AP

US Healthcare is Wealthcare

The 2018 midterm election exit polls showed that voters ranked healthcare as the top issue of concern. This poll only reflected a broader, decades-long desire of the American public to implement a humane, rational and efficient healthcare system in the country. Hardly surprising given that the population has lived under the barbarism of an international scandal of a medical system that profiteers off of pain, disease, and distress.

As a 2017 Commonwealth Fund report showed, the US healthcare system ranks dead last in performance amongst wealthy countries, with twice the per capita costs. If the goal of a system is to maximize profits for shareholders and minimize care (which affects profits), this is indeed the logical outcome we would expect.

Americans are dying for a new system.

Elizabeth Warren’s Strange Stance

Bernie Sanders has been fighting for significant changes in US healthcare for decades. His Medicare for All proposal, first introduced in 2016, is the barometer against which all other Democratic primary contenders’ proposals are being judged today.

The leading proposal for the paramount issue.

Elizabeth Warren has famously built her campaign around an amusing yet self-assured “I have a plan for that” slogan. However, for the singular issue of utmost importance, her expressed support for Medicare for All does not align with her inability to answer how such a program will be funded. As the Washington Post put it, she sounds like a student who skipped her reading when discussing healthcare.

While Bernie Sanders is quite clear, and Warren is quite eager to align herself with him, she is unable to express that while public taxes increase, private taxes to corporations in the form of premiums, co-payments, deductibles and exorbitant late fees are eliminated. This would result in all but the very wealthy families seeing an increase in take-home money while enjoying quality healthcare.

To fight for such a large national program and obfuscate middle-class tax increases is intrinsically incoherent. Her concerns are obvious. Fearing the unpopularity of such a tax increase, she is unable to fight against the political principles that have dogged Americans for decades under neoliberal capitalism — deregulation, privatization and austere cuts to government programs. These manifest themselves culturally in a selfish, vile dog-eat-dog world.

However, despite her concerns, her’s is a poor approach. The insincerity and political gamesmanship around a life and death issue is transparently unprincipled and weak. Particularly in the context of running against a perennial champion for the cause in Bernie Sanders, Warren brings her “capitalist to her bones” beliefs to this debate and is simply unable to challenge the orthodoxy.

While her campaign looks for “other revenue options” to fund this program, polls show that a majority of Americans support Medicare for All, and that this support drops when one lies about what the system entails. Enlightening.

On this particular issue, even the Fox News audience is to the left of most Democratic Primary contenders.

The Free-Market Fraud

Under Medicare for All, a single-payer insurer is established, eliminating reckless profiteering from private insurance companies. Acolytes of capitalism, oblivious to Really Existing Capitalism, argue for a marketplace of insurance plans. Indeed, in another year, Elizabeth Warren may have supported such a state of affairs. As she has said,

“I believe in markets ― markets that work, markets that have a cop on the beat and have real rules and everybody follows them. I believe in a level playing field.”

There is a good reason why a market-based argument for healthcare is fraudulent, not to mention inefficient as the US has already proven. It is because the insurance industry does not remotely adhere to lofty free-market principles at all.

What Free-Market?

The Affordable Care Act is a right-wing healthcare plan that originated from the Heritage Foundation, a conservative think-tank. One of the goals of this plan is to mandate a market into guaranteed existence for private insurers to profit from awful products. On the supply side, US taxpayers give billions in subsidies to the insurance and drug companies.

On the demand side, market efficiency is deliberately undermined with no price transparencies. Insurance plans are nebulous to intentionally create the confused customer that makes irrational choices. Massive advertising budgets from companies that are supposed to be focusing on getting medical payments out further create uninformed, confused demand.

Secondly, customers under health emergencies, or ones who have never experienced one but almost surely will, are hardly rational actors in a fictitious efficient market. It is a little hard to make sound decisions when you are unconscious in an accident.

Healthcare is not a domain where wonderful insurance products compete, and poor companies with awful practices fade from existence while happy customers shop around for fully transparent, accessible plans. Instead, it is an industry that relies on the desperation of patients and state-sanctioned domination for a singular goal: profit.

Otherwise known as Really Existing Capitalism.

This fraud runs even deeper in the pharmaceutical industry — a topic for another day.

The Wealthy are More Worthy of Living

Of course, there is one section of the US population that treasures the current system — the wealthy. Not only do they access Cadillac plans that provide phenomenal care, but they also benefit through their investments in the healthcare industry. The greater the price gouging, the greater the profiteering (maximum premiums/co-pays/deductibles, minimum pay-outs), the greater their gains.

Further, given a level of quality of care, and given a price that applies to everyone in the market — rich or poor — the dollar amount paid for healthcare is not the same. Sure, $1000 is $1000. But on a percentage basis, for the wealthy, it’s virtually free healthcare, while for the poor, it is an arm and a leg for a heart.

This is what the progressive tax under Medicare For All aims to address, along with its primary goal of funding the universal program.

Warren’s Next Move

Returning to Warren, the “capitalist to her bones” has reached a fork in the road. She has milked the popularity that comes with ostensibly supporting Medicare For All. But to fight for and implement the ambitious, humane and efficient program, she will need to shed her ideological baggage around markets and taxation.

To an extent, her rhetoric shows that she has. However, other rhetoric that refers to “many pathways” or “frameworks” is concerning. It displays a fundamental hesitation to venture into the warm waters of solidarity, mutual aid and universal public projects; rather electing to remain marooned on the islands of wonky, professorial management of state capitalism.

Healthcare is a human right. It is quite different from buying a car.

Elizabeth Warren does not have a clear answer for the most pressing issue facing Americans. Bernie Sanders wears it on his sleeve. What she decides to do next will be very revealing. As with life and death, or health and sickness, fully championing the program and not doing so is black and white.