Archive for the ‘Barack Obama’ Category
Obama’s Healthcare Reform: Hold the American people ransome to Big Pharma and corporate greed mandate
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Lee Sustar explains why we’ll be better off if proposed health care “reform” legislation that may come to a vote in the Senate is defeated.
by Lee Sustar
FROM BAD to worse to–utterly wretched.
That’s the course of so-called health-care “reform” in the Senate. The final version of the legislation is so filled with giveaways to big insurance companies that even leading liberal Democrats are threatening to join Republicans in opposing it.
While the right wing is still shrieking about a government takeover of health care, what’s really shaping up is a complete industry stranglehold over government policy.
The public option–a proposal for a minimal government-run health plan available to the uninsured–was road kill early on. Now Sen. Joe Lieberman has singlehandedly blocked a Senate effort to extend Medicare to people aged 55 rather than the current 65–even though he made just such a proposal a few months earlier.
Yes, the Senate plan would extend coverage to the uninsured–by forcing them to buy policies, whether they can afford them or not. Millions of people will have to buy high-premium, low-quality insurance through private health insurance exchanges, or be forced to pay a penalty. Those plans won’t cover abortions, if a handful of right-wing Democrats and Republican conservatives have their way.
And remember President Barack Obama’s vow to prevent insurance companies from discriminating against individuals with preexisting conditions? That’s in the proposed bill–but if you’ve got such a condition, you could pay up to 50 percent more for your coverage. Ditto for older people, who could pay premiums up to three times higher than younger people.
If you’re lucky enough to have a high-quality employer-sponsored insurance plan, you can keep it if you want, as Obama often says. But you’ll pay for it, big-time. The Senate has taken Obama’s plan to tax “Cadillac” health insurance plans–typically those won by union members over decades–even further, so now more modest “Chevy” plans will be taxed, too.
And under current legislation, today’s unaccountable corporate health insurance giants would become even more monstrous. They’d be able to move their nominal base of operations to states with the weakest consumer protection laws in order to shield themselves from patients with complaints. And they’d be shielded from much of current regulation.
From the start, opponents of the public option have wanted to portray it as big government preying upon the market, and private insurers as the embodiment of the market. But it’s just the reverse. Private insurers are exempt from competition. As a result, they are becoming ever more powerful. And it’s not just their economic power that’s worrying. It’s also their political power, as we’ve learned over the last 10 months.
THROUGHOUT THIS corporate perversion of health care reform, liberal organizations have mostly bit their tongues and gone along. Health Care for America Now, a coalition that includes labor groups like the Service Employees International Union (SEIU), has continued to put out vague advertisements and calls for action without challenging Obama’s capitulation to the insurance and pharmaceutical lobbies.
But the post-Lieberman Senate bill is so awful that some liberal groups are considering jumping ship. The AFL-CIO, for example, held an emergency meeting to discuss whether or not to oppose the legislation.
Liberal Democrats are also being pushed to the brink of opposition–or at least talking about it. Leading the charge is former presidential candidate and former Democratic National Committee chair Howard Dean, a physician, who wrote:
Any measure that expands private insurers’ monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform… Few Americans will see any benefit until 2014, by which time premiums are likely to have doubled. In short, the winners in this bill are insurance companies; the American taxpayer is about to be fleeced with a bailout in a situation that dwarfs even what happened at AIG.
The legislation is now so bad that it presents the Democrats with an impossible dilemma. If they fail to pass health care reform, they will be seen as incapable of governing. But if they do push the legislation through, they’ll face a backlash–not only from the Republican right, but from large sections of their voting base who will be socked with higher taxes now, and won’t even be able to access the new insurance plans until 2014 — and pay premiums that are likely to be still higher than they are today.
HOW DID we get here? How could Barack Obama so spectacularly squander his mandate and give a handful of “moderate” senators nearly total control over health care legislation?
Part of the answer is Obama’s repeated commitment to “bipartisanship”–an effort to get both main parties to support what is sold as “historic” legislation. But given that the Republicans are determined to oppose Obama on virtually everything but his war drive in Afghanistan, such efforts were doomed from the start. The administration’s strategy had the effect of putting so-called “moderate” Republicans like Maine’s Olympia Snowe in command of the process.
But Republican intransigence is only part of the problem. The main reason for this debacle is the nature of the Democratic Party itself. It’s not just that a key Senate figure on health care, Max Baucus, is a top recipient of campaign funds from the health insurance industry. Nor can all the blame be placed on Rahm Emmanuel, the pro-corporate New Democrat who runs the Obama White House.
The problem is more fundamental. Big business has dominated the U.S. political system since the rise of industrial capitalism more than a century ago. But in recent decades, corporate dominance of Congress has reached new levels. Health care reform has turned toxic for the same reasons that bankers have gotten trillions of taxpayer money from Congress while hard-pressed indebted homeowners have gotten almost nothing. Bankers, like the health care companies, lavish legislatures with campaign contributions and offer key members of Congress second careers as highly paid lobbyists.
What about Obama, who invoked social movements in his campaign for the presidency? The fact is that Obama was never the outsider he portrayed himself to be. His political rise had grassroots support, yet it was also sponsored by powerful businesspeople and Democratic officials.
Obama came to Washington not to transform the system, but to try to repair its image after eight years of George W. Bush and run it more competently. In other words, Obama’s priorities were chosen for him by the established power brokers–not just on health care, but every other issue, from the economy to the wars in Iraq and Afghanistan.
Some reform of the health care system makes sense for the capitalist class. But capital is determined to push the costs of any changes onto workers. Obama will try to sugarcoat that process, but he won’t alter its pro-business character.
Certainly, the White House has committed plenty of strategic blunders and tactical stupidities in the process of coming up with legislation. But the reality is that health care is negotiable for Obama — while, for example, his commitment to advancing the aims of the U.S. empire is not. When it comes to Afghanistan, Obama is prepared to move decisively and send 30,000 troops to Afghanistan to kill and be killed. Yet in the face of a threat from Joe Lieberman, he caves on health care in a day–and sends his spokespeople to attack Howard Dean for telling the truth about this terrible health care bill.
Millions of people voted for Obama because they believed he was a vehicle for progressive change–not least on the issue of health care. Many will still be tempted to support the current legislation, if only because the right has made it such a battleground.
But the reality is that everyone interested in genuine health care reform should try to stop this legislation and build a movement for something truly progressive — a single-payer system that would provide decent health care for all.
internet site reference: LINK
by John Pilger
When ignorance is Strength…
Within weeks of his inauguration, Obama started a new war in Pakistan, causing more than a million people to flee their homes. In threatening Iran — which his secretary of state, Hillary Clinton, said she was prepared to “obliterate” — Obama lied that the Iranians were covering up a “secret nuclear facility,” knowing that it had already been reported to the International Atomic Energy Authority.
In colluding with the only nuclear-armed power in the Middle East, he bribed the Palestinian Authority to suppress a UN judgment that Israel had committed crimes against humanity in its assault on Gaza — crimes made possible with U.S. weapons whose shipment Obama secretly approved before his inauguration.
At home, the man of peace has approved a military budget exceeding that of any year since the end of the Second World War while presiding over a new kind of domestic repression.
During the recent G20 meeting in Pittsburgh, hosted by Obama, militarized police attacked peaceful protesters with something called the Long-Range Acoustic Device, not seen before on U.S. streets. Mounted in the turret of a small tank, it blasted a piercing noise as tear gas and pepper gas were fired indiscriminately. It is part of a new arsenal of “crowd-control munitions” supplied by military contractors such as Raytheon.
In Obama’s Pentagon-controlled “national security state,” the concentration camp at Guantánamo Bay, which he promised to close, remains open, and “rendition,” secret assassinations and torture continue.
The Nobel Peace Prize winner’s latest war is largely secret. On July 15, Washington finalized a deal with Colombia that gives the U.S. seven giant military bases. “The idea,” reported the Associated Press, “is to make Colombia a regional hub for Pentagon operations…nearly half the continent can be covered by a C-17 [military transport] without refuelling,” which “helps achieve the regional engagement strategy.”
Translated, this means Obama is planning a “rollback” of the independence and democracy that the people of Bolivia, Venezuela, Ecuador and Paraguay have achieved against the odds, along with a historic regional cooperation that rejects the notion of a U.S. “sphere of influence.”
The Colombian regime, which backs death squads and has the continent’s worst human rights record, has received U.S. military support second in scale only to Israel. Britain provides military training. Guided by U.S. military satellites, Colombian paramilitaries now infiltrate Venezuela with the goal of overthrowing the democratic government of Hugo Chávez, which George W. Bush failed to do in 2002.
OBAMA’S WAR on peace and democracy in Latin America follows a style he has demonstrated since the coup against the democratic president of Honduras, Manuel Zelaya, in June. Zelaya had increased the minimum wage, granted subsidies to small farmers, cut back interest rates and reduced poverty. He planned to break a U.S. pharmaceutical monopoly and manufacture cheap generic drugs.
Although Obama has called for Zelaya’s reinstatement, he refuses to condemn the coup-makers and to recall the U.S. ambassador or the U.S. troops who train the Honduran forces determined to crush a popular resistance. Zelaya has been repeatedly refused a meeting with Obama, who has approved an IMF loan of $164 million to the illegal regime. The message is clear and familiar: thugs can act with impunity on behalf of the U.S.
Obama, the smooth operator from Chicago via Harvard, was enlisted to restore what he calls “leadership” throughout the world. The Nobel Prize committee’s decision is the kind of cloying reverse racism that has beatified the man for no reason other than he is a member of a minority and attractive to liberal sensibilities, if not to the Afghan children he kills.
This is the Call of Obama. It is not unlike a dog whistle: inaudible to most, irresistible to the besotted and boneheaded. “When Obama walks into a room,” gushed George Clooney, “you want to follow him somewhere, anywhere.”
The great voice of Frantz Fanon understood this. In The Wretched of the Earth, he described the “intermediary [whose] mission has nothing to do with transforming the nation: it consists, prosaically, of being the transmission line between the nation and a capitalism, rampant though camouflaged.”
Because political debate has become so debased in our media monoculture — Blair or Brown; Brown or Cameron — race, gender and class can be used as seductive tools of propaganda and diversion. In Obama’s case, what matters, as Fanon pointed out in an earlier era, is not the intermediary’s “historic” elevation, but the class he serves. After all, Bush’s inner circle was probably the most multiracial in presidential history. There was Condoleezza Rice, Colin Powell, Clarence Thomas, all dutifully serving an extreme and dangerous power.
Britain has seen its own Obama-like mysticism. The day after Blair was elected in 1997, the Observer predicted that he would create “new worldwide rules on human rights,” while the Guardian rejoiced at the “breathless pace [as] the floodgates of change burst open.” When Obama was elected last November, Denis MacShane MP, a devotee of Blair’s bloodbaths, unwittingly warned us: “I shut my eyes when I listen to this guy, and it could be Tony. He is doing the same thing that we did in 1997.”
First published in the New Statesman.
About the writer:
John Pilger is a renowned investigative reporter and documentary filmmaker who was called “the most outstanding journalist in the world today” by the Guardian. He is the author of numerous books, including most recently Freedom Next Time: Resisting the Empire, a collection of investigations into the effects of war crimes and globalization. His books and films are featured at JohnPilger.com.
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Donna Tara Lee, a transgender activist living in Florida, retired postal worker and an organizer for October’s National Equality March in Washington, D.C., describes her response to the first year of the Obama administration:
by Donna Tara Lee
I WOULD like to say that I have been a lifelong Democrat since I was first eligible to vote in 1969.
Before that, I leafleted cars for RFK in 1964 in his Senate race in New York. My family revered Franklin Roosevelt for getting us through the Great Depression and Second World War, and thought Harry Truman was a great successor to FDR for expanding the New Deal and fighting communism. These were the politics I was brought up with and learned at the dinner table.
Since that time, as I got older, I have been an unabashed liberal. I have been active in all the following causes dating back to the 1960’s: civil rights, antiwar, feminism, pro-choice, the farmworkers’ movement ( I boycotted grapes for years), no nukes, free speech, justice for the Palestinians, anti-imperialist, anti-apartheid, and, lastly, the LGBTQ movement.
I was always sympathetic, but never took action on LGBTQ issues, except to vote against any anti-gay politicians and for any LGBTQ rights initiatives that I could. And yes, I spoke up for equality for LGBTQ persons.
And I have been a loyal Democrat all these years. So why am I now thinking of leaving the party after our biggest electoral success since 1964?
I have become so disenchanted that the changes we were promised instead seem to be more of the same old politics as usual. The lobbyists are still in control.
Let’s take a look at the health care non-reform bill–as it should really be called. The insurance companies have spent an enormous amount in a misleading advertising campaign to defeat health care. Right-wing thugs took over town hall meetings during the August recess, not allowing a rational health care debate. “Blue dog” Democrats joined the Republicans in lying and slandering health care legislation, and those who support it.
Personally, I don’t support the health care bills out there. I favor a single-payer, cradle-to-grave health care plan, like they have in all other industrial countries. I believe the Obama administration has basically caved in on real health care reform to achieve a non-achievable bipartisan law.
And allowing something like the Stupak Amendment to go forward is an affront to all women in this country and everyone who favors reproductive rights. So as far as I’m concerned, there is no real health care reform on the table.
On other domestic issues, huge sums of bailout money were given to the big corporations that got themselves and us in this mess by their greed. But there have been no regulatory reforms passed to make sure the banks can no longer fleece us. So it’s back to business as usual on Wall Street.
Amazing how both unemployment and stock prices are both rising. Main Street continues to suffer, and Wall Street does better. This does not compute.
The repressive and unconstitutional USA PATRIOT Act remains in effect, and lawbreakers of the previous administration go unpunished. Hate crimes against LGBTQ people are on the rise, as are gun and ammunition purchases. Reproductive providers are threatened, and one has been killed. The birthers, tea baggers and 10th Amendment folks are all on the loose, threatening our democracy. Our education institutions continue to fail our young. The birth rate is going up for unwed mothers. There is no real climate reform. Unemployment continues to rise, and our major parties are more partisan toward each other than ever.
In foreign affairs, the wars go on, taking more of our treasury, and the death toll among our soldiers grows higher. We still support regimes that persecute women for being women, and that are repressive and corrupt. Now, we call it anti-terrorism–it used to be anti-communism.
Except for some cosmetic changes–you could call it a new brand of make-up–what has changed? Nothing is my brutally frank answer.
THESE FAILURES have led me to rethink my political philosophy. I would say that for most of my life, I have been a social democrat. I wanted to see the U.S. evolve into a social welfare democracy, like the western European and Scandinavian countries. I can see now that in our current climate, which has been growing since the big business opposition to the New Deal in the 1930s, I have been wrong, and there’s no way the evolution I hoped for will take place.
I will be leaving the Democratic Party soon and registering as a socialist. I do this with a heavy heart, but I am convinced that the only way now to a peaceful and economically just society is through socialism.
I believe we should be at peace and not supporting corrupt governments in the name of anti-terrorism. I believe our citizens have the following rights endowed to them: reproductive freedom, an equal rights for all our citizens. I believe that there is no place in a just society for racism, sexism and homophobia, and that we need economic justice, not a corporate dictatorship. I believe all citizens should have the right to health care, an education and a decent living. These obscene profits need to end, and wealth needs to be redistributed to the workers. I also believe in open borders and an end to our insane anti-immigration policies.
Since I see our two major parties doing nothing but fighting among themselves as to which is the best to keep the evils of capitalism working, I gladly embrace socialism and its goal of peace and freedom for all.
internet site reference: LINK
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Many people who were Barack Obama’s most enthusiastic supporters a year ago have grown disillusioned and angry. Alan Maass looks at the differences between President Obama and Candidate Obama — and where the hope for real change lies.
by Alan Maass
AS THE first year of Barack Obama’s presidency drew to a close, one event symbolized the gap between the promise he represented to so many people and the frustrating reality: A war president accepting the Nobel Peace Prize.
Here was the man who owed his electoral success, at least during the Democratic primaries, to the perception that he was the main antiwar candidate — and he accepted the Nobel in Oslo a week after announcing he would escalate the already-eight-year-old U.S. war on Afghanistan, with a second troop surge that brought to more than 50,000 the total number of soldiers he had committed to the war since taking office.
Sure, Obama’s Nobel speech started with the usual claims of “great humility” to be receiving such an honour — right before he delivered as ugly an example of American imperial arrogance as anything George W. Bush could have managed:
Whatever mistakes we have made, the plain fact is this: the United States of America has helped underwrite global security for more than six decades with the blood of our citizens and the strength of our arms. The service and sacrifice of our men and women in uniform has promoted peace and prosperity from Germany to Korea.
Underwritten global security? Tell it to the relatives of the innocent Afghans torn to pieces by U.S. bombs dropped on wedding parties. Promoted peace and prosperity? Ask the people of East Timor trying to rebuild a ruined nation after a quarter century of a U.S.-sanctioned occupation and genocide by Indonesia. Blood of our citizens? An Iraqi could tell you about the blood of their citizens, spilled to protect the U.S. government’s control of Middle East oil.
If Obama’s goal was to win the approval of right-wing Republicans–the ones who accuse him of “paling around with terrorists” and pander to the crazies who think Obama was born in Kenya — he did succeed on that count. “I liked what he said,” Sarah Palin chirped. Newt Gingrich praised “a very historic speech.”
Walter Russell Mead — whose title of Henry Kissinger senior fellow for U.S. foreign policy at the Council on Foreign Relations tells you everything you need to know about him — couldn’t contain his delight:
There are no flies on our President. He could sell shoes to a snake.
Barack Obama’s acceptance speech for the Nobel Peace Prize was a carefully reasoned defense of a foreign policy that differs very little from George Bush’s. He is winding down one war, escalating a second, and stepping up the pressure on Iran. He is asserting America’s sovereign right to unilateral action in self-defense, while expressing the hope that this right will not need to be exercised.
If Bush had said these things, the world would be filled with violent denunciations. When Obama says them, people purr. That is fine by me… I’ve waxed lyrical about Obama’s ability to sell our foreign policy to the world. He didn’t just put lipstick on the pig; he gave it a makeover and sent it to charm school.
Meanwhile, among the people who actually wanted Barack Obama to become president, there was bitter disappointment. As author Garry Wills wrote:
Although he talked of a larger commitment to Afghanistan during his campaign, he has now officially adopted his very own war, one with all the disqualifications that he attacked in the Iraq engagement… I cannot vote for any Republican. But Obama will not get another penny from me, or another word of praise, after this betrayal.
Obama’s surge to Afghanistan was a turning point for others who supported him in 2008. But it’s worth noting that many leading liberals weren’t nearly as put off as Wills. Nation editor Katrina vanden Heuvel, speaking to National Public Radio, claimed that Obama’s Nobel speech–the very same one admired by Sarah Palin–“had a humility and grace while confronting the paradoxes.”
When Obama announced his Afghanistan escalation a week earlier, the liberal antiwar group MoveOn.org urged its members not to protest Obama, but to call on Congress to support “a binding military exit strategy and firm benchmarks so we can bring our troops home safely and quickly.”
So the president of the United States doubles the number of U.S. troops committed to a war that even some conservatives now considered a disaster, and all MoveOn.org could ask for was “benchmarks”? That tepid response goes a long way in explaining why the Obama administration wasn’t concerned about an antiwar backlash when it approved the Pentagon’s proposal for a further surge.
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Special to The Canadian [abridged text]
US President Barack Obama has disappointed many of those who hoped his presidency would deliver “change we can believe in.”
But there’s one campaign promise Obama has kept — twice.
In his prime-time speech on December 1, Obama followed through on a pledge to escalate the war in Afghanistan for a second time, announcing that he would send an extra 30,000 US troops.
When Obama took office, less than 50,000 US soldiers were deployed in Afghanistan. He ordered an additional 21,000 soldiers there earlier this year. With the extra 30,000, he has doubled the US presence.
Obama motivated the troop buildup with a speech that recalled George W. Bush’s call for a “war on terror”. He recycled the Bush lie that the US invasion of Afghanistan, launched eight years ago, was retribution for the September 11, 2001 attacks.
He falsely claimed that Afghanistan’s Taliban government refused to hand over Osama bin Laden and al-Qaeda. “America, our allies and the world were acting as one to destroy al-Qaeda’s terrorist network, and to protect our common security”, Obama told West Point cadets.
Later, Obama concluded by summoning the war frenzy cynically whipped up by the Bush administration after September 11: “It is easy to forget that when this war began, we were united — bound together by the fresh memory of a horrific attack, and by the determination to defend our homeland and the values we hold dear.
“I refuse to accept the notion that we cannot summon that unity again. I believe with every fibre of my being that we — as Americans — can still come together behind a common purpose.”
Wrapping himself in the flag Bush-style, Obama strained to sell people on the idea that the discredited, fraudulently elected government of President Hamid Karzai can rule legitimately.
“[W]e and our allies prevented the Taliban from stopping a presidential election,” Obama boasted, “and although it was marred by fraud, that election produced a government that is consistent with Afghanistan’s laws and constitution.”
So the US military helped Karzai to hold an election so obviously fraudulent that the UN demanded a run-off, but the second-place finisher refused to take part — that’s some triumph of democracy!
Obama tried to sugarcoat the war drive with a promise that US troops will start pulling out of Afghanistan in July 2011. But given the scale of the Taliban resistance, that plan is utterly lacking in credibility. The talk about Afghans taking responsibility for their own security was a dead ringer for Bush’s promises that “as Iraqis stand up, we will stand down”.
In another note reminiscent of the Bush years, we were treated in the run-up to the speech to a steady media diet of good news about the Afghan war campaign, designed to suggest that there’s “light at the end of the tunnel”.
Take, for example, the revelation that anti-Taliban militias are “spontaneously” springing up in various parts of Afghanistan. A November 21 New York Times report said, “the Americans hope the militias will encourage an increasingly demoralised Afghan population to take a stake in the war against the Taliban”.
But even the NYT acknowledged that US Special Forces are “fanning out across the countryside, descending from helicopters into valleys where the residents have taken up arms against the Taliban and offering their help” — casting serious doubt about how “spontaneous” these militias are.
With this effort, the US is hoping to bypass unpopular and tyrannical warlords and set up tribal networks allied with occupation forces. Money for development will be used to further cement these ties.
But this strategy is a long shot at best. The NYT admitted, the strategy of giving ammunition, communication hardware and other support to these militias could backfire spectacularly.
This isn’t just a hypothetical. US backing for Afghanistan’s mujahideen fighters against the ex-USSR’s occupation in the 1980s gave rise to the armed networks that eventually produced al-Qaeda and Osama bin Laden.
Now the Obama administration cites the fight against the terrorists of al-Qaeda as the main reason for sending even more US troops to kill and be killed in Afghanistan.
This involves a double conceit — historical amnesia about the bitter fruits of US policy in Afghanistan since the 1970s, and deception about the real reasons for the continued US interests in cultivating a pro-US regime in Afghanistan.
That effort goes back to the 1979 invasion of Afghanistan by the USSR. “The day that the Soviets officially crossed the border, I wrote to President Carter”, recalled Zbigniew Brzezinski, who was Carter’s national security advisor from 1977 to 1981. “We now have the opportunity of giving to the Soviet Union its Vietnam War.”
At the time, US foreign policy officials encouraged the growth of the most extreme Islamic elements because they considered them the key to defeating the USSR.
After the US achieved its goal, the mujahideen fighters it had backed came to power — and Washington stepped aside and watched, as the country descended into a civil war among the divided factions that had triumphed over the Soviet Union.
When the Taliban emerged as the victor in 1996, the US adopted an attitude of benign indifference. At least the Taliban brought stability and an unrelenting hostility to the opium trade, reasoned US officials.
But September 11 gave the US a new opportunity to project military power into the heart of Central Asia. It quickly installed military bases in countries that had been part of the old USSR, giving the Pentagon the means to pressure China, Russia and neighbouring Iran, and provide greater US access to the region’s oil and gas resources.
Bush’s failure to secure those gains with the “war on terror” drew criticism from Obama throughout the presidential campaign.
Perhaps some Obama supporters thought that the Democratic candidate’s call to escalate troop strength in Afghanistan was simply rhetoric to shield him from criticism on the right. But Obama’s West Point speech makes it perfectly clear that he’s a willing and aggressive proponent of the pursuit of US imperial aims.
White House estimates say each additional US soldier sent to Afghanistan will cost taxpayers US$1 million a year. So Obama’s double dispatch of troops will cost an additional $55 billion over the next year. Compare that to the Afghan government’s entire national budget of roughly $1 billion a year.
The Obama administration hasn’t committed as many troops as some military hardliners want. But the reality is that the current combined US/NATO presence — 68,000 US soldiers, 33,000 from various NATO countries, and more than 70,000 US military contractors — already exceeds the number of troops deployed by the USSR at the height of its involvement in Afghanistan.
The US could continue to muddle through — unless it meets a significant opposition that can’t be ignored. Already, there is anxiety that the US public may not be willing to put up with a five- or 10-year strategy.
The anti-war movement needs to give those anxieties concrete expression by organising a visible opposition. The demonstrations organised in cities across the US to respond to Obama’s speech are an important opportunity to begin building a vocal opposition to a war that is all Obama’s now.
From: International News, Green Left Weekly issue #821 9 December 2009.
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by Stephen L. Strauss, M.D.
When President Obama announced that health care reform would be a top priority of his presidency, there was a predictable sense of optimism among millions of people. In the course of a year, however, this mood has turned sour, and now many people are just hoping that something, anything, gets passed.
Indeed, the Obama euphoria that characterized the early days of the new administration has been steadily disintegrating. His approval rating now stands at less than fifty percent. A president who promised to get the U.S. out of Iraq now says that withdrawal means maintaining the presence of 50,000 allegedly “non-combat” U.S. troops. A president who complained that No Child Left Behind was inadequately funded now threatens to withhold federal dollars from local school districts unless they comply with the law’s draconian measures.
And in health care, the president who once said he is in favor of single payer now says that such a program is off the table, that it is “too disruptive”, even though the majority of Americans support replacing private insurance with a well-run, profit-free government program. More and more, the bait-and-switch game played by the Democrats and Republicans is becoming exposed to U.S. workers.
It is a game because the agenda they are trying to sell is not in the interests of the overwhelming majority of Americans. It is an agenda in the interests of corporate America, one that is fundamentally opposed to the needs of working people. To do this, they have to lie.
When the corporations want war, the big business parties sell it as the way to achieve peace. When corporations want public schools to be the training ground for a workforce with new set of skills to exploit, they call it education reform. And when the corporations want to unload their financial obligations to workers’ health insurance, in order to keep more for themselves and increase their profits, they call it health care reform.
Indeed, the current legislation is not the reform of health care that most Americans had in mind when Obama’s smile was still taken to be sincere. Most Americans want and expected better access to doctors, diagnostic tests, safe and effective treatment, acute care, long term care, and rehabilitation. They want cost to not stand in the way, for themselves, their parents, and their children.
But this straightforward and eminently reasonable expectation among millions of Americans is not what we’re getting. Instead, we are bombarded with swirling dust-devils of confusing rhetoric about penalties for not buying insurance, a public option not open to the public, and cutbacks in Medicare. This is hardly what working people expected.
Confusion is what fills the chasm between what was expected and what we are getting. A problem that seems so straightforward can’t get a straightforward solution from the White House and Congress. We need a surge in health care and we need it to be financially accessible. What’s so difficult about that?
Nothing really. Except that this was never what the so-called debate was about. It was never about health care. It was and is about corporate profits and the efforts of big business to unload the drag on those profits represented by the money it must contribute to employee health insurance. And the debate will stay that way as long as the two parties of big business are the only ones carrying it out.
And that’s not confusing at all. Since when did the Democrats and Republicans ever act out of the goodness of their hearts on behalf of working people? Social advances are achieved by struggle against corporate power and their agents in Washington. That’s how union workers won employer health care contributions in their contracts. That’s how the American people won Medicare.
The only confusion should be in imagining that the two parties of big business are now somehow establishing a new precedent, that they are motivated by sincere empathy for working people.
The initial optimism over health care reform was based not only on Obama’s promise to make it a top priority of his presidency; not only on Obama having a cultivated image as representing real change; not only on health care feeling like the good news we’ve all been wishing for. It was based on the real, deep need people have for real change in how to get the care they need. There is nothing abstract about getting sick and about getting unpayable bills in the mail.
Thus, the need is both medical and economic. Health care is prohibitively expensive for most working people. In fact, it is essentially unaffordable. A heart bypass operation costs as much as a BMW, about $55,000. If a BMW is a luxury car that most working people can’t afford, then the same applies to coronary bypass. From a financial standpoint, it’s a luxury operation.
Health care insurance makes it somewhat easier for people to access the medical care they need. But people are still stuck with their premiums and deductibles. And this runs so high that 60% of all personal bankruptcy cases in the United States are due to unaffordable medical bills.
Having health care insurance does not protect someone against such bankruptcy. About three-quarters of these personal bankruptcies are among people who have insurance. Obviously, the insurance that most people have is entirely inadequate.
Imagine the even graver situation for people with no insurance. We are talking about 48 million Americans. Half of the uninsured are women. Half of the uninsured are Blacks and Latinos. Half of the uninsured have not seen a medical doctor in more than a year, even though they actually do have medical conditions that need surveillance and treatment, conditions like hypertension, diabetes mellitus, heart disease, and cancer.
How often have you seen a picture of a child with leukemia pasted on a neighborhood telephone pole with a plea for money to pay for chemotherapy? Or a child who needs a major heart operation or liver transplant? Or surgery for a cleft lip and palate? How often is this the child of a CEO of a major health insurance company? Never. This is a class issue.
Women obviously have health care issues quite distinct from men. Yet women are penalized for the chronic “condition” of having a uterus. In some private plans, women are charged up to 48% percent more than men for exactly the same overall coverage. In some plans, having had a Caesarian section is considered a pre-existing condition that the insurance company uses to deny coverage. Hard as it may be to believe, there are some plans that count being a victim of domestic abuse as a pre-existing condition.
The so-called “don’t ask, don’t tell” policy in the military that allows gays and lesbians to enlist has led to some interesting health care problems. Military officials are finding that the “don’t tell” part seems to carry over to the medical clinic, so that gays and lesbians in the military are not getting the care they need.
Job injuries create disabilities. Becoming elderly creates disabilities. People need long term care.
Being young and naïve makes one a target for tobacco pushers, cholesterol pushers, and sugar pushers. Draconian classroom practices, launched into the stratosphere by No Child Left Behind, are associated with increasing rates of childhood depression, anxiety, and suicide. There are all kinds of medical and psychological problems that ensue from the commodification of plants, animals, food, and learning. We need broad health education, including sex education, for young people. We need to create healthful contexts for young people.
There is virtually no end to what needs to be done. And yet this level of need leaps exponentially if we go beyond our immediate political borders, even just to nearby countries. In Haiti, for example, some poor people live on a concoction of mud mixed with cooking oil and sugar. The oil provides a smooth texture, and the sugar a flavorful taste, to the brown substance that will provide a feeling a being full once it lands in a hungry child’s stomach. Most people would agree that this is wrong. Its solution clearly shows that health care is intimately connected to politics and poverty.
A recent New York Times study revealed that, since 2004, 49 million Americans are drinking tap water containing higher concentrations of arsenic, radioactive substances, disease-bearing organisms, and other pathogens that are legally permitted. This wasn’t from an unfortunate natural disaster. It was from federal oversight agencies looking away, over and over again. The Times reported that “fewer than 6 percent of the water systems that broke the law were ever fined or punished by state or federal officials, including those at the Environmental Protection Agency, which has ultimate responsibility for enforcing standards.” Many of these pathogens are dumped by corporate polluters, for whom the nation’s waterways are just one big toilet bowl. According to the Times, “as many as 19 million Americans may become ill each year due to just the parasites, viruses and bacteria in drinking water.” In addition, breast, prostate, and other cancers, whose rates have risen over the past three decades, are linked to drinking water pollutants.
In other words, the same system that puts obstacles in the way of adequate health care is making people sick. A comprehensive health care plan must include forcing the corporate polluters to clean up the water systems. This won’t be easy, since it will cost them money. Private profit both causes disease and stands in the way of treatment.
There is a solution to this problem. Not an immediate one, but one that has an initial step that can be launched immediately. And that initial step is single payer.
A Business Week poll in 2005 revealed that about 62% of Americans support single payer, when it is clearly characterized and they understand what it is. Hundreds of locals of the AFL-CIO are on record as supporting single payer. In a recent poll, 48% of medical doctors supported it. A single payer bill, HR 676, has been introduced regularly into Congress by Representatives John Conyers (D-Mi.) and Dennis Kucinich (D-Oh.).
Single payer is a set-up in which there is only one agency to whom medical bills are sent. This agency reimburses the doctors, hospitals, and other health care providers. Crucially, it is not private. It is a government agency. In the Conyers-Kucinich bill, no private insurer is allowed to compete with the federal insurer. In other words, the private insurance industry is no more.
Some single payer advocates would still permit doctors and other health care providers to remain private. They all just submit their bills to the federal insurer. This may be a goal most easily attainable in the short run. But a far more manageable situation, one that would not allow the arrangement to be sabotaged from within, would be to have all physicians, nurses, and other health care providers be federal employees. This, of course, will take some convincing at the present stage of the struggle.
But doctors, for example, can be won to such an arrangement. The one obvious advantage is that being a federal employee eliminates the need for malpractice insurance. This does not in any way imply that doctors are no-longer periodically peer-reviewed, even censured if necessary for poor care. Rather, it means that if an unfortunate outcome occurs, a patient will still have his or her medical needs covered, as in any other situation. There will be no need to bring a lawsuit against doctors and hospitals.
One of the most important features of quality health care is the doctor-patient relationship. The patient must trust the doctor enough to feel comfortable revealing the most private of feelings and physical concerns. The doctor must demonstrate that trustworthiness through both a caring personality and professional expertise.
Single payer poses no inherent obstacle to choosing one’s physician. That means you can stay with whomever you choose, or move on to someone else. That’s your right and prerogative.
Under privately insured medicine, there is a profit-driven basis for insurers telling you whom you may or may not see. The insurers seek contracts with medical practices that will accept their reimbursement schedules. Private physicians may themselves reject insurers who, they feel, reimburse too little. Thus, not every physician is available for every insurance plan. This means that if your insurance plan changes, your doctors can change right along with it.
Under single payer, there are no co-pays or other out of pocket deductibles. There is only a single payer, the government agency. The patient is no longer a payer in a fee-for-service arrangement. As most working people understand, co-pays and deductibles are merely obstacles created by private insurers to discourage people from seeking medical care. They of course become unavoidable within the private system when you land in the hospital because of a heart attack, stroke, or other medical catastrophe.
Single payer has a stake in preventive care, since it is all about keeping the population healthy. Preventive care includes educating teens about the medical risks associated with tobacco use, unprotected sexual activity, and drug use. Preventive care is proactive in screening for breast cancer, cervical cancer, and colon cancer. Preventive care makes the population healthier.
But preventive care is not something private, for-profit insurers want to spend their money on. Even if they could be convinced that their profits would be increased because of reduced rates of preventable diseases, they are too myopic to reckon that far in the future. No capitalist seriously invests now for a return 30, 40, or 50 years in the future, especially when the economy is in a serious downturn and the goal is to squeeze through the present crunch.
Obama on Single Payer
In 2003, Barack Obama said “I am in favor of single payer.” He made this statement before an audience of the Illinois AFL-CIO. He was getting ready for a run for the U.S. Senate from Illinois, and clearly was courting labor support.
For the bureaucrats who run the union, words are a cheap way to buy an endorsement. The ambitious politician became the first African-American president of the United States, and immediately denied he ever made a statement in support of single payer. “I never said I supported single payer”, he stated.
What was he for now? He was for “health care reform”, of course, just like everyone else. But in whose interests?
Obama stated at the beginning of his presidency that health care reform would be a top priority. So important was it to have a reform measure pass in the Congress, he announced that he endorsed a bipartisan approach, and charged House and Senate committees to work out various portions of a comprehensive bill.
Now, what does it mean to endorse a bipartisan approach? It is important to keep in mind that the other party in power is the Republican Party. It is no secret that there is not one Republican who supports single payer, and virtually none who supports a meaningful public option.
If Obama’s bipartisan strategy were based on a sincere desire for everyone in Congress to work together to find a common solution to the problem facing all of us, then it is exceedingly naïve. But certainly such naivety would have been caught early on by all of Obama’s advisors.
No, the bipartisan approach was a signal to the insurance companies and the other private interests that they had nothing to fear. Their sacred profit ledgers would be protected. Behind a veneer of “working together”, Obama took sides.
Bipartisanship is a sign that something bad is coming down the pike. Bipartisanship is the watchword for the U.S. occupation of Afghanistan and Iraq, and for the occupation of the public school classroom via No Child Left Behind. Bipartisanship is the watchword for the USA Patriot Act. Bipartisanship is the watchword for Mumia Abu Jamal, the Cuban 5, and Lynne Stewart. It is why Obama’s “change we can live with” makes no dent in the ongoing terrorist activities of the Central Intelligence Agency. Bipartisan means the capitalist class, corporate America, big business. Two parties representing a single class.
When Obama held his famous health care summit in March, 2009, advocates of single payer were not invited. They staged an embarrassing demonstration outside the White House and were given visas. But their proposals were never taken seriously.
Obama pronounced in his speech that, at the present time, single payer would be “too disruptive”. Too disruptive to whom? Lack of health insurance is directly responsible for 48,000 deaths a year in this country. That’s disruptive too. Whose disruption counts more, the private insurers or working people?
Obama said that he has “no intention of doing away with the insurance industry” since they perform “a useful role”. He proposed instead a “public option” to “keep them honest”.
Perhaps Obama knows something we don’t. Most Americans regard the tobacco industry as more honest than the private health insurance industry.
In truth, the private health insurance industry performs no useful role in society and is inherently dishonest.
What is a health insurance company anyway? What does it sell? An automobile company sells cars. A soap manufacturer sells soap. A brewery sells beer. What does a health insurance company sell?
It sells risk reduction. If you are alive you are at risk for getting ill. Medical care is out there. Without it, you can become seriously disabled, even die. But it is extremely expensive, literally out of reach for most people. Thus, there is a financial risk associated with the medical risk of getting sick.
Working people know that the financial risk can economically disable them, or kill them. So an insurance company comes along and says, essentially: “If you pay us $500 a month, we will take on some of your risk. For $1500 a month, we will take on some of the risk of your family.” This seems like a good bet, and a deal is struck.
Of course, like any good gambling casino, the insurance company won’t let three cherries come up every time the slot machine is rung. Not every illness will be covered. Not every claim will be granted. The insurance company will do everything it can to shell out as little as it can get away with.
That’s the source of the company’s profits. It collects premiums. The less it spends on health care, the more it keeps for itself. The California Nurses Association discovered that 21% of claims in California are denied. The private insurance companies are in the business of denying health care.
That’s inherently dishonest. But the deception doesn’t stop there. The company has a medical director who signs off on the denials. This is a medical doctor, someone who graduated medical school and has an M.D. after his or her name. The insurance company can claim that its denials are based on a careful, medical review.
Except that these medical directors often haven’t seen a patient, or taken care of a clinical problem, in five, ten, or more years. I myself have encountered denials from medical directors who did not know the disease for which they were denying care, or the medicine they were not paying for. That is dishonest.
They say they are not denying care. They are just not paying for it. For most people, that amounts to the same thing.
Between 2000 and 2005, the private insurance industry increased its administrative staffing by 32%. This was not to provide health care, but to further bureaucratize the manufacture of health care denial.
What they do with their money is, of course, no surprise to anyone. The salaries of the CEOs of the ten biggest insurance companies averaged around $11 million in 2008. That’s the equivalent of about 2000 heart bypass surgeries.
Profits to shareholders have gone up 428% in the major companies. While denial of payment to patients is widespread, campaign contributions are quite healthy, about $19 million since 2007 just to federal candidates for the House and Senate. Fifty-six percent of these went to Democrats.
And for working people, premiums have gone up 131% over the last ten years.
It is a lie that this way of doing things has made the U.S. system the best health care system in the world. It certainly is the most costly, with about twice the per capital spending compared to countries like France, Germany, and the UK. It amounts to 16% of the gross domestic product (total spending) in the United States, versus 8% in other advanced capitalist countries.
Yet the World Health Organization reported that on their Disability Adjusted Life Expectancy scale, that is, how long someone lives healthy and without disability, as opposed to immobilized in a nursing home bed, the U.S. ranks 24th in the world!
We pay more and get less. Because we pay an astonishing $350 to $500 billion a year for private health insurance bureaucracies, from which the CEOs and stockholders amass their fortunes, from which Democrats and Republicans get bought off with campaign contributions and lobbying efforts. The administrative costs of actually running a health care system just to provide health care is about 3% of their revenues, as is the case, for example, with Medicare. The administrative costs of a typical for-profit insurer are about 32% — an utter waste of society’s resources.
And if the Democrats and Republicans get their way, we will be paying even more and getting even less.
The Public Option
It is instructive to consider what Obama said about the “public option”, the plan that would be the compromise with those opposed to a truly non-profit, government run insurer. In his speech to Congress, he praised it and called for its inclusion in the health care reform legislation. He compared the health care public option to the public option in higher education, where truly outstanding public universities co-exist alongside private universities.
Of course, the public university option is shrinking day by day, as cutbacks in capital and personnel expenses are making life more difficult for faculty and students. But even so, the kind of public option that the federal legislators debated bears no resemblance whatsoever to high quality public universities.
There are public options and there are public options. In Los Angeles, if you don’t have a car, you can take the public option – the bus. Using your bicycle on the public roads is also a public option. In fact, all these are better than the health care public option, because no version of the latter discussed by the Democrats and Republicans in Congress was in fact an option open to the public.
Indeed, like welfare and social security disability, the criteria for approval are quite stringent, designed to keep out as many people as possible. The Congressional Budget Office estimated that fewer than 5% of the currently uninsured would be eligible for the various public options being debated.
It is hard to imagine that Obama was not aware of the kinds of public option plans being considered, and that he really thought a health care equivalent of UC Berkeley or the University of Michigan or the University of Texas was in the works.
What the discussion is all about
At last count, the Senate bill was 2074 pages in length. Quite a bit of work went into something that should take only three sentences to summarize: 1. All medically approved health care will be available for everyone who resides in this country. 2. It will be paid for entirely from a non-profit government fund. 3. That fund will obtain its revenues by taxing corporations and the billionaires and millionaires of this country.
But these are not the three sentences that would express, in condensed form, what the Senate and the House have in store for U.S. workers and poor people. Their summary sentences will read more like the following: 1. The government will require everyone to purchase insurance and will levy fines on those who do not. 2. Businesses will not be obligated to contribute to employee health care premiums, but the government will subsidize the costs of premiums for those who cannot afford them. 3. The government will pay for these subsidies by gutting Medicare an estimated $460 billion over ten years and increasing taxes on working people.
This is the core of health care reform from the Democrats and Republicans. It needs to be very clearly understood, because it is not at all about health care, and never was. It is about financial restructuring in the midst of a crisis of capitalism, in which capitalist markets are getting saturated, speculative investment bubbles burst, and the corporations are scrambling to find ways to both boost and safeguard their profits.
The core of health care reform is a massive transfer of money from the working class to corporate America. Instead of big business having to contribute to employee health care, this will eventually come entirely from workers. Instead of private insurers being replaced with a single, non-discriminatory public payer, they stand to gain millions in new “customers” and billions in new profits.
To entice working class support, the government will subsidize some of those who cannot afford the premiums. But this will be paid for by taxing workers and by raiding Medicare, ultimately leaving Medicare too weak to be meaningful.
Democrats and Republicans alike have praised the core content of reform as leading to a lowering of the deficit by about $130 billion over the next decade. It should be crystal clear that it is workers who will be paying off this deficit. That will make it easier for big business and the U.S. government to continue borrowing money to pay for their wars.
Taxes to pay for this, that is, taxes that will unload big business’s financial obligations, increase insurance company profits, and pay off the deficit, will start immediately. But the reform measures won’t actually begin for five years. They plan to suck workers’ limited financial resources for five years to help build up the fund they need to make this thing work.
Some estimates of the impact of the bill include a figure of 24 million as the number of Americans who will remain uninsured even by 2019. Even if a working family qualifies for federal subsidies to pay the premiums, co-pays and deductibles will remain unsubsidized and still amount to about 20% of a family’s income, that is, before the actual insurance coverage kicks in. So, for example, a family with an income of $66,000 will pay about 10% of that for co-pays and an additional 10% for deductibles.
It will be no big deal for private insurers to cover people with “pre-existing conditions”, that is, people who pose a higher financial risk to them. They will more than make up for this with the millions of new customers they gain.
None of this should be a surprise. Since when did Democrats and Republicans take the initiative in giving working people something they needed, either economically, socially, or politically? The gains of our class have come from struggle, and only from struggle. Women’s right to vote, workers right to organize, civil rights and the end of Jim Crow, Social Security, Medicare – in short, every social gain for workers and poor people – has been won through organized confrontation with the corporations and their politicians.
The politicians have known all along what this is all about. They are wined, dined, and refined by the private insurers, the private pharmaceutical companies, the planetary polluters, the military monsters. Senator Baucus got millions from the private insurance industry. According to Physicians for a National Health Program, Senator Reid’s main staff writer of the Senate bill is none other than Elizabeth Fowler, former vice-president of Wellpoint, the nation’s largest private health… [CONTINUED.. see comment below]
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by Horace Carby-Samuels
The prevailing economic reconstruction/bail-out packages, which the U. S. Government as well as the governments of other industrialised societies are promoting, neglect to embrace people as being more than potential customers and sources of hired labour. Instead, without a doubt, these economic reconstruction packages need to set the stage in respect of where we expect to end up as a society. These packages must aim to generate circumstances which will enable people to be better able to operate as managers of the patterns of survival that they seek to secure for themselves and for their heirs. What is therefore required, is economic bail out packages that focus beyond the simple creation of commercial regeneration. The so far overlooked need is to remedy the circumstances out of which the prevailing economic downturn had been initially generated.