted “The Greatest Canadian” of all time.

It can happen here. We need a few progressive states like California to lead the way. Ultimately the states can be the testing ground. As citizens in the early adopter states reap the benefits, the demand will grow across the country – ultimately creating a wave that moves the predatory insurance companies out of its path and delivers universal health care for all. What we need now are a few brave citizens to start the movement – one person at a time until our goal is achieved.

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Fiscal Cliff – Senior Sell-out?

When I voted for Obama again in this election I was hopeful he would be more supportive of economic and social justice and favor the middle class over the special interests. In reality, there wasn’t really a choice for any reasonable American voter. The alternatives were an unabashed plutocrat and more progressive candidates in parties that did not have a chance in our 2 party system. I also felt that since Obama didn’t have to run again he would be more supportive of his base, which came through for him again, rather than treat them with the disdain he showed them in his first term.

 Unfortunately, it appears that his positions in second term may look very much like the first term. He did not accomplish the “Grand Bargain” of selling out Social Security, Medicare and Medicaid during his first term, thanks to the Republicans wanting even more draconian cuts to our social safety net. This time around he’s attacked Social Security using a chained CPI cost of living formula that can have many seniors eating pet food in future years – in spite of Democratic promises that Social Security would be off the table in the fiscal cliff negotiations. He even got Nancy Pelosi to agree to cuts in Social Security in return for withdrawing his proposal to raise the Medicare age from 65-67 – which she insisted was unacceptable.

 Obama promised consistently during the campaign that the Bush temporary tax cuts would be eliminated for those earning over $250,000. However, he has now raised that to $400,000 and is expected to raise it to $500,000 before the sellout is complete. That does not raise enough revenues to impact the deficit so the monies had to be sought elsewhere. Hence, seniors were thrown under the bus. We can expect that cuts to Medicare and Medicaid are soon to follow. The rest of the safety net cuts will be thrown over to Baucus’ committee – a politician who has totally sold his soul to the corporations.

 While recent news coverage has focused primarily on the recent Sandy Hook tragedy, Obama has quietly conducted negotiations that will further hollow out the middle class so that the wealthiest 2%, corporations and the military can continue to live high on the hog. Those wealthy recipients of his largess are currently so bloated they would not even miss the modest tax increases that have been proposed. Further, it was always understood that those Bush tax cuts would be temporary. It seems unconscionable that a Democratic president who ran on hope and change would cooperate with the Republicans to increase the already large disparity between the 1% and everyone else. Unfortunately, we are continuing to experience a significant transfer of national wealth from the middle class to the wealthy and powerful.

 Seniors have lived through an era of ongoing theft of their economic security. First corporations eliminated fixed retirement pensions in favor of 401Ks largely funded by employees. Next banks were deregulated to allow those 401Ks to lose approximately half of their value in the 2008 meltdown with no accountability on the part of the banksters. Now Social Security benefits will be reduced although Social Security has not contributed one penny to the deficit – it is funded by a trust fund paid into by recipients and their employers.

 Shame on you Obama!

 What can we do to stop the march of sending seniors over the economic cliff in their retirement years? We need a strong and vital movement that mobilizes many of those who will be affected but have not been politically active. We need to encourage everyone who is concerned about this situation to use their creative thinking to support such a movement. OSD inspired similar Occupy organizations throughout the United States. Perhaps concerned seniors can begin a network of Grey Panthers throughout the United States that would protest and lobby the Congress and the president. If nothing is done the theft of wealth from the poor and the middle class to the wealthy and the corporations will continue unabated. As Warren Buffet indicated there has already been a class war and his class won. It is time to reverse that victory.

 Wake up America before it is too late!