What’s Left 7: Healthcare is a Human Right
Liberals believe that a compromise that gets us closer to a goal is better than no progress at all. But compromise can lead to the dead end of dilution and a false sense of resolution.
The early 20th century progressive and presidential Robert “Fighting Bob” LaFollette argued that politics played into different a psychological dynamic. “In legislation no bread is often better than half a loaf,” he observed. “Half a loaf, as a rule, dulls the appetite, and destroys the keenness of interest in attaining the full loaf.”
Nothing in recent history demonstrates LaFollette’s viewpoint more clearly than the evolution of then healthcare debate. When Obama won the presidential election in 2008, healthcare—particularly its expense—was such a big worry for American voters that the ruling classes came to view the problem as a crisis. The system was expensive, dysfunctional and despised. Despite an economy reeling from a severe Great Recession, the new president quickly moved to address the issue by pushing for passage of his 2009 Affordable Care Act, popularly known as Obamacare, and even a divided Congress went along.
Obamacare was a classic political compromise of the variety that moderates adore: it made nobody happy. The healthcare industry—though their concerns soon proved to have been wildly unfounded—worried about losing some of their precious profits. Patient advocates preferred a European-style, fully socialized system in which doctors and nurses are government employees to the ACA, a market-based system originally conceived by the conservative Heritage Foundation. Figuring that the ACA would move the center of gravity closer to socialized medicine, leftists supported it despite their reservations.
By most accounts, the ACA has failed to fix the problems it was supposed to address. In many American counties (health plans are designed by county) the government “marketplace” has just one or two plans to “choose” from. The only high-income nation without universal health coverage, the U.S. spends more by far on healthcare, both per person and as a share of GDP, than other countries. Yet we still have the lowest life expectancy at birth, the highest death rates for avoidable and treatable conditions, the highest infant mortality and the highest rate of people with multiple chronic conditions and an obesity rate nearly twice the OECD average. Premiums are high but co-pays are low, so we see physicians less often than patients in most other countries. A whopping 650,000 Americans go bankrupt each year due to healthcare bills, accounting for 60% of all personal bankruptcies. Americans are extremely dissatisfied with the cost and access to healthcare.
A decade and a half later, healthcare ranks near the bottom on the hierarchy of policy priorities articulated by voters. How can this be?
LaFollette’s dictum at work! The half-loaf of ACA dulled the appetite, creating the illusion that the healthcare problem had either been resolved—an opinion common among those with employer-supplied health insurance and/or those who live in one of the big cities where the online marketplace has competition—or had been as fixed as is reasonable to expect from the current system. As a result, there is no indication that politicians of either party are inclined to propose a legislative improvement any time soon.
Nevertheless the need is acute. People want affordable healthcare (even if they despair of ever getting it). The right to affordable—no, free—healthcare is a basic human right. Without it, after all, people quite literally drop dead.
According to a 2020 estimate by the nonpartisan Urban Institute, Bernie Sanders’ Medicare For All plan—the most thoroughly thought-out, frictionless plan on the drawing board that salvages as much from the existing network as possible, would cost about $3 trillion per year. However, a Yale study concluded that the government would save about half a trillion each year “by improving access to preventive care, reducing administrative overhead, and empowering Medicare to negotiate prices.” Working net cost: $2.5 trillion per annum.
Medicare For All would replace our current, highly wasteful system. “We’re already paying as taxpayers for universal basic automatic coverage, we’re just not getting it,” economist Amy Finkelstein says. “We might as well formalize and fund that commitment upfront.” She points to the fact that the federal government currently pays $1.8 trillion a year for Medicare, Medicaid, veterans’ services and other government-funded healthcare costs—all of which would vanish after they were replaced by a holistic Medicare For All scheme. Third-party programs, which are often government-funded, and public health programs eat up an additional $600 billion per year.
Medicare For All would also save the lives of the 45,000 Americans who die annually due to lack of insurance. The IRS would collect an additional $1 billion a year in tax revenues as a result.
So the net cost of treating everyone who needs medical care is about $100 billion per year, which is just over two percent of the $4.5 trillion we’re currently wasting on wars and other things that make our lives worse.
Most analyses of Medicare For All focus on how it would save patients money. Even if they had to pay higher taxes, this is indeed true. For liberals, such an improvement might be triumph worth celebrating. The Left, however, must be as ambitious as possible, even under the bourgeois electoral democracy currently in place pending the Revolution for which we are waiting and ought to be working for. Healthcare, a basic human need every bit as essential to life as food and clean water, should be provided by the government, gratis. The good news is, we can afford it. What we require to enact a real First World healthcare system is for the Left to come to power.
Next: A college education is a right. So is the choice not to attend college, yet still be considered for a job.
(Ted Rall (Twitter: @tedrall), the political cartoonist, columnist and graphic novelist, co-hosts the left-vs-right DMZ America podcast with fellow cartoonist Scott Stantis. You can support Ted’s hard-hitting political cartoons and columns and see his work first by sponsoring his work on Patreon.)
The Final Countdown – 3/12/24 – Congress Weighs Loaning Ukraine Funds from Seized Russian Assets
The Final Countdown – 3/11/24 – When It Rains, It Pours: Legal Probe Hits Boeing
The Final Countdown – 3/8/24 – Biden’s State of the Union Address Turns into Reelection Speech
The Final Countdown – 3/7/24 – State of the Union Preview: Guest List and Topics
DMZ America Podcast #140: Super Tuesday Leaves Two, Euthanasia Comes to Illinois, Troops in Subways
Editorial cartoonists Ted Rall (from the political Left) and Scott Stantis (from the political Right) discuss the week’s biggest stories without the boring yell fests but with force and passion.
The first segment of this week’s offering covers some major developments in the 2024 presidential campaign. The US Supreme Court followed Ted’s lead, choosing democracy over the Constitution, ruling 9-0 to invalidate the 14th Amendment cases attempting to remove Trump from the ballot. Super Tuesday saw broad sweeps by Biden and Trump, Nikki Haley’s withdrawal and progressive discontent over Biden’s support of Israel’s war against the Palestinians in the Gaza Strip. Scott and Ted preview the State of the Union Address and detail what Biden would have to do there—it involves violating the laws of physics—to drive a stake through concerns about his mental acuity. Oh, and it’s definitely Biden versus Trump this fall.
The second segment takes a hard turn into Illinois’ move toward legalizing doctor-assisted suicide. Scott expresses concerns about whether God would approve and whether there might be a potential for abuse. Ted gets personal about a friend and colleague who recently decided to end her life after suffering from depression.
Finally, New York Governor Kathy Hochul has ordered state police and the National Guard to New York City’s beleaguered subway system to restore law and order…and search your bags.
Watch the Video version: here.
The Final Countdown – 3/6/24 – Nikki Haley Drops Presidential Bid After Crushing Defeat
SYNDICATED COLUMN: What’s Left 6 – End Homelessness Now
Homelessness is the single-most powerful indictment of capitalism, the embodiment of human disposability, the ultimate expression of callous cruelty. In this nation where one out of sixteen rental homes is vacant at any given time, one in six hundred Americans (550,000) sleeps outside. An additional 3.7 million people, the so-called “hidden homeless”—one out of ninety of our sons, our daughters, our brothers, our sisters, our fathers, our mothers—are doubled up in other people’s homes because they can’t afford their own place.
“You look out the window of the White House and see the ragged and pathetic figures huddled over the steam grates of the Ellipse,” President George H.W. Bush told an audience of insurance agents in 1989, calling homelessness “a national shame.” “It’s an affront to the American dream.”
He was right, of course. He promised to do better. Yet, because not even a president can change an economic system, nothing has improved. Only the Left can fix it.
Of the many ways America fails its citizens, its failure/refusal to ensure that everyone has somewhere warm and safe to sleep at night is the starkest reflection of what passes for a social compact: Unless you are lucky enough not to be born into poverty, and lucky enough to avoid succumbing to addiction or some other dysfunction, and lucky enough not to suffer a debilitating physical or mental illness, and lucky enough to have the charm and the education and the experience that an employer happens to need, and are lucky enough that the economy is not contracting at that time, and you are lucky enough to find a needy employer at the exact moment he happens to need someone exactly like you, sooner rather than later you may find yourself sleeping on the street or a subway platform or on a park bench or a steam grate across the street from the White House.
Such a society cannot credibly claim to believe that every life is precious. It cannot criticize the way other societies handle their affairs. It has zero moral standing whatsoever.
Chronic homelessness creates problems that impact housed people as well. Responding to calls about public drinking and trespassing diverts the police from dealing with serious crimes. Areas with a high homeless population suffer significantly reduced property values, which lowers assessments and hurts municipal budgets. Because homelessness is associated with chronic health conditions, mental illness and substance abuse disorders, homeless peoples’ frequent visits to emergency rooms—where they account for a third of all patients—cost hospitals an average of $18,500 per year per person, unreimbursed since they are uninsured. Those expenses are passed on to the rest of us. Mentally-ill people are 35 times more likely to commit a crime if they are homeless, compared to the mentally-ill domiciled; they are also much more likely to become victims.
Homelessness is expensive. National Alliance to End Homelessness estimates that one chronically homeless American costs the taxpayer an average of $35,000 per year. That comes to about $20 billion for the Americans now living outside.
Catching a glimpse of a misérable attempting to shelter outdoors also has an insidious downward effect on wages and living standards for we, the housed. It reminds you: this could happen to you. Better, then, not to risk asking for a raise.
Cynical Marxists have suggested that this may be a feature, rather than a bug, of the current system. Fear of falling is a powerful motivating force.
The answer to the present state of homelessness is “re-housing.” We give homes—not shelters—to the people who need them. If they don’t have money for rent, give them stipends. Most cities keep doing what doesn’t work: dangerous shelters that are only open overnight, no path to housing, people are denied shelter for drinking, using drugs or acting out.
This is exactly wrong.
Real homes, not shelters, help people get off drugs and alcohol because people abuse substances to numb the misery of their situation. As it happens we have plenty of real homes sitting empty: 15 million homes are vacant. 550,000 of them, beginning with abandoned units and those that have remained without a tenant for a long time, should be seized under eminent domain.
Rapid rehousing can and should be mandatory; no one should be allowed the “freedom” to succumb to the elements. Rehousing should be done free of traditional preconditions like employment, income, absence of criminal record or sobriety. Each person’s individual needs, whether they be addressed by physical rehabilitation, job or language training, psychological therapy or other services, should be carried out by a team of social workers and other experts. Housing first, The New York Times reported in 2022, rests on a reality-based approach: “When you’re drowning, it doesn’t help if your rescuer insists you learn to swim before returning you to shore. You can address your issues once you’re on land. Or not. Either way, you join the wider population of people battling demons behind closed doors.”
Houston, the nation’s fourth-largest city, moved 25,000 people directly into apartments and houses between 2011 and 2022, reducing its homeless population by 63%. Denver, another housing-first city, saw arrests of homeless people drop 95% and dependence on government cash-benefit programs fall by 80% after housing-first took hold.
According to the National Alliance to End Homelessness, “supportive housing” costs an average of $12,800 per person per year. That comes to $7 billion for the outdoor homeless population, or $55 billion if you also include the “hidden homeless.”
The higher figure is 1.2% of the $4.5 trillion a year the U.S. is currently wasting on wars and other garbage. And after you subtract the $20 billion a year we’re currently spending on policing and hospitalization, it’s 0.8%.
Next: How to guarantee everyone the right to free, high-quality healthcare.
(Ted Rall (Twitter: @tedrall), the political cartoonist, columnist and graphic novelist, co-hosts the left-vs-right DMZ America podcast with fellow cartoonist Scott Stantis. You can support Ted’s hard-hitting political cartoons and columns and see his work first by sponsoring his work on Patreon.)