As July 4th approaches amidst raging forest fires in Colorado and across the U.S. (CBS reported 50 fires in 30 states two nights ago) during an epic drought in yet another one of the hottest Junes and summers and years on record, let us pause to consider what a hot stinking corporate-plutocratic mess U.S. politics and policy have become.
Health care is an obvious case in point in the wake of the Supreme Court’s decision last week to uphold the corporatist “health insurance reform” that Barack Obama, the Democrats, and a few Republicans passed in early 2010 (the so-called Affordable Health Care Act).
Think back two presidential election cycles to the conservative campaign of John Forbes “Reporting for Duty” Kerry – a man so thick that he declared himself a fan of (Ohio State) “Buckeye football” while campaigning in Michigan. Like all Democratic presidential nominees since at least Harry Truman, John “I am Not a Redistribution Democrat” Kerry declared himself an advocate of “health care for all.” What sort of plan did he propose? Not the single-payer (government as insurer) system (what we might call “Improved Medicare for All”) that Truman advocated (imagine) – not the program that prevails in Canada and other industrialized states and that most Americans have long supported.
During the 2004 campaign, Kerry “took pains…to say that his plan for expanding access to health insurance would not create a new government program.” Why did he do that? Because, New York Times reporter Gardiner Harris explained, “there is so little political support for government intervention in the health care market in the United States.” In his 2006 book Failed States, Noam Chomsky found Gardiner’s comment “interesting” in light of actual public opinion:
“A large majority of the population supports extensive government intervention, it appears. An NBC-Wall Street Journal poll found that ‘over 2/3 of all Americans thought the government should guarantee ‘everyone’ the best and most advanced health care that technology can supply; a Washington Post-ABC News poll found that 80 percent regard universal health care as ‘more important than holding down taxes’; polls reported in Business Week found that ‘67% of Americans think it’s a good idea to guarantee health care for all U.S. citizens, as Canada and Britain do, with just 27% dissenting’; the Pew Research Center found that 64 percent of Americans favor ‘the U.S. government guaranteeing health insurance for all citizens, even if it means raising taxes’ (30 percent opposed). By the late 1980s, more than 70 percent of Americans ‘thought health care should be a constitutional guarantee,’ while 40 percent ‘thought it already was.’ One could only imagine what the figures would be if the topics were not virtually off the public agenda.”
Then, as now, the nation’s “unelected dictatorship of money” (Edward S. Herman and David Peterson wonderful phrase) had a standard response to such facts: “so what? Who cares?” It’s nothing new. The great American philosopher John Dewey noted nearly a century ago that U.S. politics was little more than “the shadow cast on society by big business.” He prophesized correctly that it would remain so as long as power rested in “business for profit through private control of banking, land, industry, reinforced by command of the press, press agents, and other means of publicity and propaganda.” One could argue that the New Deal era (1932-1975) brought some real “countervailing power” and policy victories for popular forces through at least the early 1970s. Since the onset of the long neoliberal age (wherein deepening inequality and regressive policy feed each other in a disastrous downward negative feedback loop that cannot be broken through the usual political means), Dewey’s shadow has morphed into a thick poisonous vapor that seeps into the corridors of policy and corrupts politics and media to a degree that almost defies belief.
“The Health Insurers Have Already Won” (August 2009)
Four years after the bumbling aristocrat Kerry’s failed bid, the silver-tongued and “charismatic” (so they say) Barack Obama swept into history and the White House on the promise to (among other things) deliver universal health care and free ordinary people from the tyranny of the giant private health and drug companies. Having campaigned on a pledge to let all voices be heard in a spirit of openness and conciliation, the Dollar Dalai Obama then proceeded to exclude single payer activists from even a tiny seat at the edge of the table of a health care “reform” process he advanced as the signature domestic priority of his presidency. It was brutal, consistent with his right wing corporatist chief of staff Rahm Emmanuel’s advice: “ignore the progressives.” While Obama golfed and confabbed with leading private insurance and pharmaceutical executives and lobbyists, the venerable black Congressman and single payer advocate John Conyers (D-MI) and Obama’s own “good friend” Dr. Quentin Young (a longstanding single-payer proponent) had to fight even to get invited to the White House Health Care Summit. There they were treated like forgotten stepchildren despite the curious fact that they represented the policy perspective of the nation’s purportedly sovereign citizenry.
The health “reform” that actually passed in early 2010 could have been called the “All Power to the Six Leading Insurance Companies and Big Pharma Act.” The final bill left the private insurance and drug mafias in parasitic, profit-extracting control of the nation’s absurdly expensive health care system, whose costs are pushed up mainly by the insurance syndicates’ giant investment in marketing, tracking, and denial of service. These giant socio-pathological firms were happy to concede on matters like giving up their right to deny coverage to people with pre-existing conditions as long as the federal government would offer no competing public plans and all Americans going by choice without insurance would be compelled to purchase private health insurance.
The corporatist nature of the “Affordable Health Care Act” (AHCA) was a foregone conclusion, thanks to the aforementioned dictatorship. Knowing the authoritarian score, Business Week was able to candidly tell its affluent readers that “The Health Insurers Have Already Won” in early August of 2009, when dozens of new heat records were set across the country. As the magazine’s health care correspondents Chad Tehrune and Keith Epstein explained:
“As the health reform fight shifts this month from a vacationing Washington to congressional districts and local airwaves around the country, much more of the battle than most people realize is already over. The likely victors are insurance giants such as UnitedHealth Group, Aetna, and WellPoint. The carriers have succeeded in redefining the terms of the reform debate to such a degree that no matter what specifics emerge in the voluminous bill Congress may send to President Obama this fall, the insurance industry will emerge more profitable. Health reform could come with a $1 trillion price tag over the next decade, and it may complicate matters for some large employers. But insurance CEOs ought to be smiling.”
“…The [insurance] industry has already accomplished its goal of at least curbing, and maybe blocking any new publicly administered insurance program that could grab market share from the corporations that dominate the business (emphasis added).”
The key point for the corporate insurance bosses was to block any public insurance competition or alternative. They were ready to give on “pre-existing conditions,” lifetime benefit caps and the like in order to do that. They knew that “reform” was in the air and had support from many large business, political, and professional interests, not just the nation’s quaintly excited citizenry. A popular new president had staked his reputation and perhaps his re-election chances on some (almost any) version of “health care reform” being passed in his name. Something was going to happen, the big private insurance and drug protection outfits knew. Their goal was to set the terms in a way that left core corporate prerogatives unchallenged by popular public alternatives.
That goal was achieved early on and in standard defiance of irrelevant public opinion. Contrary to politicians’ and dominant (corporate) media pundits’ insistent claim that public insurance lacked popular support, a CBS-New York Times polls in January of 2009 found that 59 percent of Americans supported a single-payer health insurance program. (The exact same percentage of doctors supported the same system in an April 2009 poll). In a poll conducted in late September of 2009, 65 percent of more than 1,000 Americans randomly surveyed by CBS and the Times responded affirmatively to the following question: “Would you favor or oppose the government offering everyone a government-administered health insurance plan – something like the Medicare coverage that people 65 and over get – that would compete with private health insurance plans?”
None of this ugly plutocratic record stopped the Orwellian right wing propaganda machine from insistently and absurdly calling Obamacare (the right’s term, initially) “socialistic” and even “Marxist.” The right propagandists never informed those they egged into neo-McCarthyite/John Birchian/tea-bagging dread that Obama’s “radical leftist” health bill was based on the legislative proposals of the Republican Heritage Foundation in the 1990s. Modeled largely on a state-level plan that Republican presidential nominee Mitt Romney passed and oversaw as governor of Massachusetts, it was dedicated to a vision of “change” that left the corporate and financial oligarchy free to extort massive profits that drive health care costs to the breaking point for individuals, families, communities, non-profits, small businesses, and government. Touting his record as a “centrist” at the Associated Press luncheon last April, Obama himself boasted that the AHCA was taken from the Republicans to privilege “market solutions” over “government solutions” in addressing the nation’s problems.
“The Real Winners”
Upon notification that Chief Justice John Roberts had passed the AHCA, the political hot air machine in and around Washington D.C. cranked up the propagandistic temperature to match the capital city’s record-setting June swelter. While the Republicans ran with their standard preposterous narrative of radical-left “big government” takeover, Obama’s liberal defenders and Democrats quickly proclaimed the decision “a big win for the American people.” The influential liberal economist and New York Times columnist Paul Krugman (himself occasionally critical of Obama’s tepid right-centrism) agreed. Excoriating the mendacious sadism of the “reform’s” die hard Republican opponents, he argued in his day-after column that “the real winners” of Roberts’ vote were “ordinary Americans.”
The Republicans may be ridiculous and viciously wrong on the AHCA (as they are on everything that matters), but the liberal cheerleaders are equally off base in their own partisan, fake-progressive way. The Heritage-Romney-Obama-Roberts health care bill falls far short of the fair, efficient, cost-effective, and egalitarian solution that most Americans have long wanted and deserved: extending Medicare to include everyone on the single-payer model. It introduces what Krugman kindly calls “an awkward hybrid of public and private insurance that isn’t the way anyone would have designed a system from scratch.” The complex “hybrid” leaves the private insurance and pharmaceutical syndicates fat and happy and very much in control, Krugman might have added. (Remember: the corporate masters were completely willing to give on things like pre-existing conditions and lifetime benefits and on the expansion of Medicaid so long as their power to parasitically poach spectacular premium- and other price-inflating profits from the nation’s citizens, businesses, non-profits, and governments remained intact and as long as they were compensated for the loss of the ability to do terrible things like deny coverage to people with pre-existing conditions with a federal mandate requiring uninsured people who can afford coverage to buy health insurance from them.) At the very least, Krugman ought to have included the owners and top managers of the insurance and pharmaceutical mafias in the category of “real winners.” They got what they wanted and they got it three years ago, before the bill passed Congress. They remain free to rake in billions of dollars of profits they don’t deserve and which we can’t afford while Krugman rails against the undeniable sadism of Eric Cantor and other radical right Republicans (they should never be called “conservatives).
“Here’s How the Unraveling Will Look”
That freedom will ultimately be the undoing of “Obamacare’s” core claim to provide affordable health care for all. Listen to the realistic reflections of Harvard physician and health care professor Marcia Angell on the Huffington Post last Friday. Her diagnosis merits lengthy quotation:
“Obamacare is simply incapable of doing what it is supposed to do — provide nearly universal care at an affordable and sustainable cost. The problem is that three years ago, in his futile efforts to win over Republicans (remember the embarrassing courtship of Olympia Snowe?), Obama gutted the law before it was even passed. He made the private insurance companies the linchpin of the new system, and promised them millions of additional customers and billions of taxpayer dollars. He also did nothing to rein in the profit-oriented delivery system that rewards providers on a piecework basis for doing tests and procedures. So with all the new dollars flowing into the system and no restraints on the way medicine is practiced, the law is inherently inflationary. “
“Although there are some provisions to curb the worst abuses of the insurance companies, such as excluding people with preexisting conditions, there is nothing in the law that would stop insurers from raising premiums. A senior executive of the industry's trade association, America's Health Insurance Plans, told me privately that that's exactly what the companies will do if regulations cut into their profits. Thus, costs under Obamacare will almost certainly rise even faster than at present. No reform can work well or very long if its costs are unsustainable.”
“In fact, it is unlikely that Obamacare will ever be fully implemented as it stands. If Romney is elected, with a Republican Congress, it will be quickly overturned. If Obama is re-elected…it will come apart more slowly. But unravel it will, as costs rise and it becomes clear that there are still tens of millions of Americans priced out of the system.”
“Here's how the unraveling will look: Many of the uninsured who are subject to the mandate to purchase private insurance will choose to pay the penalty/tax instead. That will lead the insurance companies to raise their premiums, demand that the penalties be greater, or both. Deductibles and co-payments will increase to the point that many people will have insurance they can't afford to use. (This is the case in Massachusetts.) Many employers will simply stop offering health insurance, since our high unemployment means workers no longer have the leverage to demand it, or they will stop insuring dependents (thus avoiding having to cover grown children to age 26). In addition, because insurers have a strong financial incentive to evade the new regulations requiring them to take all comers, it will take a huge bureaucracy to monitor them.”
“Next year, states are supposed to set up insurance exchanges to pool risks and offer a menu of approved insurance plans for individuals and small businesses. But they are unlikely to be functioning by 2014, as called for in the law, either because Republican states simply refuse to set them up and hamper federal efforts to step in, or because of the administrative complexities. Some states may also refuse to accept the funds to expand Medicaid, as called for in the law, since the Supreme Court found that they could opt out without losing their existing federal Medicaid funding. Here again, the bureaucracy necessary to aid and monitor state compliance will be huge, diverting resources from health care. In addition, there are likely to be multiple legal challenges to nearly all provisions of the law.”
“Obamacare partially offsets the costs of federal subsidies to insurance companies and Medicaid costs by cutting Medicare reimbursement to providers. That means hospitals and other health facilities will take a hit, and many are already struggling….There will be efforts to patch it up as we go along, but because Obamacare leaves our current inflationary system largely in place, they are unlikely to be successful.”
In other words, U.S. health care remains a stinking hot plutocratic mess, as before.
Here’s How the Unraveling of Livable Ecology Looks
“More Than a Little Scared”
Meanwhile, in a story that hardly captures attention, the planet is on fire. Speaking of hot plutocratic messes, the raging Colorado wildfires are just the latest in a growing list of signs that the threat posed to humans and other living things by global warming is reaching a new stage of lethality (The dominant corporate media has been reluctant to connect the wildfires to the anthropogenic climate change, of course). According to new research released last month by the science journal Nature, humanity is now facing an imminent threat of extinction with human-generated climate change in the vanguard of the menace. The report reveals that our planet's biosphere is steadily and ever more rapidly approaching a “tipping point.” Earth’s ecosystems are nearing a sudden and irreversible change that will not be conducive to decent human life. The authors describe a rapid “state shift” once the tipping point is reached – a sharp difference with the mainstream view that environmental decline will take centuries. "It's a question of whether it is going to be manageable change or abrupt change. And we have reason to believe the change may be abrupt and surprising," said co-researcher Arne Mooers, a professor of biodiversity at Simon Fraser University in Canada's British Columbia.
"The data suggests that there will be a reduction in biodiversity and severe impacts on much of what we depend on to sustain our quality of life, including, for example, fisheries, agriculture, forest products and clean water. This could happen within just a few generations," stated lead author Anthony Barnosky, a professor of integrative biology at the University of California in Berkeley. "My colleagues who study climate-induced changes through the Earth's history are more than pretty worried," he said in a press release. "In fact, some are terrified.”
The report, written by 22 scientists from three continents ahead of this year's laughably tepid and inconsequential United Nations Rio+20 climate summit, claims that the “state shift” is likely. They think that humans “may have a small window over the next few decades to redesign their relationships to each other and to nature through international cooperation to avoid extinction.” 
“The Great Melt…A Commons-Despoiling Tragedy”
A recent special 14-page cover story in the proudly neoliberal-capitalist Anglo-American weekly magazine The Economist is dedicated to an interesting topic: “The Vanishing North: What the Melting Arctic Means.” The Arctic is warming twice as fast as the rest of the planet, and at a much quicker rate than the direst predictions expected, Economist researchers found, adding that “The shrinkage of the sea ice is no less a result of human hands than the ploughing of the prairies. It might even turn out as lucrative. But the costs will also be huge. Unique ecosystems, and perhaps many species, will be lost in a tide of environmental change. The cause is global pollution, and the risks it carries are likewise global. The Arctic, no longer distant or inviolable, has emerged, almost overnight, as a powerful symbol of the age of man.”
Candid acknowledgement of harsh realities is permitted in media venues targeting ideologically safe system coordinators. They should have added: “a powerful symbol of humanity’s self-destruction and murder of other species.”
Torn between thrill over the short-term profit opportunities offered by the retreat of Arctic ice and long-run horror at deepening environmental catastrophe, The Economist notes the reluctance of the world’s multinational petroleum corporations to acknowledge the viciously circular, mutually reinforcing relationship between the vanishing of the North and the extraction of previously un-reachable Arctic oil and gas resources:
“In the long run the unfrozen north could cause devastation. But, paradoxically, in the meantime no Arctic species will profit from it as much as the one causing it: humans…. the great melt is going to make a lot of people rich…The Arctic…has oil and gas, probably lots…Oil companies do not like to talk about it, but this points to another positive feedback from the melt. Climate change caused by burning fossil fuels will allow more Arctic hydrocarbons to be extracted and burned.”
The more oil and gas they extract, the more they melt the North. The more they melt the north, the more oil and gas they extract. “Positive feedback” is an interesting term for a process that The Economist calls at the end its report “a textbook illustration of the commons-despoiling tragedy that climate change is.” Serious thinkers and activists might wish to dig a littler deeper on the subjects of which “humans” are going to profit most from “the great melt” in the short-term and whether it is really “a paradox” that a profits system might extract profit (for some “humans” – if that’s how he want to describe the sociopaths who extract personal gain from the ruination of livable ecology) from a process that is certain (there is no reason, really, to use the magazine’s qualifier “could”) to “cause devastation” over “the long run.”
“In a Rational World”