Can We Talk About Obamacare Now?

Whole Foods' CEO John Mackey really isn't very good with definitions.

It all started a few years back when he attempted to label the Affordable Care Act, 'Obamacare', as socialism, even writing a Wall Street Journal op-ed that fittingly began with a completely incoherent Margaret Thatcher quote on the subject.  Given that Whole Foods - as a 'healthy living' type grocery aimed at more conscious (read: well-off) consumers - tends to attract the same type of people who support Democratic policies, there was noticeable backlash over the issue.  But that didn't seem to bother Mackey all that much, as he again discussed the healthcare bill on a recent NPR program, saying:
"Technically speaking, it's more like fascism. Socialism is where the government owns the means of production. In fascism, the government doesn't own the means of production, but they do control it — and that's what's happening with our health care programs and these reforms."

And, again, it sent many liberals into shock.  Apparently having been convinced that a business which caters to their dietary sensibilities would by default support their political economic views as well, they were amazed to see that its CEO was, like most capitalists, a true believer.

But as clueless as his rambling might seem, he was actually attempting to describe a very real problem with the way Obamacare is set up - mainly, that it further entrenches the health insurance industry into our lives, ensuring they will receive patronage from each and every one of us.  Mackey is probably campaigning against this because of the increased requirements on businesses like his to provide coverage for their workers.  Or maybe it's just because he's a huge fan of free enterprise capitalism, as he mentioned over and over again when trying to backtrack from his use of the word 'fascism'.  After all, he wrote a book on the subject, which - if that previous article is any indication - is certain to be a badly written amalgamation of standard laissez-faire talking points.

Either way, it's clear he's missed the point.  The real reason mandating health insurance for all citizens is troublesome is because health insurance is not healthcare.  Health insurers are the middlemen, and one of the biggest reasons why U.S. expenditure on healthcare is so inefficient compared to the rest of the world.  And rather than being affiliated in any way with collective ownership of the means of production, health insurance (indeed, insurance in general) is just one of the many monsters created by Mackey and his 'free enterprise capitalist' friends.  It can only exist in a privatized atmosphere wherein grotesque characters are allowed to bet on the lives of other people for their own personal gain.

This, incidentally, is the same atmosphere that created Obamacare.  The fascism corporatism inherent in the bill - what Mackey claims to be upset about - is actually of his own creation.  It's thanks entirely to American faith in privatization and market solutions that we can't have the real solution to this problem: universal healthcare.  The health insurance industry, through its accumulation of wealth and power, has become almost as unassailable as Wall Street.  They (literally) wrote Obamacare; that's how much sway they have in Washington.  But even if they didn't have the lobbying power to make things go their way, that den of corporate shrills we call Congress would still argue the industry was simply too large to kill off.  They'd tell us that the economy would suffer too much, or that it isn't how we do things in America, or offer some other short-sighted cop out of an excuse.

The result is that we can't just have healthcare.  We have to have health insurance first.

Those who can accept that, and still have the patience to push for some semblance of universal health coverage, want to at least have a public option, which would make sure the government has its own insurance agency that can serve (at the very least) as a fallback to those who are shut out of private insurance.  But, once again, capitalist interests won't have any of it.  The government can't be allowed to compete with private industry, they say.  That would be wholly un-American, they say.

So we're stuck with a privatized healthcare system which:

Firstly, is both inefficient and unequal.  From the New York Times a couple weeks ago:
By many objective measures, the mostly private American system delivers worse value for money than every other in the developed world. We spend nearly 18 percent of the nation’s economic output on health care and still manage to leave tens of millions of Americans without adequate access to care.
Britain gets universal coverage for 10 percent of gross domestic product. Germany and France for 12 percent. What’s more, our free market for health services produces no better health than the public health care systems in other advanced nations. On some measuresinfant mortality, for instance — it does much worse.

Secondly, creates grotesque incentives that call into question what should be an unquestionably positive sector of society.  No one should ever have to even think twice about whether or not the doctors treating them consider their livelihood to be paramount to self-interest.  We shouldn't see publications running articles that claim "things your doctor / the medical profession / the pharmaceutical industry doesn't want you to know".  No company should have a greater incentive to create a pill which eases your symptoms than it does to create one which cures them completely.

Medicine should not be an ambiguous display, it should be a science - different solutions for each person, yes, but only because we are all different, not because we can't trust those who offer us care.  The privatization of medicine has only helped foment the all-too-American atmosphere of distrust, creating scenarios wherein people who otherwise have options still feel the need to turn to pseudoscience to cure their ails.

And for the record, should we really have those in the medical profession who, worried that their income would decrease if Obama were elected, put up signs stating that those who voted for him would not be welcome to their services?

Thirdly, plays to the fallacy of choice.  Having the 'luxury' of making a decision is not a plus by default, and is only preferable when we have enough information to reasonably believe we are making the right choice.  Putting aside the obvious fact that all free market choices could actually be worse than a single public alternative, there is just no way that with all of the various factors coming into play in any given health plan, and all of the options available for each, you can possibly come to an enlightened decision.  If you personally have the option to decide between different types of coverage, you've seen this in action.

The privatized Medicare drug plans are a prime example, with each of the dozens of plans offering different stipulations and fees, which all change depending on where you live, and what combination of drugs you take.  The complexity can be overwhelming, and the end result is that you're more likely to give up than you are to be able to pick the best plan.

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And so, in the end, nearly early every failure of the American healthcare system will remain unchallenged.  The rich will still receive far better coverage than the majority of people, and things will go on much how they have in the past.

Maybe this is too pessimistic, though.  There's no doubt Obamacare will benefit many out there (including myself) who have difficulty accessing any form of healthcare at all, or are up to their neck in medical debt.  Shitty health coverage is better than none, right?  Maybe, maybe not.

I just find it hard to accept half-assed reform that so often ends up being one step forward, two steps back.  It's exactly this type of offering which placates desire for the revolutionary changes we should be demanding, channeling all of our energy into working within a corrupt, overbearing, and inhumane system.  Welcoming inadequate legislation with open arms signals the death knell of passionate activism, and the rise of a defeatist attitude which begins arguing from a position that concedes nearly everything it once sought to gain.  Movements become measured, lethargic, full of people grateful for any crumbs left over that happen to come their way.

Americans may want to believe that the political system is a healthy bit of push and shove from left to right, an ideological battle that usually ends up leaving us somewhere around the middle, but true reform does not come from the charades partisans play out in governmental bodies.  The real battle is fought between the interests of the weak and the interests of the powerful.  And the powerful - politicians included - only throw the rest of us a bone when they feel threatened enough to do so.  Every last scrap of progressive reform must be torn from their bloodied hands.  This is how it has always been: from slavery, to labor laws, to universal suffrage, to civil rights (of which every one was fought against by the monied interests); and that is how it will be up until the day we finally achieve equality.

So, we can take Obamacare for what it is, but we shouldn't be happy about it.  We can't let it silence our voice, temper our desire for real change.  Privatization of social goods and services is not just unhelpful, it is a crime against humanity, and it's time - in an era of great abundance for some, and great need for others - that we demand more than the usual airy concessions.


Ironically, John Mackey's use of 'fascism' conjures up an interesting definition of the term:  capitalists' last line of defense against the rising threat of revolutionary socialism.

Applying this definition to Obamacare paints quite the picture.  Is this the last-ditch effort of the health insurance industry to preserve its place, knowing that healthcare reform would eventually come, and that progressives would be after their heads?

Despite uproar over the idea of calling Obama fascist, in many ways he fits the given description.  Due to the fact he's a Democratic politician, and thereby gains benefit of party loyalty, he's been able to defend capital's interests far better than any Republican ever could.  During his presidency, Congress has been even quieter on issues of inequality than usual.  Even with the Occupy movement in full swing, most politicians offered nothing but silence or hollow words.

Obama also has cemented Bush-era crackdowns on civil liberties into bipartisan law, and extended the war on terror in scope, using nationalist fervor in pursuit of an expansionist foreign policy.  He charges whistleblowers with aiding the enemy simply for disclosing abuses of power and war crimes (both of which go unpunished at the same time).  He masquerades as a populist, while actually protecting the interests of the high and mighty.  All he's really missing is the macho, authoritarian rhetoric.

You wonder how many people would be calling him a fascist if he were to implement the same policies speaking in Dick Cheney's voice.

Just some food for thought.

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