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Why No National Health Care?

The United States has the best health care that money can buy, provided one has the money to buy it. Jill Quadagno’s “One Nation Uninsured” answers the question “Why the U.S. has no national health insurance.” It’s a brisk, engaging read that neatly summarizes how 90 years of failed reform efforts have entrenched the powerful interests that profit from the system.

The most prominent early opponents of a national health service were the doctors themselves. Their lobby, the American Medical Association, fought against “socialized medicine” out of fear that it would lead doctors to lose their sovereignty to bureaucrats basing decisions on budgetary needs rather than medical needs. Allied with southern politicians who feared that a federal health system would force racial integration of hospitals, these forces successfully kept national health care out of Roosevelt’s original Social Security legislation. They favored market solutions like Blue Cross and commercial insurance. A new business was created, resulting in a more powerful lobby.

The trade union leaders of the time, many of whom were social democratic in their outlook, reluctantly shifted their efforts at creating a social safety net to the bargaining table, winning employer-sponsored health care plans. Some unions – notably Sidney Hillman’s Amalgamated Clothing Workers – created their own networks of health care clinics, socialized medicine in miniature. Wartime government policies that encouraged fringe benefits over wage increases greatly expanded the private welfare state so that by the 1950’s, most large employers (including non-union firms that aimed to remain non-union) provided health care benefits.

Trade unions continued to push for a government solution to health care, but by the 1960’s they narrowed their focus to the proverbial “camel’s nose under the tent,” health insurance for the nation’s elderly. The Medicare program that the coalition of labor and seniors won had several unintended consequences. One was that with senior citizens covered through the program, and most working families fully covered by an employer’s plan, few voters clamored for a universal national health care system for the next few decades. Another consequence, happily, was the racial integration of most hospitals, under threat of being denied Medicare funding.

A regrettable consequence of Medicare was rampant inflation of cost of health care. Doctors and hospitals provided comprehensive care for senior citizens, ordering tests, procedures and drugs that they might not have before there was guaranteed funding, which was a boon not only to the health of senior citizens but to the corporate bottom line of the for-profit hospitals and insurance companies that joined the market for health care services. The cost of Medicare skyrocketed, until government efforts to control costs caused insurance companies to simply pass on the costs to employers in the form of higher premiums for their employees. Companies responded in turn by cutting benefits, introducing co-pays and turning to health maintenance organizations to control costs by denying care. The doctors’ worst fear, losing sovereignty over medical decisions, was realized through the insurance companies that they were responsible for creating.

This brings us to our current circle of hell, where an employer’s threat to cut benefits leaves many unions close to helpless in contract negotiations, where people with the dreaded “pre-existing condition” are denied meaningful coverage and where the existence (or non-existence) of national health care or employer-sponsored insurance goes a long way towards determining a company’s competitiveness in the global economy.


This January, I’ll be taking an elective class with Dean Robinson that will be exploring the United States’ lack of a national health service and its impact on our health, wealth and democracy. Quadagno’s “One Nation Uninsured” is the first book assigned. Others are Kawachi and Kennedy’s “Health of Nations: Why Inequality Is harmful to Your Health” and Sered and Fernandopulle’s “Uninsured in America.” For my paper, I will be taking a look at some trade union health clinics, particularly the Amalgamated’s (now UNITE HERE) and the NY Hotel Trades Council’s, which was inspired by Hillman’s example. These socialized medicine-in-miniature not only provide comprehensive health services, but they keep costs so low that employers actually offer up concessions in order to take part.

The lesson here, I think, is that while we might succeed in creating a single-payer health care system like Canada’s (particularly as health care becomes more of a crisis), inflation and price-gouging will be crippling until we take the profit out of the system and nationalize health care services to serve the interests of the people, not the corporations.

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New (To Me) Record Round-Up

“Enemies Like This.” Radio 4. I root for Radio 4 like I root for the Mets. They’re the home team (if you can call Williamsburg anyone’s home) and they deserve to win. I’m not sure that this is the record that will make them stars, however. The propulsive poly-percussion and Gang of Four-style slashing guitars are still there, but after the first four tracks it all starts to lose steam.

“Big Star, Small World.” Various. I’m utterly perplexed that power pop never conquered the world. Infectious pop sensibilities, crunchy guitars: something for everyone, no? Instead, it’s a weird little niche for freaks like me. The grand-daddy of all power pop groups, Big Star, were feted with a tribute record from the little pups who worship them. Released in 2006, goodness knows how long these tapes were sitting on the shelf, as half the bands on “Big Star, Small World” (the Gin Blossoms, Afghan Whigs, Whiskeytown and Posies) have since broken up, and two of them (the Posies and the Gin Blossoms) found time to reunite, too.

Unfortunately, all the bands here are too faithful to the source material, and thereby pale in comparison to Big Star’s slender, seminal work. The Posies eke slightly more desperation out of “What’s Going Ahn” and Wilco manages to find even more tender nuance in “Thirteen.” Otherwise, there’s nothing here that doesn’t make you want to spin your copy of “#1 Record/Radio City,” instead. The reunited “Big Star” (basically, Alex Chilton and drummer Jody Stephens, augmented by various Posies) contribute a weak track, “Hot Thing,” that sounds like an outtake from one of Chilton’s anemic solo R&B records. Stick with the classics.

“One Day It Will Please Us To Remember Even This.” New York Dolls.A reunion that doesn’t disappoint, the living Dolls (all two of them) might have put out the best rock-n-roll record of 2006. It’s all snarling guitars, sneering attitude and horny come-ons. The delightful “Runnin’ Around” starts off as an ode to feet before delving into more freakiness and something about flesh-colored panties. Elsewhere, David Johansen declares that happiness is “Fishnets & Cigarettes” and goes shopping in the red-light district in “Rainbow Store.”

Since the Dolls imploded in the 70’s, Johansen found success as a comic actor, and the influence shows. Not so much singing as growling off-key, for most of the record, Johansen employs a hoary Noo Yawk accent that Archie Bunker couldn’t get away with. “Exorcise yer demons with that monkey grin,” he sings on the witty Christian Fundy-tweaking “Dance Like a Monkey,” “Cuz we gonny inherit the wind!” Gonny? That’s probably his ballsiest move on this ballsy record.

“The Believer.” Rhett Miller. On his second solo record, Rhett Miller disappointingly displays little of the songwriting wit and rock bravado of his band Old 97’s. Either temporarily out of ideas or else in need of good collaborators, two of the three good tracks on this record are retreads of earlier Old 97’s tracks. “Question,” which was no more than Rhett and his guitar on the 97’s excellent “Satellite Rides,” is somehow schmaltzier here, which means that this is the version of the song that we are all doomed to here at every wedding we ever attend until the day we die. “Singular Girl,” previously an outtake from the same record, suffers from the lack of ragged edges that the band gave it.

The saving grace of “The Believer” is a duet with Rachel Yamagata on “Fireflies.” Miller’s songwriting prowess is in full force here, audaciously referencing lines from at least three of his most beloved songs and tying an awkward comparison of his lost love to his mother and the so-bad-it’s-good analogy “In a jar / Fireflies / Only last for one night” into a slow-burning song of heartbreak and regret. This is why I buy this guy’s records, and why I can’t wait until the next proper Old 97’s record.

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The Elusive Third Party of the People

The Green Party failed to regain ballot status in New York on Tuesday. With its superior budget and no threat to the two-party system, the Working Families Party easily retained its ballot line. We have a new, independent socialist Senator in Vermont, although his Progressive Party studiously avoided incurring the wrath of the Democrats by not contesting any major elections.

This is a disappointing time for supporters of an independent people’s party. The Green Party is clearly on the wane, with ballot status in a few dozen states and the mighty Nader campaign of 2000 a fading memory. Not to be too pessimistic, but I have been predicting it for six years now. The Greens will join a crowded graveyard of similar efforts to establish a third party, a party of the people, to supplant the Democrats. They come along every few election cycles. There’s Bob LaFollette’s 1920’s Farmer-Labor Party, Henry Wallace’s Progressive Party in 1948, the 1960’s Peace and Freedom Party of Eldridge Cleaver, the 1970’s People’s Party of Benjamin Spock, the 1980’s Citizen’s Party of Barry Commoner and the Green Party of Ralph Nader. There is no such party on the horizon, just the detritus of past efforts, which exist here and there scattered among the states.

I was not a supporter of the Greens at their height. In 2000, I managed the Socialist Party’s presidential campaign of David McReynolds. I drafted the candidate to run, raised about $20,000, put him on the ballot in seven states (including Florida, where his 622 votes eclipsed the 537 votes by which Bush officially triumphed; fuck you very much), got him in front of dozens of college audiences and garnered some pretty fantastic press coverage for a tiny little party.

Was I wrong in 2000 not to support Nader’s candidacy, one of the most energetic, high profile threats to the two party system in the late 20th century? The answer to that question is complicated. Certainly in a year when the burning question among liberal circles was whether a vote for Nader was, in effect, a vote for Bush, it was a tad awkward to explain to people that, no, I wouldn’t be voting for Nader or Gore but for someone they’d likely never heard of. It struck most listeners as typical sectarianism of the socialist left, and, indeed, it was.

In the Socialist Party’s defense, our crystal ball was just as clouded as the Green Party’s. Ralph Nader ran lackluster, quiet semi-campaigns in 1992 and 1996 (the former in the Democratic New Hampshire primary, the latter as the Greens’ drafted standard bearer), and there was no telling in late 1999 (when the SP had to choose to run or not) that Nader would, in fact, campaign seriously, energetically and in the face of such opposition from his liberal former allies. Had I known then that he would do so, I would likely have still supported running a Socialist Party candidate, but I’d have been wrong. But even that is complicated. As exciting as the 2000 Nader campaign was, as much of a blow to the two-party system that it had been and as many activists that it created, as many voters it ripped away from the Democrats and as many progressives it split away from the shrill, bankrupt liberals, a few short months later, only the barest hint of the Nader movement was left as many of its supporters were scared back into the Democratic fold. Meanwhile, the attention that the Socialist Party got for its campaign (we delighted in media attention; I got David on “Politically Incorrect” and “the Daily Show” and my sarcastic voicemail in response to the Florida vote controversy was quoted in the “Washington Post.”) increased our tiny membership by about 30%.

But that’s a sectarian justification. As little as there was, in the end, to show for the Green Party effort, the right policy would have been to support it, to strike a blow at the two-party system and gain the long-term loyalty of as many voters as possible for an eventual mass party of the people. The problem with an organization like the Socialist Party, that makes the running of candidates under its banner – even if done in only a handful of instances a year – its raison d’etre is that it inevitably leads to the priority of party building over movement building.

The mass people’s party that we need will not be able to meet the stringent ideological requirements of sectarian socialists. It cannot be Marxian, although it must be free of corporate money and influence. We need a party that will push for universal health care, oppose militarism, democratize the broadcast media, promote equal rights for gays and affirmative action for blacks, that will be feminist in its internal decision-making, promote unions rights, expand Social Security, tax the rich, fully fund our schools, open up our ballots and push for fairer systems of elections. We socialists should take our place within such a party as activists and allies of the major streams of progressivism, only splitting after major reforms have been introduced and we can take a sizable following that demands to go further with us out of the party. It would be far better to be left opposition to powerful social democrats than weak liberals.

Should such a party form, it is likely to happen only when a large number of the furthest-left liberal elements of the Democrats – including many officeholders – are willing to finally break with the Siamese twins of capitalism, and might perhaps be cobbled together by the patchwork of state ballot lines and parties – the detritus at past efforts to create a national people’s party – that have gained substantial followings. Which means that the “correct” electoral policy for a socialist to follow largely depends on the state in which you live. In California, it means being active in the Peace and Freedom party, or even the Green Party. In Vermont, it probably means Bernie Sanders’ Progressive Party. In New York, it might mean a policy of boring from within the Working Families Party and forcing primary elections against the worst of the Democrats in the best of the districts.

Should I join another socialist organization, it will certainly not be one that considers itself a “party.” I’ve spent too much of my life trying to recreate the conditions of Eugene Debs’ long-gone era. We need greater flexibility of tactics and openness to our natural allies, and less nostalgia and sectarianism.

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Cultural Learnings of America

Your honor, it was the beer talking. Not me. It’s a lame excuse coming from Mel Gibson when he’s caught being himself (a sexist, anti-Semite yob), but even lamer when coming from drunken frat boys being drunken frat boys, on camera no less! The unnamed frat boys in question were the ignominious stars of “Borat: Cultural Learnings of America for Make Benefit Glorious Nation of Kazakhstan.”

I don’t need to tell you that Borat is the brainchild of comedian Sacha Baron Cohen, a fake TV journalist from a former Soviet republic who baits Americans to say outrageous things (that they likely believe) with his seeming innocence. On his TV show, he famously got a bar room full of country-western fans to sing along with a song called “Throw the Jew Down the Well.”

The movie is savagely funny. It has a fair amount of poop jokes and Jackass-style gross-out humor, but it also has a keen eye for mocking the elite and the powerful, and the racism and sexism of ordinary Americans. While everyone is baited, some of our fellow citizens pass their tests with flying colors, such as the driving instructor who responds to Borat’s “traditional” two kisses on the cheek with a grumbly, “Well, I’m not used to that, but that’s fine.” But most take Borat’s bait and reveal the ugliest tendencies of Americans. A crowd of rodeo fans applaud Borat’s speech, in which he wishes that Bush drink the blood of every Iraqi man, woman and child; a gun store clerk responds to Borart’s query of the best way to protect against Jews with the instant recommendation of a very large handgun.

Unlike these other victims of the fake foreign journalist, the frat boys in question – who are so embarrassed by the spectacle they made that they are suing the filmmakers to have their appearance removed from the film – needed no prodding at all. As soon as Borat hitchhiked his way onto their RV, they were extolling the virtues of slavery, the innate inferiority of women and how tough it is to be a white man these days where no one gives you any breaks.

I saw the new Borat movie on opening night with a raucous Times Square crowd, and the scene with the frat boys was the only part of the movie that hushed the crowd. It wasn’t funny. It was scary and depressing. These morons are the future of America. They’re probably future Congressmen.

Writing in the Nation, Richard Goldstein accuses Borat of double standards, of couching bigotry in humor in order to get away with the bigotry that Borat himself employs. Goldstein either did not see the movie, or did not get it. It is significant that the only black people (other than Alan Keyes, who deserves mockery) who appear in the movie are in on the joke, and help satirize genteel white racism. Everyone is not fair game, just the rich, the powerful and the intolerant.

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