Supreme Court declines to take US Health Care in direction of Sub-Saharan Africa

Well, we dodged the bullet of looking like Zimbabwe on this issue. But we still need a single payer system. And the court exempting states from medicaid expansion could leave millions uninsured.

(From this site, though I made some changes; China, e.g., at least tries to provide health care to its citizens; and Iraq is now on its own).

21 Responses

  1. Robert’s calling it a tax is worrisome. At what point will the government decide that they will contract out government duties and dictate that we pay these for profit corporations our “taxes” directly?

    • I think we’re awfully close to that already. The govt is only tolerated by the aristocracy as a collection of lucrative contracts awarded to their companies on the basis of campaign contributions. Having the govt as a central collection agent not only is more effective, what with it being armed, but it directs the resentment of the voters about their increasingly crappy services towards the government, instead of the private contractors. Then the contractors kick back their booty to far-right Congressmen (as happened in the Duke Cunningham scandal) to promote more hatred of the government, for which the only solution is to have more businessmen in charge of government and more privatization of services.

      It’s a no-lose gambit for the bad guys.

      • “plutocracy” rather than “aristocracy”, which has some association with words such as “noble” or “gentleman”

        • Words, words, words…

          I prefer “Kleptocracy” as the best descriptor for the Current State. That’s just me, of course.

          Another quibble: “leave millions uninsured,” as opposed to “leave millions with no regular health care and using the ERs as an expensive necessity, or just dying”? Why is the whole “healthcare” thingie (almost) always framed in terms of “insurance” and “coverage?” I know, the train left the station decades ago, and the PR scum for the “stakeholders” have been banging that drum (and delivering the ca$h) for just as long. But every repeat of that “meme” just adds weight to the idiot notion that “insurance” is the way to think about and “manage” this whole great public issue, turning it into just another other massive wealth redistribution schtick.

  2. So according to the map, the best chance to get American funding for your health care is to be a citizen of a country (Afghanistan) that is in a state of war with America.

    The mouse roars again!

  3. In Zimbabwe’s defence we did have a universal healthcare system in place until the mid 1990s. It was done away with to comply with a World Bank inspired Economic Structural Adjustment Plan which apparently was designed to liberalise the economy.Unfortunately as with most of those programs in Africa it had the opposite effect and led to some of the frustrations ZANU-PF was able to exploit to devastating effect during the late 90s and early 2000s.

  4. It would be nice to see a color-coded map showing the degree to which health care is for profit versus for health.

    • Well, the key to that is that in some universal health care systems, like Germany, private insurance companies exist, but apparently they run like non-profits. Now these things are relative, since there’s still the matter of what medical bureaucrats, pharmaceutical corporations, and doctors and nurses are paid. But the form of the insurance company (or lack of same) seems to be what drives the rest of the system. America’s insurance companies seem to be the most rapacious and arrogant on earth, so no health care plan can be passed without paying them an enormous ransom in some fashion. It is now inconceivable that Americans could nationalize their insurance comopanies the way they once did greedy utility companies.

  5. The southeastern corner of Europe should be colored orange. Balkan countries where universal health care is guaranteed by law include:

    Macedonia

    Serbia

    and

    Bulgaria

    Meanwhile neighboring Turkey deserves at least a yellow color.

    Please correct the map.

  6. China’s medical sector is notoriously capitalistic, and moving backwards. The poor are excluded, while the rich receive harvested organs.

  7. Having grown up in the US (I even lived in Detroit for awhile as a young lad) I feel fortunate to live in Canada where we have a civilized health care system that costs about half per capita what America spends on a system that leaves out a large chunk of the population.

    Our relatively efficient health care system is under attack by our copy cat Republican wannabes on the federal level, especially under Herr Harper and here in BC under the BC Liberals (more appropriately labeled the BC neo-liberals).

    It is almost, or in actuality as if they want to degrade the existing system to a degree that would make us want to emulate the useless American model. Fortunately for myself I don’t even use the health system, except for the occasional chain saw incident, being fortunate so far with my genes or lifestyle. But I certainly do feel good knowing that it is there for me, if I should need it and have no qualms about paying a bit of taxes to see it there for me and my family.

    I’m not impressed with Obamacare, as it seem more aimed at the health and welfare of insurance companies. But even though I still have lots of friends and relatives south of the 49th I cannot understand why they have been so bamboozled into thinking that a single payer system like we here in the Great White North and most other civilized and industrialized nations have is some kind of socialistic attack on “freedom.”

    When I immigrated about forty years ago to Manitoba, one of the first communications I got was from the province telling me that now that I was a resident I had to join the health care plan, and if I couldn’t afford premiums they would be subsidized and I was thrilled.

    My American relations couldn’t believe when one of my sons was born prematurely with a herd of doctors attending the birth and mom and baby both hospitalized for two weeks my out of pocket expenses amounted to forty dollars. He is in his thirties now pumping out grand children, and incidental costs are a bit more, but, hey you can’t beat it. Doctors still are well (and deservedly so) compensated, but spared the trouble of chasing down patients for payment.

  8. Juan,

    You ought to have another colour (red?) for countries (governments, I mean, not electorates) attempting to *end* universal health care.

    That is how it is in the UK at the moment, especially in England. (Scotland and Wales gain some protection via their devolved powers: though whether they can hold out against profiteering and big business, is yet to be seen.)

    The current coalition government – really a Conservative government with some wannabe Tory hangers-on in tow – has passed legislation to completely re model the NHS. Nearly everyone opposes this, public and healthcare professionals alike. The claimed intent is to open up the system to competition and introduce market ‘efficiencies’. This is despite the fact they have been experimenting with an ‘internal market’ system for years and it has been a disaster; and despite the examples from other countries that show what a bad idea this is.

    The real aim is the neo-liberalisation of healthcare: profiteering and privatisation.

    There is no mandate for the change: it was not included in the manifesto of either the Conservative (Tory) or Liberal Democrat party at the last election. More than a million people have signed a petition against the changes. And the various professional health organisations speak out against the changes almost weekly. What support existed – and there was some amongst GPs, who made some nominal gains from the bill – is falling away rapidly, as the true future shape of the NHS becomes clear.

    But a large number of the Lords (our archaic second chamber) and certainly MPs too have vested interests in healthcare start-ups and, lo!, the bill was passed.

    Private insurance companies and health start-ups are popping up all over the place. Private health insurance – once seen as a bit of an eccentric oddity – is now common, and is commonly included as a ‘benefit’ of better paid jobs. The presence of a ‘healthcare industry’ is now widely recognized, and the phrase often passes without comment. Healthcare industry lobbying is increasing and, now, we are moving towards privately run, for-profit hospitals. And ‘commercial confidentiality’ is increasingly cited to keep the public from knowing the details of privatisation plans.

    The government produced a risk register of the dangers of these plans, then refused to publish it (though an earlier draft was leaked). They have been ordered to disclose the register by the Information Commissioner (twice) and by a tribunal (once). Flouting normal democratic processes in the UK, the government used a bit of arcane trickery to block publication even then – a mechanism used only three times in the last decade, and which places this document’s content on a par with the UK’s preparations for the Iraq war. The content of the final document will now never be disclosed to the public.

    In the UK, private companies are creaming off the easier medical procedures at inflated profits and dumping the difficult medical problems back on the NHS, which is increasingly besieged and under strain. Doctors and (especially) nurses now seem to feel that they are in constant conflict with management (the very thought of ‘management’ in health provision would have been somewhat novel ten or so years ago: in the past medical professionals ran hospitals, now managers are everywhere).

    Once all the services of a hospital were controlled by the hospital. Now services like cleaning and sanitation are out-sourced, less accountable and standards have declined. This has coincided with an increase in outbreaks of in-hospital infects. This may or may not be cause and effect.

    The ethos of the NHS has completely changed. Once everyone involved in the NHS, doctors and nurses but also cleaners and support staff, drivers and maintenance, saw themselves as performing a valued and respected service, a public good and a duty. There was even some similarity to the ethos of the military; the NHS was, after all, constructed in the aftermath of WWII in an era of real austerity – not the faux austerity hoisted on the UK now, largely as a pretext for neo-liberal impositions.

    I can only urge solidarity between those seeking to build a universal healthcare system in the US and those seeking to save one in the UK.

    I hope one day, when these battles have been fought and won, a time will come for the founding of a GHS: a Global Health Service. Perhaps funded by a Tobin or Robin Hood tax.

  9. Privatization of US hospitals is another related trend. It’s sad to see institutions such as St. Mary’s hospital of Waterbury, CT which has been a nonprofit Catholic institution for a century, now merging with Waterbury Hospital and going for-profit. I think the founding nuns must be turning over in their graves now.

  10. “Once all the services of a hospital were controlled by the hospital. Now services like cleaning and sanitation are out-sourced, less accountable and standards have declined. This has coincided with an increase in outbreaks of in-hospital infects. This may or may not be cause and effect.”

    The neo-liberal Gordon Campbell government here in British Columbia has done the same thing, fired the unionized cleaning and maintenance employees and contracted out to exploitive “free enterprisers” who offered half the wages for twice the work and outbreaks of hospital acquired infections and deaths have sky rocketed in the last decade. I have no doubts about the cause of the effect. At this rate pretty soon we will be back to Victorian Era standard where the rich NEVER entered a hospital, bringing doctors to their home and even the poor avoided the hospitals of the day as long as they could, since they were not so much treatment centers as waystations on the way to the grave. without the palliative care of a hospice!

  11. The plan in the UK and Canada seems to be to sabotage the functions of public hospitals, then use the decline in quality to justify all-out privatization. The public is easily confused about the difference between a public institution, a public institution that contracts out services, a privatized institution that is guaranteed tax money, and a truly marketized enterprise.

    This sounds terribly like what is being done to destroy America’s public school system and go back to church-controlled and oligarch-controlled schools which teach superstition and worship of wealth. Here is an example of the wretched education being tax-funded in Louisiana:

    link to talk2action.org

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