Neoliberalism and American Exceptionalism: they’ll win if it kills you

Today, about 50 million Americans exist everyday without healthcare coverage. To put that in perspective, that’s more than the population of California and roughly equal to the population of England. Let that sink in a moment, equal to the entire population of England. That’s the population of an entire industrialized nation. On top of that, we spend about two to three thousand dollars per capita on average more than other industrialized nations yet our life expectancy is among the lowest in that category. To blindly perpetuate the idea that all is well in the world of American medical services is disingenuous and a backhand slap in the face of the American people.

Death panels, rationing, Obamacare, it’s un-American. We’ve all heard these phrases bandied about by opponents of universal healthcare initiatives and supposed proponents of consumer choice. And it happens to be really unfortunate, because those accusations, or might we say, marketing slogans, obfuscate the real issue at hand and intentionally mislead; they make it seem that a general healthcare program that insures coverage from the least to the greatest is an affront foisted upon Lady Liberty by subversive liberals, who are the real enemies of democracy rather than the immortal, immoral, practically politically Omni powerful citizens we call corporations. Well, at best they simply miss the point, at worst though, they’re economic terrorists and brigands who prey upon the apathy, social fatigue, economic impoverishment and emotional disengagement of the middle, working class and poverty level populations. Consistently, the project of healthcare reform and the introduction of a universal type of healthcare system is made out to primarily be an attack upon consumer choice, freedom and the rugged individualism that so characterizes the American Spirit, and implicitly a rebuke of American Exceptionalism. But in reality it isn’t about choice or market nationalization, though it is, I think, a rather indicting proclamation regarding American Exceptionalism. The truth, though, is something quite different, a bit more profound and more relevant to the people, because, to put it bluntly, healthcare is about dignity, human rights and egalitarianism.

The idea of privilege is a leftover and cancerous ethic of aristocracy, justifying all manner of oppression and imperialism both at home and abroad. The consequences of the idea of privilege are made manifest when it comes into conflict with idea of entitlement. Sadly, entitlement as a social descriptor has gathered a lot of baggage, some certainly justified while others not so much, that detracts from the idea that it really represents, that people, particularly citizens, are imbued with inherent and ordained rights that they are entitled to by virtue of their very existence. Life, Liberty and the Pursuit of Happiness are some such entitlements; safety from tyranny and oppression, freedom of association and speech, protection (at least formerly) from federal intrusion into privacy without cause, we could also say that as Americans we hold to these as entitlements as well. But when we come to healthcare it suddenly becomes, rather than an entitlement, a privilege and object of consumer choice. And honestly, none of the previous entitlements, or rights and freedoms that I spoke of, have that profound an effect upon the market’s function of assigning value and producing profit, whereas the categorization of healthcare as an entitlement rather than a privilege has significant consequences upon the authority of the Market and the illusion that it functions in a moral sense. Ultimately, the market may provide the best possible care, but it does so for the smallest possible number of the population; quality of care becomes a privilege afforded those with the economic affluence to not be constrained by the overall cost of care that renders it prohibitive to those of a lower economic caste. And that is part of the fundamental problem with the market regulating the healthcare industry, and presently it exerts significant control and influence over both access and quality of care. Economics can be just as effective in rationing healthcare as any bureaucratic method, with the persons involved being much less inclined to altruism and compassion (in fact the market mitigates against the influence of those two virtues) then a bureaucratic system comprised of people, however flawed. Furthermore, the cost of care for even those who have healthcare coverage is often as prohibitive to utilization as it is to those who have no coverage at all. An easy example is dental insurance. There is usually a yearly spending ceiling regarding what the insurance company will pay in addition to what percentage of a procedure they will cover, and that ceiling is generally quite low; significant enough for general maintenance and preventive care but is typically insufficient for major work. This commonly leads to concessions, care is put off with the hope of being able to deal with, the unfortunate result is that it usually leads to larger costs in the long run due to the more extensive care that is then needed. This is economic healthcare rationing, where the market forces the worker to decide what is more important, health or food, health or housing, etc. As a concrete example of the prohibitive nature of current healthcare costs in America, more than 60% of personal bankruptcies are the result of unmanageable medical debt.

Is healthcare a privilege or a fundamentally modern civil right? How one answers that question largely determines how you approach the current debates about healthcare and even so far as to how you morally appraise Barack Obama. And if you respond by saying that you don’t think that your tax money should go to something that you might not directly or immediately benefit from than you should stop paying your taxes altogether. Because who really needs Medicare or Social Security, the Military or Emergency Relief Funds, or hell, who needs the Foster system, let the kids figure it out for themselves. But at the end of the day, healthcare isn’t about socialism or communism, or democracy for that matter, it transcends those things. It’s about the claims we have upon each other as fellow human beings that share these cities, counties, states, country and ultimately this planet upon which we move and breath.

Hopefully, in the end…

We are, at least, rid of some of our illusions. We can no longer buy the highest satisfaction of the individual life at the expense of social injustice. We cannot build our individual ladders to heaven and leave the total human enterprise unredeemed of its excesses and corruptions. –Reinhold Niebhur: Moral Man and Immoral Society