A lot has been said and written about the Obama administrationâ€™s plan for universal health coverage, but see if you can spot whatâ€™s wrong with this picture: senior citizens at a town hall meeting screaming about how they donâ€™t want the government â€œmessing with their healthcare.â€
Right. Seniors are already enrolled in government health care-itâ€™s called the Medicare program!
Now, the funny thing here is that surveys done over the years have discovered that by and large, seniors (and others enrolled in Medicare, like the disabled) are for the most part very happy with the level of care they receive in the program, and the satisfaction level was raised even higher after George Bush and the Republicans expanded benefits by including prescription drug coverage. So why the big fear over universal health coverage now?
Forty years ago, historian Richard Hofstadter wrote a book called â€œThe Paranoid Style in American Politicsâ€ after observing the blacklisting of artists and intellectuals accused of being communist sympathizers during the â€œred scareâ€ of the McCarthy era. Hofstadter identified what he called a peculiarly American pathology-proneness to conspiracy theory (I totally disagree that the â€œpathologyâ€ is purely American; Hitler used conspiracy scare tactics to great effect during his own rise to power).
Hofstadterâ€™s made the observation that a person suffering from economic or status anxiety, particularly one who is among the struggling middle class, was susceptible to what he called the politics of scape-goating. And although he believed it was possible to be seen on the Left, he viewed the paranoid style mostly as a right-wing phenomenon.
Fanning the paranoia flames over universal health coverage during the great universal health care debate of 2009 is none other than former Alaska governor and Republican vice-presidential candidate Sarah Palin, who argued that based on the Democratic bill in the House, the elderly and ailing would be coerced into accepting minimal end-of-life care in order to reduce health care costs.
But there will be no ”death panels” under the legislation being considered. In fact, the provision in the bill would simply allow Medicare to pay doctors for voluntary counseling sessions that address end-of-life issues. The conversations between doctor and patient would include living wills, making a close relative or a trusted friend your health care proxy, learning about hospice as an option for the terminally ill, and information about pain medications for people suffering chronic discomfort. The American Medical Association and the National Hospice and Palliative Care Organization supported the provision.
The strange thing is that Palin herself has actually been a proponent of end-of-life counseling. As Alaska governor, she signed a proclamation making April 16, 2008 â€œHealthcare Decision Dayâ€ with the goal to have health care professionals and others participate in a statewide effort to provide clear and consistent information about advance end-of-life directives.
Even some Republicans have sought to distance themselves from Palin; Sen. Lisa Murkowski of Alaska said that Alaskaâ€™s former governor and other critics were not helping the GOP by tossing out false claims. Portions of the Democratic health care bills ”are bad enough that we don’t need to be making things up,” Murkowski said.
Nevertheless, the growing furor over end-of-life consultations forced the six members of the Senate Finance Committee (three Republicans and three Democrats) working on a bipartisan bill to drop the provisions ”entirely because of the way they could be misinterpreted and implemented incorrectly” said Sen. Chuck Grassley, R-Iowa, one of six, who added there was a difference between a ‘’simple education campaign, as some advocates want,” and paying ”physicians to advise patients about end-of-life care.”
The paranoid Right has gone so far as to criticize the U.K.â€™s National Health Plan (NHP) which has been guaranteeing birth-to-death health care for every British citizen since 1948, ridiculing it as a bureaucratic and â€œOrwellianâ€ system that often denies care to the elderly that Palin herself decried as â€œevilâ€.
The thing is, Palinâ€™s arguments are totally misinformed. First, Obamaâ€™s proposal is not a British-style NHS because there would be no government backed insurer running hospitals, as is still largely the case in the UK.
Second, and even more important, of the 17% of GDP the U.S. spends on healthcare costs (about double the amount spent in the UK), nearly half is already funded by tax dollars through Medicare, Medicaid and the Veterans Health Administration, which does run medical facilities and provides some of the best health care in the US.
Meanwhile, British politicians of both major parties have united in defense of the UKâ€™s healthcare system after it became a byword for the failings of universal, state-funded provision among the US Republican right. Gordon Brown, prime minister, and David Cameron, leader of the Conservative opposition party, last Friday both declared their commitment to the National Health Service.