Le Monde diplomatique
 The Nation
Richard Bulliet
Rami G. Khouri
Peter Kwong
Patrick Seale
Immanuel Wallerstein
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US Health Care Sham| by Serge Halimi | Released: 1 Sep 2009 |
A Republican Congress and President Bill Clinton abolished a welfare programme in 1996 under the (largely fallacious) pretext that it bred fraud, waste and abuse. Thirteen years on, the reforms that Barack Obama is proposing will not fundamentally change the United States’ abysmal healthcare system because those who profit from it have been able to buy protection from the lawmakers. The welfare programme ditched in 1996 absorbed about 1% of the US budget; today’s well-ensconced private insurance companies swallow most of the 17% of the budget set aside for healthcare.
Paradoxically, the US president is one of the most spirited prosecutors of the system he has chosen to retain. Day after day he recounts how “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 healthcare system that too often works better for the insurance industry than it does for the American people.”
Obama’s project initially set out with two important objectives. It proposed compulsory health cover for the 46 million Americans outside the system while funding the poorest amongst them. It also suggested the creation of a public insurance system with less prohibitive costs than private companies, which commit huge resources to finding legal loopholes (“pre-existing conditions”) allowing them not to pay out when their insured clients fall ill.
What is it that so alarms the right? Bobby Jindal, the Republican governor of Louisiana, claims that “any government plan will benefit from taxpayer subsidies and be able to operate at a financial loss, competing unfairly in the marketplace until private plans are driven out of business.” Other more telling tales of distress might have concerned him, particularly in Louisiana, one of the poorest of the states in the US.
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. Banks, insurance companies and the pharmaceutical industry have almost nothing to fear. Max Baucus, the Democrat chairman of the Senate finance committee, whose approval is needed for reforms to be adopted, is also the lawmaker who receives the most money from private hospitals, insurance companies and doctors. However, these largest donors are hardly worried about the problems of Montana -- the small rural state he represents -- since 90% of their contributions come from elsewhere in the country. Will anyone be surprised to hear that Baucus opposes a complete overhaul of the current medical system?
A year after the crash of neoliberalism, the (small-scale) panic that gripped the ruling classes has vanished. The political system remains locked in their favour. From time to time, a more corrupt or unlucky operator goes to jail; the mantra -- morals, ethics, regulation, G20 -- is chanted, then it all starts again. Questioned recently about the huge bonuses awarded to traders at BNP-Paribas, Christine Lagarde, France’s economy minister and a former Chicago business lawyer, had only this to say: “If we say no more bonuses, the best trader teams will simply move elsewhere.”
Cradled in a political system that protects them -- and which they in turn protect -- and profiting from the public’s widespread cynicism and all-round despair, financial traders and medical insurance companies can pursue their parasitic ways. “Abuse” is not just some aberration in their practice, it is their essence. So any “reform” they would agree to would not do: What is needed is their disappearance. -- translated by Robert Waterhouse
Serge Halimi is editor-in-chief of Le Monde diplomatique, and the author of Le Grand Bond en Arrière: Comment l'ordre libéral s'est imposé au monde (The Great Leap Backward: How the liberal order was imposed on the world).
© 2009 Le Monde diplomatique – distributed by Agence Global
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Released: 01 September 2009
Word Count: 624
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