I’m sometimes accused by commenters on this blog of wishing to make Europe into the US, and while it is true that I often yearn for European politics to be a bit more self-assertive, ambitious or efficient, make no mistake - I would never wish for European politics to devolve into the kind of mob hysteria US political discourse has sadly become.
The current debate going on in America over Obama’s attempt to overhaul the broken US healthcare system has been particularly hard to watch in this regard, and makes me feel pretty fortunte that I live in Europe. The way this healthcare debate is unfolding in the US is not only shockingly unreasonable, it’s getting downright scary. And unfortunately, what’s been occurring around the heathcare debate isn’t an isolated incident - it’s reflective of the dangerous road the American right wing is heading down.
The worst part is that the illogical hysteria surrounding the debate is drowning out any kind of reasonable argument. The scare stories being floated in the US media about single-payer systems in the UK and France would be missing the point even if they were true – what’s being proposed by Obama isn’t a single-payer system but rather a multi-payer combination of public and private plans, much like exists in Germany. But astonishingly, Germany hasn’t been mentioned at all in the US debate, even though it currently has a system very similar to the one being proposed, while the British and French systems don’t even resemble the Obama plan.
A ‘Plot to Kill Old People’
The health insurance lobby in the US has launched a full-on campaign to sink Obama’s efforts at health care reform. The plan that is working its way through congress is to add a public option to the list of private insurance options available to the American public. Currently the US has a completely private system for those under 65, the only non-universal healthcare system in the developed world, in which nearly one in five Americans under 65 don’t have any healthcare at all.
Not having healthcare can bankrupt a person if they get sick or have an accident, and it happens often. In fact, medical debt is the principle cause of bankruptcy in the United States.
Healthcare in the US has developed in an uncoordinated fashion over the past half century after the US government was unable to come to an agreement over a national health plan (Medicare, in which the government insures all people over 65 through a single-payer system, was a compromise enacted in 1965).
People under 65 have traditionally been insured through their employer. This means if you lose your job, you lose your health insurance (so if you get hit by a bus two months after losing your job, you’re facing a $30,000 hospital bill and no income!). But as healthcare costs have risen many small businesses have been unable to offer their employees health insurance any longer, leading to a dramatic rise in the number of uninsured. Even people who are insured face ever-rising deductable costs every time they visit a doctor, and their insurance companies can deny them coverage at any time by claiming that they had a “pre-existing condition” before they enrolled in the plan.
So to put it mildly, the system is a mess. Yet what Obama and congress are proposing isn’t a complete overhaul - it’s more of a reform. The private insurance companies would continue to exist, and everyone who’s already insured could keep their existing plan if they so wish. But a new player would be introduced into the market, a government-funded public insurance plan that people can opt into. Additionally, everyone would be required to have insurance, and regulation of the insurance industry would be tightened to prevent insurance companies from denying people coverage because of pre-existing conditions or charging exorbitant deductable charges.
However the insurance industry fears that having the US government as a competitor will eventually drive them out of business. So they’ve mobilised their media outreach, finding people in countries with single-payer universal healthcare systems like the UK, France and Canada, and trotting them out to do interviews with US media outlets about their horrible experiences. These strange, wild-eyed European defectors tell stories of being denied treatment and having to go to the US in order to have desperately needed operations to save their lives.
Or, they tell tale of public hospitals with dead people lying on the floor all over the place. I wish I was making this up. To hear the stories that have been spread in the US media, the NHS in England is effectively a government euthanasia program that kills people once they reach old age Republicsn Congressman Louis Gohmert has said under the reform seniors "be put on lists and force them to die early.”
This group that’s spreading word that the healthcare reform bill will kill old people have even been given a nickname, the “deathers” – a reference to the mob of people claiming that Obama wasn’t really born in the US – the “birthers”.
Of course, all of these tales have been proven to be absolute lies by reputable organisations, yet these people keep appearing on US cable news.
Harnessing the Mob
Now the healthcare lobby and the Republicans have gone a step further, actually organising mobs of angry 'birthers', 'deathers', 'teabaggers' and other assorted crazies to show up at open town hall meetings that Democrats typically host during the August recess. These mobs have been instructed to scream down the representatives as they try to speak. It’s absolutely insane, and getting quite scary. Take a look at this clip from the Rachel Maddow show.
Right-wing lobby groups are organising these mobs, telling them where the town halls are, and instructing them to block all discussions. They refuse to allow anyone to speak. If actual townspeople at these town halls try to ask a question, the mob shouts them down with chants of "just say no". Congressman Boehner, the Republican House minority leader, has praised these mobs and encouraged them to continue.
The Republican party is now aggressively harnessing the energy of the “teabaggers” –a group of mostly lower middle class Americans who are angry at Barack Obama’s election and were organized into protests by GOP groups earlier this year under the mistaken belief that Barack Obama’s budget was making their taxes go up (Obama is actually lowering their taxes or keeping them the same). It’s also harnessing the energy of the “birther” movement, a group of angry white Americans so incensed that Barack Obama was elected that they have developed a conspiracy theory that he wasn’t actually born in the US and is therefore ineligible to be president.
Republican congressmen and talk show hosts have given credence to the conspiracy by saying Obama has never released his Hawaii birth certificate – even though he has and it’s been on his website since the campaign.
So it’s a two-pronged attack by the right: organising mobs of crazy people to disrupt town halls where Democrats are attempting to explain heath care reform to their constituents, and getting fake healthcare scare stories into the media
Better European Comparisons
But beyond the fact that these random Canadians, Brits and Frenchmen being trotted out are just flat-out lying and are actually being put out there by the health insurance industry, the reality that everyone in America seems to be missing is that even if these stories were true, they are completely irrelevent to the current US healthcare debate. Canada, France and the UK all have single-payer systems – where you walk into the doctor’s office and never see a bill. That system is not on the table in the current debate in the US. What is being proposed is a combined public/private universal health insurance program much like exists in other European countries, most notably Germany.
Germany’s system would be the more obvious comparison, yet it has not been mentioned at all by the US media, which continues to focus on single-payer systems that have no relevance to the current debate.
Germany has a universal multi-payer system with two main types of health insurance: the public fund and private funds. Everyone is mandated to have healthcare, which is provided by the public fund to people below a set income level for a low rate. So, the wealthy can pay for exceptional private health coverage if they want to, or they can pay a small amount for the state insurance (many opt to do this). The end result is that everyone is covered and Germany spends 10% of GDP on health care, compared to 16% in the US.
Alternatively, the US media could use the example of Switzerland, although I’m not sure I would use that as a glowing model considering it has the highest health care expenditure in Europe. But they also have universal healthcare in a combination of public, subsidized private and totally private healthcare providers, where the insured person has full freedom of choice among the providers in his region.
Unfortunately, using comparative examples that make sense have not been part of the debate around this issue, which has instead focused on the hysterical screaming of the right. US policy, much like hotdogs, is always something that can be a little stomach-churning to watch being made. But lately the level of vitriol being launched by an increasingly desperate Republican party has been downright disturbing. Outright lies? Fake experts? Organised mobs? Is this America or a banana republic?
The most troubling part is that these tactics are working. Recent polls have shown that 42% of Americans now think Obama’s healthcare plan is a bad idea, and 69% of Americans are concerned their care would suffer if they were on a government-run plan.
They say citizens get the government they deserve. Perhaps it can be said that they also get the healthcare they deserve. If the American public can be so easily manipulated by the powerful forces of the right, even when it jeopardises their own health, I don’t know if there’s much hope for real reform in that country. It's very sad to watch. One thing is for sure – the behaviour exhibited over the past several weeks has not been a proud moment for American political discourse. These are dangerous tactics the American right is using, and they can easily spiral out of control. In the mean time, they are blocking meaningful discussion over how to reform a healthcare system whose dysfunction has reached crisis proportions.