Barack Obama's powerful speech Wednesday
night was undoubtedly the letter from which
he read, sent to him from "our beloved friend
and colleague" Ted Kennedy.
Kennedy had asked, back in May when he
wrote it, that the letter should not be
opened until after his death.
As Obama reported, Kennedy "expressed
confidence that this would be the year
that health care reform—'that great
unfinished business of our society,'
he called it—would finally pass," and in
doing so, define "the character of
Indeed, it is amazing that while Kennedy
served for more than four decades in the Senate
and dedicated much of his energy and
superb legislative skills to the passage of
just such a program,
the problem has only gotten worse over time.
Given the degree of the problem, it can be
difficult to understand, writes Serge Halimi,
editor of France's prestigious Le Monde
Diplomatique, why Barack Obama,
who has established himself as one
of America's most effective diagnosticians of w
hat ails our health care system,
is proposing so modest a reform to address
As the president told a Montana town hall
meeting this past August,
"We are held hostage by health insurance
companies that deny coverage, or
drop coverage, or charge fees
that people can't afford for care
they desperately need …
We have a health care system that too
often works better for the insurance industry
than it does for the American people."
Halimi answers his own question: "American
politics is so poisoned by money flowing
from industrial and financial lobbies
that the only proposals ensured a
smooth ride through Congress are
those that cut taxes."
Indeed, according to BusinessWeek,
in 15 states more than half of
the "market" is held by one private
health care company, and this kind of
monopoly profit is not going to go off
quietly into the night.
And yet this essential fact is often
missing from a media debate
that focuses on nonexistent,
often crazy issues like imaginary
"death panels" and whether or
not Sarah Palin would be forced
to murder her own child.
Late in the dog days of August,
The Washington Post published a piece
by T.R. Reid, a reporter who has left
the paper and written a book called
delineating what he called "five myths
about health care around the world."
It's worth reading the piece, not only for
the information it offers, but for the picture
of just how far our debate has drifted
Barack Obama is right.
We do have a health care system that is
not only unsustainable in the long term,
but a great shame on the heads of
those of us who can afford to buy
the health care we need whenever we need it.
Not only are the alleged horror stories
about "socialized medicine" untrue,
but its superiority to our own system
is largely absent from our debate.
In addition to the issues Reid raises—I have
not yet read his book—I did some research
on this question while writing Why
We're Liberals, and I found the following:
- The United States and South Africa are
- the only two developed countries
- in the world that do not provide
- health care for all of their citizens.
- Nationally, 29 percent of children had
- no health insurance at some point in the
- last 12 months, and many get
- neither checkups nor vaccinations.
- The United States ranks 84th in the
- world for measles immunizations and
- 89th for polio. These figures are
- particularly shocking given that
- Americans spend almost two and a
- half times the industrialized world's median
- on health care, nearly a third of
- which is wasted on bureaucracy and administration.
- Americans have fewer doctors per capita
- than most Western countries.
- We go to the doctor less than people
- in other Western countries.
- We get admitted to the hospital less
- frequently than people in other
- Western countries.
- We are less satisfied with our health care
- than our counterparts in other countries.
- American life expectancy is lower than
- the Western average.
- Childhood-immunization rates in
- the United States are lower than
- Infant-mortality rates are in the 19th
- percentile of industrialized nations.
- Doctors here perform more high-end
- medical procedures, such as coronary
- angioplasties, than in other countries,
- but most of the wealthier Western countries
- have more CT scanners than the
- United States does, and Switzerland,
- Japan, Austria, and Finland all have
- more MRI machines per capita.
- Nor is our system more efficient.
- The United States spends more than
- $1000 per capita per year—or close
- to $400 billion—on health care-related
- paperwork and administration,
- whereas Canada, for example,
- spends only about $300 per capita.
- And, of course, every other country in
- the industrialized world insures all
- its citizens; despite those extra hundreds
- of billions of dollars we spend each year,
- we leave 45 million people
- without any insurance.
- Meanwhile, the Finns, for instance,
- devote less than half of what we do
- to medical care, as a percentage of GDP,
- and yet their infant mortality rate is
- half that of the United States—and
- one-sixth that of
- African-American babies—while their life
- expectancy rate is greater.
- The United States ranked 42 in life expectancy
- behind not only Japan and most of Europe
- but also Jordan, Guam, and
- the Cayman Islands, according to
- the most recent census figures.
Conservatives, members of the American medical
industrial complex, and other defenders of
the U.S. status quo frequently berate
the European health care alternative
because they say the care that patients
receive there is both less responsive
and less advanced than that available
to Americans, however much more we may
have to pay for ours.
But American patients wait longer,
on average, for routine treatments than
those in France and Germany.
Moreover, hospitals in those two nations
also provide new mothers more than
four days to recover, while insurance
companies insist that doctors
send American mothers home after only two.
Swedes enjoy better success rates
treating cervical and ovarian cancers.
The French best the American system
when it comes to stomach cancer,
Hodgkin's disease, and
The French also benefit from more
cancer radiation equipment than Americans.
And despite so many American boasts
on exactly this topic, Germans get the most
In the area where one hears the loudest
cheers for the American system—making
new cancer treatments available to patients
as quickly (however expensively) as possible,
the United States is merely tied
with Austria, France, and Switzerland.
I could go on—almost indefinitely.
And perhaps there are good reasons why
we cannot match the performances
of all of these countries when it comes
to providing decent health care to
our citizens despite being the wealthiest
nation in the world.
But the arguments related to economic
efficiency are demonstrably false.
Conservatives so consistently denigrate
21st-century Europeans that one can't help
but wonder what has them so worried.
"If you want a lower standard of living,"
conservative policy experts Grace-Marie
Turner and Robert Moffit argued in a
December 2006 op-ed, "the Europeans
have the right prescription."
Their argument echoes views, as The New
Republic's Jonathan Cohn noted,
that are popular across the conservative
spectrum, from Newsweek's Robert Samuelson
("Europe is history's has-been") to The
National Review's Jonah Goldberg ("Europe
has an asthmatic economy") to The New
York Times pundit David Brooks
("The European model is flat-out unsustainable").
Conservatives have been making exactly
these arguments for roughly
five decades now, yet these same European
nations have by almost every
measurement—individual rights and
community, capitalist enterprise and
social solidarity, and even personal
mobility—demonstrated results that
Americans can only envy.
(You can find the details supporting
these claims in chapter one of
In the meantime, shouldn't we be
able to at least discuss these issues,
instead of largely ignoring them and
focusing on the shouts and screams
of hysterical crazy people who accuse
our president of being a racist,
a Communist, and a Nazi, only to be
rewarded with guest appearances (and
even their own shows) on Fox?
Can America have fallen so far that this
is our answer to Ted Kennedy regarding
the content of our character?
Barack Obama gave one answer
last night but, let's face it, it rested on
"hope." Congress and the American
people will give a more final answer
in the coming months; let's hope
it demonstrates a different form of
"character" than that on display
on CNN, MSNBC, and Fox, alas.
Eric Alterman is a Senior Fellow at the
Center for American Progress and
a Distinguished Professor of English
at Brooklyn College. He is also
a Nation columnist and
a professor of journalism at the
CUNY Graduate School of Journalism.
His seventh book, Why We're
was recently published in paperback.
He occasionally blogs at http://www.thenation.
com/blogs/altercation and is a regular
contributor to The Daily Beast.
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