Sunday, January 29, 2017

Healthcare Could Have Been and Should Be Free: World War II to the Present








"Our country has the largest military industrial complex in the world, it has the largest prison industrial complex in the world, and it has the largest pharmaceutical industrial complex in the world. Why, then, can it not have the large single payer healthcare insurance industrial complex in the world?" - Kent Allen Halliburton

Introduction

This article is based largely on a ‘what if’ scenario, but it should be noted, looking at what ifs can help people to imagine what could have already been done, so that there is something to go on when people finally come around to realizing the mistaken priorities that their society has perpetuated for an untold period of time. The debate over healthcare in this country has been going on for a long time. From its days in infancy, during the early years of the republic and the Marine Hospital Service, to the present day and programs like Medicare, Medicaid, and the Patient Protection and Affordable Care Act, the conversation over how healthcare should be managed in this country has never ended. Probably, the most intense debate has been over how to pay for it. How much money should be allocated to research? How much to clinical care? How much to hospitals? How much to private practices? Even more so, who is going to foot the bill for all of this? Will the government need to play a role? Will the private sector be willing to help relieve the government of some of the cost? Should the government even place itself in the market for healthcare? How much should the people be expected to pay in taxes to help fund a given health initiative?

For some reason, it seems that these questions are backwards, in almost direct violation of the Hippocratic Oath. Physicians take an oath to do no harm, to prevent disease before they have to treat it, and to treat whoever is in front of them, no matter the circumstances or the cost, among others. Shouldn’t basic healthcare services be a human right? If this country stands for life, liberty, and the pursuit of happiness, then serious thought should be given to the idea that someone that is falling over dead from a given illness is pretty much out of the chase for those ideals. They can’t work because they are sick, they have poor living conditions because they can’t work, and the state loses production capacity because this person is no longer putting out labor. Thus, to them, one could imagine that a quick death would be preferable. In this article, it is argued that it is possible to create a system of totally free Universal Healthcare. The good citizens of the state of Vermont agree with this contention. This article will be discussed in more detail later in the article (McGill, Mariah, “Human Rights from the Grassroots Up: Vermont's Campaign for Universal Healthcare,” Health and Human Rights, Vol. 14, No. 1 (June, 2012), 106-117). It is also contend that the government, private industry, and many others know that it is possible, as well. Now, are they intentionally blocking such legislation? This will also be a topic of discussion in this paper.  Or, rather, are they simply dealing with an inherited system of mixed up priorities? This will also be a matter of discussion in this article.

The main thesis, however, will be a little broader. If one contends that the modern difficulty with paying for public healthcare programs is rooted in a line of mixed up priorities, how would would go about proving it? To be clear, it is going to be shown how it would have been possible to establish a free universal healthcare system and maintain it indefinitely with no cost to the public. So what would have needed to change? The discussion will begin with the foundation of Medicare under the administration of Lyndon B. Johnson. There are number of frivolous, expenses that could have been rerouted and made a free system possible. Military spending since World War II has been astronomical. This is probably the biggest problem. Another problem would be the bailouts that many major US companies have received in the last fifty years. Another political device that could be regulated to allow for more money to be available for healthcare is the Political Campaign Juggernaut. Billions of dollars are spent each year by politicians, special interests, and many others in an effort to flood the airwaves with their messages. The money donated to the candidates in the last Presidential election, alone, is fiscally ridiculous. Another program that could be dutifully ended and reassigned would be Federal Subsidies to professional sports teams, where teams are given money by the government to help them build new stadiums. One can get a fantastic review of the practice in an article on the topic. (Jenson, Scott A., “Financing Professional Sports Facilities: Is it Sound Tax Policy?” Marquette Sports Law Review (Vol. Art. 15, Spring/2000), 425-460). Finally, going back to business, regulating industry executive bonuses would also provide another pool of money that could instead be invested into providing healthcare and better wages to workers.

Mixed Up Priorities

In July of 1965, President Lyndon Baines Johnson signed the Medicare program into law (Folliard, Edward T., “Medicare Bill Signed By Johnson: 33 Congressmen Attend Ceremony In Truman Library,” The Washington Post (July 31, 1965), A1). It subsequently provided for the health needs of all American citizens age sixty-five and older, regardless of income. It was a system designed to increase access to healthcare and make it more affordable, especially for the elderly. The program was available to the disabled under sixty-five, as well (Pearson, Drew, “What Medicare Means to Taxpayers: How to Get Voluntary Insurance,” The Washington Post (July 29, 1965), C13). Another interesting aspect of the law was that in order for physicians or hospitals to be eligible for payments, they had to desegregate their facilities (Eichner, June, ed., Report of the Study Panel on Medicare and Disparities, “Strengthening Medicare’s Role in Reducing Racial and Ethnic Health Disparities,” National Academy of Social Insurance (October, 2006). So, how much did this initial program cost, and how much does it cost now? One way to look at it would be to view expenditures as a percent of the GDP. As a percent of the GDP, Medicare spending has gone from under one percent of the GDP in 1966, to right at three percent of the GDP in 2015, with a projection to 2020 that Medicare will be at just above three percent of the GDP. This would seem to be a result of the inflation of that same period. There are near constant continuous inflation increases by month each year. It is no wonder Medicare expenditures rose.

Of course, Medicare is not the only government program that has seen an increase in spending since post World War II. Defense spending has increased to such a degree that some would consider astronomical amounts. The increase has been unusually steady over the years, however that increase has been at a much higher rate. Going back to using the GDP, it is also clear that the same goes for government spending as a whole. It is clearly visible that overall government spending has increased at just about the same rate as Medicare and military spending. There is definitely a positive increase in overall government spending over time. One must admit that a positive increase in overall spending does not necessarily indicate anything unique about Medicare spending, though. It simply followed the same rate of inflation and spending increases as all of the other categories. However, there is something else that can be drawn from this. It should also be fairly clear from the presented information that defense spending vastly outpaced spending on Medicare. That, in itself, is also not very unique; if it is combined with another statistic, a clearer pattern might just be visible. This statistic would be the average poverty level over the same general period. Using the Average Poverty Thresholds by Size of Family Unit, it can be shown that the number of people considered to be living in a state of poverty also shows the same positive increase as the inflation rate and government expenditures.

Combine this, also, with information about the overall general health and well being of the general population in the United States. Using the United States’ fertility rates since the 1950s, one can infer that the overall general health of the US population has deteriorated over time. One might also look at the rate of cancer deaths in men over the last near eighty years. While there is a present decline in cancer related deaths, the overall trend is one of increased cancer deaths over time. The link also shows exactly which types of cancers have been the most virulent over time. One can see a similar trend in the rate of heart attack deaths. Once again, the most recent numbers point to a decline in the number of deaths from heart attacks in the past few decades; however, again, the overall trend is an increase in heart attack deaths over time. One might also track the total casualties in major US military conflicts since World War II. In World War II, the United States lost 400,000 soldiers, marines, sailors, and airmen. Consider the numbers for the Korean War, nearly thirty-five thousand US dead. See, also, the numbers for the Vietnam War, with nearly sixty thousand recorded deaths. See also the numbers for the Iraq and Afghanistan Wars, with nearly thirty-five thousand dead to date.

Many other ailments and factors could be added to this list of indicators of the condition of the general health of the US population. One could look at liver disease, one could look at murder rates, one could look at drug related death rates, and among other things, one could look at the number of deaths per year from overuse of legal substances like alcohol, tobacco, and prescription drugs, as well as, mental health problems, and many others.

So, this all has to lead to something, and it leads to the title of this paper, “Healthcare Could Have Been and Should Be Free: World War II to the Present.” First, it shows that a lot of people have died in this country in the last century, and it shows that the US has a declining rate of fertility, which could lead to a population stall over, possibly, even a decline. Related to this, it also shows that a lot of people have died needlessly from causes that could have been prevented. The most obvious one that can be seen is war. Just stop taking the nation into wars over resources and the like, thus spending less time manufacturing a reason to go to war, and then spend more time interacting with the nation’s trade partners on a more equitable basis, and thus, spend less money on death. This would improve the nations international reputation and credit as a trading nation. It would also result in a significant retention of life. Those soldiers that would have died could stay home and help bolster the US economy. There would also be much less money being spent for defense purposes overall, thus opening up a well of funding for the medical needs of the population, perhaps even increasing funding to educational programs so that people can begin to avoid the more destructive behaviors that cause their ailments and seek real professional medical help for their medical problems. There could also be vast improvements in medical technology, which could lead to even more treatments for diseases and conditions once thought incurable.

This is kind of a general representation of what could really be a much larger project. One could review all of the numerical data on the original Medicare bill from 1965, the annual funding increases to the program, the data on the cost of all the new additions to the program over the years from limited assistance for patients with chronic mental health, to Medicare Part D, which helps fund prescription medications that was passed under the Bush administration. One could bring Medicaid into the discussion, which would bring out a whole new avenue for discussion, a more in depth analysis of the health and well-being of children in the United States, accounting for income level, available care, along with deaths from preventable diseases. The average expenditures for 2013 alone were astronomical in their scale. These numbers could also be analyzed year by year. Imagine what avenues could also be pursued in cancer research. Some even argue that it is curable now. If so, money spent on war could now be spent on making those possible cures more scientifically sound and available to everyone. The same could be done with average US defense spending per year. One could compare the money spent on healthcare versus the money spent on military technology and preventable wars docket by docket. The amount of money spent is ridiculous. That money could have gone to many different noble life saving causes. One could also breakdown Medicare section by section, discussing what each section means and how each section is funded. One could also discuss all of the, sometimes very intense, political debates that began early on in the program’s life, some of which are still going on. The most obvious debate is always over reducing costs and increasing or decreasing funding, and this tends to be type of discussion that can destroy a politician’s career. Another would be the changing rules over eligibility. The number of topics that could be brought up are numerous, such so that they cannot all be mentioned here.

The Philosophy

Having gone through a general overview of the funding issue, it would be prudent to discuss the philosophy of the discussion. Is healthcare a human rights issue? A good review of the concept can be found in Health and Human Rights, in the article entitled, “Human Rights from the Grassroots Up: Vermont’s Campaign for Universal Healthcare,” by Mariah McGill. She discusses the great desire for health coverage by Vermonters, starting in the early 2000s. In 2006, the Vermont Worker’s Campaign launched the ‘Healthcare is a Human Right,’ Campaign. To build their case, the organization sought precedent from international treaties and documents that recognized health as a natural right. They referred to items such as, the Universal Declaration of Human Rights, and even, the International Covenant on Economic, Social, and Cultural Rights. Article 12 of the Covenant recognizes the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. This is not a reference to how much they can afford to obtain according to their level of income, but rather, according their basic intrinsic human value. She also discusses the process behind making such a program available in Vermont and how it affected a great many in the population with adequate access to insurance and affordable care now more available. The movement discussed in this article was a grassroots movement that brought people from the general population of the state of Vermont together in support of a common cause, which led directly to an improved average rate of health for the entire state.

There is, however, a deeper philosophy present that needs to be discussed. This philosophy, of course, is an economic one. It is, as stated before, the idea that health should not be something that can be commoditized and sold on the world market. Marketing health immediately creates a coverage gap in the population by basing quality and availability of coverage on the income of the applicant, and in some cases, denying coverage or services to those most unable to offer adequate financial restitution for any services that they may have needed or any charges that they may have incurred. According to the Zeitgeist Movement, health is one the most basic but most primary needs of the human species. It determines the level at which a person is able to contribute to the common welfare of the community. They argue that if one person is unhealthy and unable to work, they become a drain on the resources and sustainability of the economy and should be treated quickly. If they are not, the drain increases as more and more people call in sick and are unable to produce for the economy. They also argue that access to adequate healthcare or the lack thereof, is often used as a weapon of social control by elites in the United States, in that certain health strata are maintained in conjunction with the income ladder. Essentially, they use healthcare as a means by which to retain control of the political system of the country, for fear that a healthier, more economically sound general population would be more likely to offer physical resistance to abrasive social policies, whereas, people with minimal incomes, poor health, and very little means to improve their condition are less likely to be able to offer any reasonable resistance to those same policies.

It would not be wise to take the Zeitgeist movement for everything that it is worth. It makes a lot of statements that can be classified as far fetched and even radical, and while that is not necessarily a bad thing, there is not a whole lot of discussion of the in-depth processes and cultural transformations that would take generations to implement, and the rigid governmental structure that would be needed, as a new more peaceful humanity is developed. Some might argue that it even stinks of the social eugenics scientists and programs of the nineteenth to twentieth century. An ‘off the cuff’ example would be the Aryan myth established by Adolf Hitler in 1930s Germany, of which, an ethnic cleansing was the end result (Kershaw, Ian, Hitler: A Profile in Power, Rv. Ed. (New York: Rutledge, 2013), 143-162). The programs initiatives also had some undeniable but eerie connections to the work of the American eugenicists of the late nineteenth and early twentieth century.

Despite the Movement’s leanings towards the radical left, a point that they would argue against, saying that they do not support any modern political party or system as they are bred of a market capitalist system that makes manipulation and victimization of the general population, for profit, its primary goal, we are on one accord on a major issue, health. In the third movie, the general health of the population plays a key role in the establishment of a system that would benefit the overall well being of every person on Earth, eliminating, with the use of automation, the need for human labor in almost all modern occupations, to include financial institutions, as in a resource based economy, money does not exist. They honor the basic intrinsic value of each individual human life, regardless of potential financial burden that that might place on a ruling body. They argue that without money, such burdens would never exist to be dealt with in the first place.

Summation

To wrap up, I have argued that all government costs are connected to inflation, that more over all money has been spent on national defense than on Medicare, and that if that money had been better prioritized, towards heath initiatives, perhaps, the United States would have had the financial means to create a totally free Universal Healthcare System that would have been perpetuated by a more available and productive workforce, as well as, the untold millions not being spent on useless military ventures. To further the discussion, I would need to compare all the expenses line by line of Medicare and do the same for the other topics like defense spending, as well as, the built in cost measures of the bill that would create such a public institution, going into as detailed a display discussing as much of the raw data, itself, as is possible, but that is outside the scope of this project. The idea that healthcare is a natural right and showed how in Vermont was also presented, as near universal healthcare coverage was establish at a discount to the general population of the state. The philosophical nature of the topic was also discussed and presented the Zeitgeist Movement as an example of an organization that thinks a little bit along the same lines, in that they believe that healthcare is a basic human need and natural right. However, they lack a clearly defined process, by which they intend to make their ideal world really come about. For the sake of time, military expenditures were the only thing discussed when it comes to mixed up priorities, but rest assured, the numbers in the other areas would have made the argument even more secure, as millions of dollars have been frivolously spent on funding sports stadiums, and the like.

Conclusion

To conclude, one should revisit the reference to the Hippocratic Oath at the beginning of this paper. If, as in the oath, as mentioned earlier, physicians must swear to do no harm and to treat any patient that needs their help, no matter what, it would seem that such a statement would prohibit the practice of denying a person the needed life saving medications or surgical procedures, to restore their health because of a pre-existing condition or general lack of financial means to pay for the services. Yet, this is essentially what happens in this country on a daily basis. It has happened to the point that some people have even died in waiting rooms at hospitals, while waiting for treatment that they would not be able to get otherwise and that would have saved them from death. This is something that as a species, we simply cannot allow. There are plenty of rational excuses why such things are horribly counterproductive in so many different ways, such as the labor lost and production reductions caused by sick workers calling in sick for their shifts or the potential damage to the American economy as people’s purchasing power is affected by missed time and wages. One could also argue potential innovation is snuffed out before it begins because people are too occupied with making money to survive that they are unable to achieve their full intellectual capacity. However, more than anything, this is a matter of honoring basic intrinsic human value over profit, another central argument of the Zeitgeist Movement.

One should, however, take the much more practical approach to solving the problems in the American Healthcare system, by logically reassessing how the nation prioritizes its spending needs. Pissing the entire world off is unsustainable and counterproductive, so one might think that the US government could begin to rethink the use of funds as it pertains to defense spending. Rerouting that money to healthcare would go a long way towards funding a free healthcare system. Also, pulling money from other venues could be explored in a longer project, as well, referring back to the other general possibilities for funding initiatives for a free health program. Finally, to answer the question about why nothing has been done, there is a little bit of a mixture in why this was. Politicians have, in fact, commonly and intentionally blocked healthcare measures, for reasons that are well known, mostly related to the activities of Super PACs, special interests, and lobbyists. It also has to do with an inherited system of bad priorities, for example, astronomical defense spending and corporate welfare bailouts. There may also be something said about the complexity of the issue and the difficulty that comes with hashing out mutually equitable arrangements in federal legislation. However, these are not sufficient excuses. A life is a life, and to use a little cynicism, money talks. If the United States, as a people, are unable to serve the basic healthcare needs of the most elderly, physically, mentally, or fiscally challenged citizens, how can they sustain the wealth and quality of life that the elite enjoy? No production equals no profit, equals economic instability, equals social unrest, followed by more aggressive attempts to restore order, equals higher crime rates, more loss of life, and possible political upheaval. This creates more problems for the general health of the nation and repeats the cycle of inadequate healthcare and social manipulation.

Reprioritizing future government expenditures away from overly excessive defense spending and towards economically sound allotments to the health and well being of the population as a whole, will create the kind of self-sustaining free healthcare system that has been discussed in the article. As people are in better health over all, as they produce more for the economy, and as they pay more and more into the healthcare system, rated according to their level of income, if that is even a factor when such a system is implemented, the system will be less likely to fail. Such a system could potentially also affect other areas of concern. Making the same level of advanced healthcare available to everyone, regardless of their economic or social status, will make the job market more competitive as more and more people would be in the best condition possible to improve their education, increase their professional training, and increase their labor output making them more sought by potential employers. It will also dim the lines of class distinction as more people are able to gain access to the higher paying jobs of the new white collar economy, such as banking, higher education, international trade, and the like. Will this drastic of a change happen overnight, if it happens at all? It will definitely not happen overnight. However, given the appropriate prioritizations, a completely free healthcare system, and frankly, a more peaceful world, as a result, could be established. That, unfortunately, has yet to be seen.

1 comment:

  1. IT'S KKKorpUSA - PERIOD!

    NO OTHER REASON!

    Post WW2, the Allies led by the US, forced both Germany and Japan to Mandate in their new Democratic Constitutions, FREE UNIVERSAL HEALTHCARE, plus that ALL CORPORATE BOARDS be required to have at least HALF their members ELECTED BY the WORKERS... To PREVENT FASCISM!*

    *Merriam-Webster › dictionary › fascism
    Definition of fascism for Students. : a political system headed by a dictator in which the government controls business and labor and opposition is not permitted.

    Douglas Seretan MD 2G Ophthalmologist; 4G Physician-Med-Scientist, son of LtCol EL Seretan MD, Army Medical Corps WW2 S.Pacific Campaign, Occupation of Japan 1945.

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