Category: Politics & History

Medicare for everyone!

Let’s imagine that, somehow, Americans reached agreement that universal, single-payer health care is the way to go. How could it be implemented? Clearly, the transition would have to be managed in stages. It might seem logical to gradually lower the eligibility age for Medicare—say, five years of eligibility every twelve months. In the first year, 60-year-olds would be eligible; in the second year, 55-year-olds; and so on.

It makes more sense, however, to start with the children. Shouldn’t the health of our children be our first priority? And aren’t families with young children the people most in need of affordable health care? The problem, however, is that taking the youngest people out of the private health insurance pool would make it impossible to cover the expenses of older Americans without enormous premium increases.

The solution, it seems to me, is to move people into Medicare from both ends of the age spectrum, so that the balance of people left in the private system—younger, healthier people and older people with more medical expenses—remains about where it is now. In that way we could both give children first priority, and avoid a huge spike in insurance premiums for those still in the private system.

Imagine a transition something like this:

Year Medicare for everyone ages . . . 
2020 0-10, 65—>
2021 0-10, 60—>
2022 0-20, 60—>
2023 0-20, 55—>
2024 0-20, 50—>
2025 0-25, 50—>
2026 0-25, 45—>
2027 0-30, 45—>
2028 0-30, 40—>
2029 0-35, 40—>
2030 Everyone!

In the first year, families with young children would immediately benefit. Those who already had health insurance would save money by removing their children from their policies, and those without insurance, or whose insurance included high deductibles and co-pays, would be able to take their children to the doctor without worrying about what it would cost. Both the finances and the health of working families would improve dramatically.

In the second year, people ages 60-64 would become eligible for Medicare. Every year thereafter, another group would be added, alternating between younger and older. Making the transition in this gradually like this would allow all the legal and bureaucratic and financial changes time to take place in an orderly way, and would give the private insurance companies time to move into other products. With experience, better arrangements would be discovered, and adjustments made. Companies providing insurance to their employees would have time to plan and implement the transition to the day when everyone would be covered by Medicare.

If the process began in 2020, then by 2030 every American would be covered by Medicare, and the United States would finally have caught up to the rest of the developed nations by providing health care to every citizen, with the costs borne by everyone through an equitable system of taxation—a non-profit, universal health insurance system that would benefit all of us, instead of filling the accounts of behemoth insurance companies with billions in profits, while leaving ordinary people scraping to pay medical bills, putting off medical care to save money, and fearing financial ruin should we suffer a major illness or injury.

I say, let’s do it.

Terrorism, Racism, and Healing the Body Politic

If you ask Chinese people to compare traditional Chinese medicine with Western medicine, they will say that Western medicine is very strong and works quickly, while Chinese medicine is gentle and works slowly. Western medicine works quickly, but it only treats symptoms; Chinese medicine aims to restore health to the body by addressing the weakness or imbalance that caused the illness in the first place. The Chinese people I know will use both Western medicine and Chinese medicine, often in combination, depending on the situation. They know that Western medicine will quickly treat the immediate problem and allow them to continue with their daily lives, but that without restoring balance they will fall ill again and again.

Yesterday’s terrorist attacks in Paris reminded me of how Westerners, and Americans especially, treat political problems in the same way they treat medical problems, and with similar results: temporary relief, followed by repeated bouts of illness. Terrorists bent on mass murder resemble a serious infection that must be treated quickly, with strong and effective medicine, or perhaps even surgery. If we do not consider the causes of these infections, however, and address the causes at the same time we respond to the immediate crisis, then we condemn ourselves to chronic illness. And that is what I see today.

As an example, consider a different chronic political illness in the United States: racism. The white majority generally ignores this issue until a crisis brings their attention once again to the daily injustices experienced by people of color in America. Responses to the crisis vary, but are invariably short-term and focused on the immediate situation. Most white Americans prefer to ignore the obvious truth—that racial politics in the U.S. have deep roots in our history, and that the unaddressed consequences of that history continue to poison us. Poverty, discrimination, educational disparities, social injustice, and injustices in the legal system continue to blight the lives of many Americans of color. Until those deep causes are dealt with, along with the racism that continues to linger in white America, sometimes overtly but more often under the surface, we will suffer periodic crises, as we have seen in recent years when police violence against African-Americans have provoked outraged protests. Predictably, however, those crises have been short-lived, and once the situation calms down we return to business as usual. So long as there are no riots or mass demonstrations in Baltimore or Ferguson or Philadelphia, most white Americans turn their attention elsewhere. We are like chronically ill people who, in between trips to the doctor’s office or the emergency room, continue the unhealthy eating and living habits that cause our debilitation. We will continue to suffer until we address the root causes of our national illness.

America’s racial differences tend to disappear when it comes to foreign policy. There, too, however, we are behaving like diabetes patients bingeing on candy bars between trips to the ER. Why do we not smarten up, and start looking for the causes of terrorism? Because we love our candy bars, and we don’t want to give them up. Our foreign policy addictions, since the end of World War II, have centered on three simplistic ideas: opposition to Russia and communists everywhere; promotion of American corporations in foreign countries; and the imperative to acquire and secure access to massive amounts of petroleum resources. Our obsession with these aims have blinded us to numerous, repeated acts of gross injustice that we, our allies, and our intelligence services have committed around the world. Any foreign leader or movement or government that threatened or seemed to threaten these aims became our enemy. Any foreign leader or movement or government that opposed communism and welcomed American corporations and sold us oil became our friends, no matter how many horrific crimes they may have committed against their own people in the process. The list of democratically-elected leaders we have conspired to assassinate or overthrow, and of dictators and oppressive regimes we have supported, and continue to support, is too long to repeat here. If you are one of the far too many Americans who are unfamiliar with this history, it is a few clicks away in your favorite search engine. However, the people who have suffered around the world as a result of America’s foreign policies know this history very well. They know, too, that it continues today. And a very small fraction of them are radicalized by this knowledge, and become terrorists.

In the short term, we must do whatever we can to find those people who are determined to commit mass murder, and stop them. Longer-term, however, we will never rid ourselves of terrorism until we attend to its root causes. The U.S. government must shed its obsessive fear of left-wing ideology, must end its unthinking support of corporate profits at any cost, and must end its marriage with Big Oil. In the place of these misguided and failed attachments that have caused so much suffering, it must dedicate itself to peace and justice and real democracy, even when peace and justice and democracy bring to power leaders and movements that do not love Exxon and the U.S. Chamber of Commerce, who may call themselves socialists, and who are not VIP customers of the U.S. arms industry.