Healthcare: Of Weakest and Strongest Links in the Battle of Ideas
by: Murli Natrajan on August 23rd, 2009 | 6 Comments »
Despite the fact that some individuals have shown up at the town hall meetings literally armed, left progressives need to continue to seriously identify and attack the strongest links (not the weakest) in the ideological repertoire of those who are so rabid in their opposition to the Obama healthcare plan. This means that focusing on the “will my granny be put to death” argument is only a distraction. This is not among the strongest arguments that congeal whatever opposition to this healthcare plan emanates from the broadly defined right-wing. It is definitely the strangest, perhaps.
Anyway, focusing on the strongest link is what the Italian communist Antonio Gramsci languishing in Mussolini’s prison wrote in his Prison Notebooks as the strategy in an ideological struggle as different from a military struggle. For Gramsci, whereas in the latter kind of war one has to attack the weakest link of the enemy, in the former kind of war one needs to attack the strongest link. This is because of the power of ideas which is not only of a longer durability than a military formation, but is also of a different quality – ideas when developed into beliefs and then upheld through rituals (customs, traditions) that reinforce beliefs – have a way of digging themselves very deep into psyches and collective consciousness. In this sense, the television shows we see are of course all living room war-games of the ideological kind.
So, what are some of the strongest links in this chain of right-wing ignorance and arrogance? At the outset, we can agree that much of the left too critiques the current Obama health plan and has proposed a much better, much saner, much fairer, much less labyrinthesque (is this a word?), and much more efficient (yes this too!) plan with a great name: Medicare for All. So, the left critique of the plan needs to be differentiated clearly from the right critique.
Although I cannot lay much claim to having followed all the town-hall brouhaha, it seems to me that the following are three of the deadliest sins that anyone can commit in the eyes of the well-armed townhallers fighting for granny.
1. Promoting a healthcare plan that is socialized medicine
2. Claiming that government can be efficient and sometimes more efficient than private sector
3. Claim that every sector in the economy need not be open to profit-making
This gives us the three strongest links in the right-wing chain of thinking:
1. Socialism is inherently evil; the Obama Plan is socialistic; therefore it is evil.
2. Government is inherently inefficient (if not evil); the Obama Plan with its (vaguely defined) “public option” will monopolize the market and soon control everything; therefore it is inefficient
3. Profit-making is inherently moral; the Obama Plan will curtail profit-making; hence it is immoral.
So, our task is to actually show that:
1. Socialism is not inherently evil OR the Obama Plan is not socialistic
2. Government is not inherently efficient and can be efficient in some cases/sense/contexts OR the public option in the Obama Plan will not control or monopolize the market
3. Profit-making is not only not inherently moral but is mostly inherently immoral OR the Obama Plan will not curtail profit-making
It should be clear by now that the President’s team has decided to fight the fight only by choosing the latter options (following the “OR”) in each of the three argument above.
Progressives can do better; indeed must. We must find ways to constantly and consistently show that socialism is not inherently evil, that the government could be efficient given the context for it, and that profit-making if not inherently immoral definitely need not be allowed uncurtailed or allowed in every sphere of public life.
Sometime back, the non-socialist, non-communist media channel, Public Broadcasting Services (PBS), made a very illuminating film Sick Around the World which takes the discerning viewer into the healthcare systems and lives of people living in five capitalist countries: the UK, Japan, Taiwan, Germany and Switzerland. The film which documents – through interviews with policy makers, patients, academics, doctors, hospital staff and politicians – the facts of these five healthcare systems makes at least three solid points:
1. That socialized medicine far from being evil, actually ensures that the elderly (and the very young) are fully taken care of regardless of their financial capabilities. Noone, not a single person in each of these five countries goes bankrupt taking care of their health. Moreover, the moral sensibilities in most of these countries, holds it abhorrent that anyone will be allowed to go bankrupt in a system! Check out especially the Swiss case in the film.
2. That the government in each of these countries does run the system (or that part of the system for which they are responsible) in relatively efficient ways. The best statistical evidence for this is of course in the fact that each of them spends far less % of their GDP and far less amount of $$ per capita on providing as good if not better healthcare than the US healthcare system does. See these fascinating graphs (which many may have seen but all of us need to send to more folks out there).
3. That each of these capitalist democracies had a robust public debate (including referendums in some cases) and came to the following conclusion: that whatever one may think about profit-making, it was in the best interest and morality for their society to not allow the healthcare sector of the economy to operate freely for profit! Yes, Japan, Germany, UK, Switzerland and Taiwan – all seem to have made this decision in some way or another. Of course, all the systems are not the same. Hence some of them allow some small kind of profit making system (most ban insurers from profiting on basic care), some amount of competition, and many kinds of private enterprises within their healthcare systems (except for UK, for the most part, all others have private industry in this sector).
I am not sure if this gem of a film (complete with resource material for engaging in intelligent and bold discussions) has got the publicity in these critical times as it should. So………….please check out the website and send it to your friends….and (ideological) enemies. Then what? Well, how about the next film on PBS – Sick Around America.
Peace
I added your blog to bookmarks. And i’ll read your articles more often!
Everyone should also see “Critical Condition’, which aired on PBS Bill Moyers Journal this past weekend! Nuff said.
http://www.pbs.org/moyers/journal/08212009/profile.html
A letter that I sent to my local newspaper two weeks ago covers points 1 and 2 — (a) Socialism is not inherently evil , and (b) Government is not inherently inefficient. It falls within the 300-word limit that many newspapers impose. Please feel free to send it to your local newspaper or rework it to your liking:
*****
When enacted in 1965, the Medicare program did not reform medical care. Instead, it provided needed single payer insurance for seniors. It did not create socialized medicine or allow a “government takeover of health care”. It did, however, socialize the way we fund care for the elderly. Which Republican or conservative Democrat will go on record wanting to dismantle this “socialist” program?
In Canada, doctors are independent and run their own practices. Only the insurance pool is socialized, enabling lower costs and universal coverage. The notion of endemic waiting is exaggerated, and for every such story from Canada, far more instances of delays, exclusions, and retroactive cancellation of coverage on technical grounds occur in the U.S. Rationing is another scare tactic used by opponents of single payer. In Canada, care is rationed according to need. Here, it’s rationed by one’s ability to acquire insurance and pay the bills.
What accident of history created our peculiar hit-and-miss employer-based insurance system? Single payer unshackles businesses from the burden of insurance costs, allows employees currently held hostage to employer-provided insurance to seek better jobs, and permits all businesses, large and small, to compete on a level playing field for the best personnel.
Nearly all revenues from broad based progressive taxation for a low-overhead single payer program would cover care and medication. Private insurers, on the other hand, spend lavishly on executive bonuses, lobbying and marketing, political contributions, and armies of workers ferreting out ways to avoid paying for care.
Short of single payer, the public option is a watered down compromise with diminished effect. The most cost-effective and compassionate alternative is a public single payer plan, providing care for all, controlling cost, and disencumbering business. It will come eventually, after years of suffering and waste. Why not seriously discuss its merits now?
If the public option is in the healthcare bill, it will reduce the cost of medical care by increasing competition, allow people who arre not covered to be covered and prevent the private sector from preventing people who become sick to contiue coverage. It is the moral way to go. In the USA, medical care is too concerned with the profit motive.
I think the central assumption we need to tackle is the assumption that profit-seeking is mankind’s greatest good. This assumption is incorrect. In fact, basing our moral choices on profit has not only destroyed our healthcare system: it has severely crippled our food production and distribution system, our environment, our criminal justice system, our national security and our schools.
Profit, as an organizing factor for society, is bankrupt. A little bit of socialism can go a long way to fix the imbalance!
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