Another Fake Ally for Health Care
Andy Stern continues to invite more strange fellows into his bed. The President of the Service Employees Union has drifted far astray from the rest of the labor movement and most sensible healthcare reformers by partnering with Wal-Mart, the Business Roundtable and other pro-business groups whose agenda is in direct opposition to ours. Their wet dream is to dump their insurance obligations on the public ledger, not to ensure that everyone can receive good medical treatment at “no cost” through public funds, funded in large part by a payroll tax on employers. “Medicare for all” must be our goal, and any proposal that leaves private insurance companies free to exploit and profit, or that places most of the burden for funding the program on the backs of taxpayers and workers who have already won health insurance from their employers through their unions is bound to fail.
Stern recently welcomed into his “unlikely alliance” the National Federation of Independent Business, the small business lobbying group that killed the last effort at achieving universal health care. This group’s number one objective is to fight any new payroll tax. They are an enemy of “Medicare for all.” Aside from the perversely exploitative profit motive of private insurance companies, which leads to medical inflation that prices too many people out of the system, the second biggest problem with our fractured health care system in the U.S. is the unfair competitive advantage that companies that shirk their responsibility to insure their employees gain over responsible companies that do. It’s Wal-Mart vs. Pathmark. Small businesses are the worst offenders in this regard. More than 60% of the 47 million people who have no health insurance in this country work for small businesses.
If all employers paid into the same insurance – Medicare – then companies like GM and Pathmark would benefit from the enlarged group plan and pay new payroll taxes that would be lower than their old premiums. Small businesses and companies like Wal-Mart would face a tax hike that would bring their total payroll closer to that of their competitors. Any proposal for a national health insurance plan that calls for a substantial income tax hike in lieu of a tax hike on employers is asking, in effect, for unionized employees and others who bargained for good health insurance in lieu of greater pay to take a pay cut in order to subsidize irresponsible businesses. This is not a matter of standing on principle and refusing to make pragmatic compromises. It’s a matter of being pragmatic in building the coalition we will need to win health care for all. Inviting the National Federation of Independent Business and the Business Roundtable – who have been and always will be opposed to a single payer health care system like “Medicare for all” – to take part in the “grand alliance” will cost any reform effort the support of regular taxpayers whose political pressure for such reform is essential. Whatever proposal comes from Stern’s coalition will be a political non-starter.
The High Cost of Health Care (For Cats)
The high cost of health care is a problem for more than just us monkeys. The price of veterinary services has skyrocketed faster than inflation, too. I had the opportunity to buy pet insurance through my union, but declined. Pet insurance is for little old ladies who order chemo-therapy for their hobbled, mangy 19-year-old cats, isn’t?
Well, about two months ago, my cat, the duck, began a campaign of biological warfare in protest of my longer hours at work on a campaign in New Jersey (or so I thought). I took her to the vet. Urine tests were inconclusive, but antibiotics were prescribed anyway, in case it was a urinary tract infection. Oh, and duck needed booster vaccinations. It’s the law, the vet said. The bill was eighty bucks, but that didn’t seem too bad a price to pay to get my cat to stop peeing on every piece of furniture I owned.
The duck would foam at the mouth when the cold white goo was injected in her mouth, and she proceeded to go on a three day hunger strike. Back at the vet’s office, she was admitted for overnight observation and more tests, also inconclusive. This time the diagnosis was behavioral, and the doctor ordered anti-depressents, which included options for kitty Prozac and kitty lithium. “They’re actually the same as human Prozac and lithium,” the vet helpfully explained, in case I might want to dip into the supply myself after seeing the bill. Another ninety dollars.
This bought thirty days of relief. As soon as the medication was out of her system, though, she peed on my couch. This time I found blood in her urine. Back to the vet for another overnight stay, more tests and another hundred and something dollars in expenses. The tests, an X-Ray and MRI, found a stone in her bladder. Surgery would be required. That was estimated to cost seven hundred bucks.
Of course, there were options when I brought her back for the surgery. Laser surgery would reduce bleeding and improve recovery time. That would be another fifty dollars. An IV catheter was strongly recommended for older cats (Oh, yes. I forgot to mention. duck is an older cat. When we rescued her from the mean streets of Valley Stream, LI, she was estimated by that vet to be two years old. When I brought her in to the local clinic for the first time, the vet said, “If I was being charitable, I would say this cat is six years old. This is a middle-aged cat.”). The IV and fluids would cost another seventy bucks. What the hell. It’s kinda like throwing in options on a new car. You’re already paying so much, what does it matter now?
It’s a good thing I’m in line for a promotion at work. All the money will go directly to the duck. Back at home, the couch is covered in garbage bags because the stitches on her bladder will itch and irritate and may still cause “accidents” for the next ten days. She also needs to take antibiotics, which, helpfully, are pills this time. She gobbles them and her pink crazy pills like a good little pill popper. Her front left leg is shaved like a poodle, as is a good deal of belly, revealing a ridiculous fleshy paunch with a zipper of stitches in the center. She’s wearing a cone around her neck to keep her from chewing out the stitches. She looks more annoyed than usual, and her equilibrium is totally thrown off. She does a ridiculous high step so she can see her paws and be sure they’re walking in the right direction. She keep bumping and snagging on doorways, as she still slinks and rubs against them before entering a room.
With great timing, I’m finally being sent back to New Orleans on Monday. A sucker, er, sweet friend has volunteered to duck-sit and handle medical chores. I need to figure out a living situation for me and the duck if the promotion I get is a traveling organizer position with the national union. This has involved calling ex-girlfriends to see if they would be foster cat moms while I sell my apartment in order to trade up to a 2-bedroom with space for a cat-loving roommate.
Re-reading this article, it occurs to me that I have become the little old lady who orders chemo for her geriatric cat.
More On Inequality Sickness
Following up on my previous post, in case I wasn’t clear (“Are you following me?”), here is a simple graph that argues much more clearly that inequality is making us sicker:
This chart represents diabetes rates by income group (divided simply into thirds; the richest third of the population, the middle third and the poorest third) in the UK and the US. First, note that the poorer you are, the likelier you are to have diabetes. In America, this is not surprising, because our poor lack health care. In the UK, however, the poor has the same health care as the rich (or at least the middle class), and yet they are still more likely to have diabetes, although not nearly as likely as their American counterparts.
But now, compare the poorest Brits to the richest Americans. Lower rates of diabetes! Both groups receive similar quality of health care, so what accounts for it? Surely, it can’t be the average British consumption of fish and chips, lager and fags. What the research is pointing to is a surprising correlation between inequitable income distribution in any given country, and higher rates of disease and death across all income groups.
Dr. Robin Hood
Dean Robinson’s “Health Politics and Inequality” class has taken some surprising turns. Jill Quadagno’s book, “One Nation, Uninsured” served as an efficient history of how we got the lousy system of health care that we have, so the questions of how and what kinds of alternatives we ca have were neatly dispensed with.
Basically, the “simplest” and fairest universal system would be to simply expand our already existing Medicare system to cover everyone. That would give us the Canadian “single payer” system (which, coincidentally, is also called Medicare). Of course, to fund the program, the government would have to institute a new payroll tax on employers. For employers who already pay around a quarter of an employee’s salary in insurance premiums, this would essentially replace those premiums and would probably lower their costs and improve their market position, as it would serve to “take health care out of competition” by equalizing their equalizing their costs with those of employers that do not currently provide health insurance for employees (and for whom such a payroll tax would be a new and unwelcome development). Business, being business, would likely seek to take the cost of health care off its ledger and dump it on the public in the form of tax income tax increases – which would naturally be controversial. Yes, polls show that Americans are willing to pay higher taxes for more social services. But, the millions of Americans who already receive health care through their employers do not want to pay for what they already have. This would not be a tax increase, as much as it would be a pay cut. The combination of such anti-business tax agendas with the fact that such a “Medicare For All” solution would necessarily be a frontal assault on the rich private insurance industry creates a powerful coalition of capitalist opposition to universal health care that is built in to the problem. This is to say nothing about the potential to energize the religious right over the issue of public financing of reproductive health services. Clearly, it will take a rock-solid coalition of “the good guys” if we have any chance, and the labor movement must take a leading role in forming such a coalition.
Where Dean’s class has taken an interesting turn is the presentation of Ichiro Kawachi’s research of the effects of inequality on health. The research presented in his book, “The Health of Nations: Why Inequality is Harmful to Your Health,” basically finds that the level of inequality in a given society has a direct relationship with average life expectancy, disease rates and infant mortality. Kawachi controls for income levels, access to health care and a host of other factors one might expect to explain these numbers. Holding all other things equal, a person who lives in a country that has a large gap between the rich and the poor is unhealthier than his direct counterpart in a more equitable country. This is the same for rich people as it is for the poor.
You might expect a socialist to love this report, but I find it troubling. The problem is that wealth redistribution is just so…un-American. In my past life as a teenage mutant ninja socialist, going on speaking tours and doing media interviews for the Socialist Party, I’ve always de-emphasized the Robin Hood aspect of socialism. What’s most important to talk about is, first, what we as working people need and deserve: Meaningful work at good pay; decent, affordable housing; health insurance, vacations and pensions. Second is what’s preventing so many of us from having these things: the capitalist system of production for profit and not for need. I’ve always differentiated between private property and personal property. What we want is to publicly own and control the basic companies and industries, not to share your toothbrush and wife. Taking away mansions and yachts from the rich is not crucial to the functioning of the economy, and would not be the first step of a socialist revolution. But I don’t talk about it because Americans don’t like the idea. They want to believe that anyone can “earn” such ostentatious wealth (as if the Waltons and the Hilton’s “earned” their daddies’ money!). But, if Ichiro Kawachi’s research is correct, those ostentatious displays of wealth are terrible for our health. Watching “MTV Cribs” could literally kill you (and the rich idiot with the air-conditioned display room for his hats).
In many ways this is a moralistic argument for socialism, and I hate those. I’m a materialist, and prefer to focus on jobs, peace and freedom. But, Robin Hood was right, and we need more people like him.