[Marxism] Curb your Enthusiasm for Obama

[Greg McDonald]

Curb Your Enthusiasm for Obama
http://www.truthdig.com/report/item/ 
20080831_curb_your_enthusiasm_for_obama/
Posted on Aug 31, 2008

By Chris Hedges

Barack Obama’s health care plan coddles the corporations that profit  
from the misery and illnesses of tens of millions of Americans. The  
plan is naive, at best, and probably disingenuous when it insists  
that we can coax these corporations, which are listed on the stock  
exchange and exist to maximize profit, to transform themselves into  
social service agencies that will provide adequate health care for  
all Americans. I wish we lived in such a rosy world. I know, and I  
suspect Obama knows, that we do not.

“Obama offers a false hope,” said Dr. John Geyman, the former chair  
of family medicine at the University of Washington and author of “Do  
Not Resuscitate: Why the Health Insurance Industry Is Dying, and How  
We Must Replace It.” “We cannot build on or tweak the present system.  
Different states have tried this. The problem is the private  
insurance industry itself. It is not as efficient as a publicly  
financed system. It fragments risk pools, skimming off the healthier  
part of the population and leaving the rest uninsured or  
underinsured. Its administrative and overhead costs are five to eight  
times higher than public financing through Medicare. It cares more  
about its shareholders than its enrollees or patients. A family of  
four now pays about $12,000 a year just in premiums, which have gone  
up by 87 percent from 2000 to 2006. The insurance industry is pricing  
itself out of the market for an ever larger part of the population.  
The industry resists regulation. It is unsustainable by present trends.”

We face a health crisis. The Democratic and Republican parties, awash  
in campaign contributions from the beasts they should be slaying on  
our behalf, have no interest in addressing it. A report in the  
journal Health Affairs estimates that, if the system is left  
unchanged, one of every five dollars spent by Americans in 2017 will  
go to health coverage. Half of all bankruptcies in America are  
because families are unable to pay their medical bills. There are  
some 46 million Americans without coverage and tens of millions more  
with inadequate policies that severely limit what kinds of procedures  
and treatments they can receive.

“There are at least 25 million Americans who are underinsured,” said  
Dr. Geyman. “Whatever coverage they have does not come close to  
covering the actual cost of a major illness or accident.”

Obama, like John McCain, did not support HR 676, the single-payer  
legislation. The corporations that run our for-profit health care  
industry, which would be shut down if the bill was enacted, have  
vigorously fought it through campaign contributions and armies of  
lobbyists. A study by Harvard Medical School found that national  
health insurance would save the country $350 billion a year. But  
Medicare does not make campaign contributions. The private health  
care industries do. They have lavished money on Obama. He received  
$708,000 from medical and insurance interests between 2001 and 2006,  
according to the Center for Responsive Politics. And Michelle Obama  
is a vice president for community and external affairs at the  
University of Chicago Hospitals, a position that paid her $316,962  
annually.

“The private health insurance companies and the pharmaceutical  
industry completely and totally oppose national health insurance,”  
said Dr. Stephanie Woolhandler, one of the founders of Physicians for  
a National Health Program. “The private health insurance companies  
would go out of business. The pharmaceutical companies are afraid  
that a national health program will, as in Canada, be able to  
negotiate lower drug prices. Canadians pay 40 percent less for their  
drugs. We see this on a smaller scale in the United States, where the  
Department of Defense is able to negotiate pharmaceutical prices that  
are 40 percent lower.”

Sen. Obama argues that we can improve the system by expanding  
government oversight. The government, he says, should require doctors  
and hospitals to prove they provide quality care. His plan links  
payment with reported quality. This would mean that health care  
providers would have to hire even larger staffs to collect and report  
this data to the government. There would be a $10-billion federal  
investment in health care information technology over five years  
under the Obama plan, in essence turning record keeping from paper to  
electronic data.

Obama’s plan, said Dr. Don McCanne, who writes on health care issues,  
would actually make health plans “more expensive, which compounds the  
problem.”

Obama says he would require insurance companies to use more income  
from premiums for patient care.

“There isn’t an enforcement mechanism,” Geyman said bluntly. “Most  
states have been unable to control rates or set a cap on rates.”

Obama’s plan would also not cover all Americans. Unlike in Canada,  
citizens would not be enrolled in a plan automatically. Americans  
would have to go looking for one they could afford. And if they could  
not find one they would remain uninsured. Dr. Woolhandler, who is  
also a professor at Harvard Medical School, estimates that “tens of  
millions” of Americans would remain uninsured under Obama’s plan.  
These numbers would swell as employers, who provide plans for 59  
percent of those who are employed, continue to reduce coverage.

“The only way everyone will get insurance is with national health  
insurance,” she said from Boston in a phone interview. “There is  
nothing in the Obama plan that will change the bitter reality that  
working-class families face when their breadwinner gets sick. People  
with catastrophic illnesses usually lose their jobs and lose their  
insurance. They often cannot afford the high premiums for the  
insurance they can get when they are unable to work. Most families  
that file for bankruptcy because of medical costs had insurance  
before they got sick. They either lost the insurance because they  
lost their jobs or faced gaps in coverage that meant they could not  
afford medical care.”

Obama has borrowed John Kerry’s idea to have the government absorb  
certain severe costs, although again the details are not spelled out.  
Insurers, he says, would no longer be able to discriminate based on  
preexisting conditions. All children would have health coverage. He  
would, he says, expand Medicare and Medicare-like coverage to protect  
the very young and the elderly. This is laudable, if he can make it  
happen. But the fundamental problem is a health industry run for  
profit. Our health system costs nearly twice as much as national  
programs in countries such as Switzerland. The overhead for  
traditional Medicare is 3 percent, and the overhead for the  
investment-owned companies is 26.5 percent. A staggering 31 percent  
of our health care expenditures is spent on administrative costs.  
Look what we get in return.

We on the left, those who should be out there fighting for universal  
health care and total and immediate withdrawal from Iraq and  
Afghanistan, sit like lap dogs on the short leashes of our Democratic  
(read corporate) masters. We yap now and then, but we have forgotten  
how to snarl and bite. We have been domesticated. And until we punish  
the two main parties the way big corporations do, by withdrawing  
support and funding when our issues are ignored, we will remain  
irrelevant and impotent. I detest Bill O’Reilly, but he is right on  
one thing—we liberals are a spineless lot.

Labor unions don’t negotiate with corporations on the basis of good  
will. They negotiate carrying the threat of a strike. What power do  
we have as long as we cave on every issue we stand for, from  
opposition to the death penalty to battling back against the military- 
industrial complex?

It is not about liking or not liking Obama. It is not about race or  
class or gender. It is not about growing up poor or a member of the  
working class. There is no shortage of greasy politicians who, once  
in power, sold out their own. Look at Bill Clinton. It is about  
fighting back. It is about confronting a system that belittles us,  
what we stand for and what is best for the majority of Americans. We  
need to throw our support behind alternative candidates who champion  
what we care about, whether Cynthia McKinney or Ralph Nader. Bob  
Barr’s health care plan, like John McCain’s, is even worse than  
Obama’s tepid proposal. We need to begin to actively and militantly  
defy the corporate state, and this means stepping outside of the two- 
party system. Universal health insurance is one issue. There are  
others. Nothing we care about will change until we do.

The Democrats, who promise to end the war in Iraq, create jobs and  
provide universal health care, ignore these promises once election  
cycles are over. And we never make them pay. They gave us NAFTA, the  
destruction of welfare and increased military spending, and we gave  
them our vote. This is the party that took back Congress in 2006 on  
an anti-war platform and then increased troop levels and funding for  
the Iraq war. This is a party that talks about the crushing weight of  
debt carried by Americans and then refuses to cap predatory interest  
rates as high as 30 percent imposed by credit card companies. This is  
a party that promises to protect our constitutional rights and then  
passes the FISA bill to protect the telecommunications companies. The  
list goes on.  These politicians, including Obama, must begin to feel  
heat. They must learn that there is a cost to be paid for working on  
behalf of corporations and disempowering citizens.