2018

5 April 2017: Single-payer health care is the way to go

Health care is a human right based on a simple principle: Every human requires medical interventions, western-trained physicians, shamanic, or Ayurveda. Having the right is one thing; accessing it is quite another.

The health insurance industry has evolved—apologies to Charles Darwin—into a modern-day Gorgon, which in mythology are three hideous-looking sisters with hair of venomous snakes whose looks turn people into stone. Like Medusa, the best known, the health insurance industry lost its way.

In the early twentieth century, insurers began writing policies for men disabled while working primarily in factories, which then were equivalent to death zones. The policies didn’t cover health; instead, they gave the workers stipends to live off.

As labor unions became empowered to negotiate benefits for their membership during the Great Depression and World War II, health care became part of the negotiating packages. It made sense as industries understood the need for a healthy, reliable work force. The downsides were the burgeoning of a health insurance colossus and institutionalizing the notion of health care being something one accessed vis-à-vis employment.

What had been a benign force, as was the lovely Medusa before she succumbed to Poseidon’s charms, began to morph during Richard Nixon’s administration. Insurers became gatekeepers to health care. They solidified their dominion by working in tandem with Big Health—hospitals, which then were often charitable religious institutions—and Big Pharma. The family doc who made house calls became extinct.

There we have it: Three Gorgons we enjoy the pleasure of encountering whenever our needs extend beyond two aspirins. With calamitous and oftentimes lethal results.

Last week, the Denver Post reported on two separate news items that when viewed together, tell a consequential story. The first was about Republican legislators axing $500 million from the budget, which would cause rural hospitals to close. The other was about the growing death rate among older, pre-senior white males, primarily in rural counties. Among the causes: increased use of alcohol, tobacco, and drugs; continuing economic stagnation in rural America; and the inability to access treatment due to its unavailability or being prohibitively costly.

A sense of hopelessness is becoming prevalent causing men, mainly, to let go of their pride and throw in the towel. A Washington Post report discussed the increasing rate of disability among rural Americans. One thing that ties Americans together is the health-care war story each has either about him/herself or of a family member or friend.

The crash and burn of repeal and replace showcased far more than the Republican Party’s dysfunction and incompetence when it comes to governance; it made clear the priority of glib-talking politicians, like Senator Cory Gardner and Representative Mike Coffman, is not the welfare of their constituents but of their deep-pocket donors, the ones who demand, and get, return for their investment in terms of votes. In everyday jargon, we call it “pay to play.”

Republicans and conservatives have done a masterful job over the past 40 years of caricaturing government, Democrats, and progressives, the ones who created the safety net—Social Security, Medicare and Medicaid, and Obamacare—as human Beelzebubs. And the Democratic Party has in large part taken the bait by ghettoizing itself into the party of urban America.

Donald Trump is no advocate for working and middle class America. His pontifications to the contrary, he has no interest in advancing the cause of the under-classes with his moral compass set on his own North Star. His shoulder shrug to Fox News’ Tucker Carlson when Carlson confronted him with the non-fake reality of tens of millions losing their health care coverage under the GOP bill confirmed it.

There’s one fix to which we’re inexorably heading: Single-payer, universal health care. Even conservative columnist Charles Krauthammer considers it.

“Don’t be surprised,” he wrote, “if, in the end, single-payer wins out.” The leader of that potential, the modern-day Perseus who slew Medusa, Krauthammer sighs, might be none other than Trump himself. Now, that would be something.

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