The mainstream media is not an evil, liberal-to-radical
behemoth by any means. It is, however, often a willing, and sometimes
self-deluded, ally and shill for the interests of the well-to-do in society, as
well as for many questionable government policies. The latter is particularly
important in the drumbeat buildups to wars, and is recently apparent in the
coverage of Venezuela in journals such as the NY Times. The US government is making the case not only that
Venezuelan president Nicholas Maduro is illegitimate because it has decided his
election was “unfair” and “tainted”, as well as an evil and violent dictator, but
that it will recognize unelected self-declared Juan Guaido as president. The Times has gone so far as to publish a self-congratulatory
op-ed by Guaido, and it news coverage is typified by ‘Venezuelans
Opposed to Maduro Pour Into Streets for Day of Protests’ and a Sunday Review piece by a Guaido
supporter called ‘Venezuela’s
Very Normal Revolution’.
I do not doubt that
thousands marched against Maduro or that millions oppose him (or probably that
millions support him). I certainly am not saying Maduro and his government is
good, or that there is not justifiable opposition to his violent repression of
opponents. I am not saying that revolutions are bad. I am saying that this one
is funded and supported by the US government not because Maduro is bad -- the
US has supported and continues to support dozens of brutal dictators around the
world. It is because he is not our
dictator, not one who supports US policy, and this is critical because
Venezuela is the country with the largest oil reserves in the world. As for the
NY Times -- as with most leftist
governments, the support for the one in Venezuela comes more from the poorest
people, while those with access to the NY
Times are among the most privileged.
And this is the connection to domestic health policy, and in particular coverage
of the Democratic candidates for president’s positions on Medicare for All. The
NY Times (and all mainstream media)
is of course owned by the very wealthy, and as individuals they see the world
as members of the class of which they are part. But, possibly more important,
the editors and reporters are middle and often upper-middle class, and they see
the world from this perspective, from that of their families, and friends, and
neighbors who are – amazingly – also privileged! The people who have access to
these editors and reporters are very skewed away
from the most needy, or indeed most people (who are not the same as most people
in an upper middle class suburb).
In specific, we get essentially uncritical
coverage of the statements of billionaires like Michael Bloomberg and Howard
Schultz that “Medicare for All” is unaffordable, despite the clear fact that it
is the current system that is unaffordable, and that a universal health system
is going to cost less. One key part of this lower cost is the elimination of
private health insurance companies’ profit, and their incentive to increase it
by decreasing the availability of care. Yet the
Times article covering Elizabeth Warren’s
increasing iffiness on the issue contains phrases like ‘would people lose
the choices offered by private insurance?’ That is, your ability to choose (maybe, depending upon what their employer offers) which overpriced-to-unaffordable
policy, offered by which rapacious, obscenely-profit-making insurance company, to
cover you so that, even after paying the premiums and co-pays and deductibles, you
find out that, whoops, it doesn’t really cover what you thought it would or
should, and you’re out of luck, and either have to pay out even more money you cannot
afford or go without the health care you need. Wasn’t that what the insurance
you bought supposed to get you?
Nope, not necessarily, and often not at all. The first goal of private
insurance companies is to make a profit. That profit has to be maintained and
expanded. The two major ways of doing so are 1) by raising the prices people (and
their employers, if they are lucky enough to have employers who pay offer
health insurance) pay, in premiums, deductibles, and co-pays, and 2) by denying
coverage for care, or paying less for it, which often results in providers not,
well, providing it to you. The insurers hire “pharmacy benefit managers” to get
them the ‘best’ prices on drugs, often requiring your doctor to keep writing a
different brand-name drug-of-the-month (again, see Danielle Ofri, “The
Insulin Wars”), with the cost to you always going up.
What would Medicare for All offer? Or, more explicitly, Improved and
Expanded Medicare for All, as in the House Bill that was H676 and will get a
new number this year? First, everyone would be in the same program. No more
shopping around for the least bad deal among the universe of bad insurance.
Everyone would get the same benefits. The benefits would include all medically
necessary health care: inpatient, outpatient, nursing home, home care, drugs,
mental health, dental, eye care. Even hearing aids. Nothing excluded, except
perhaps truly cosmetic surgery. Providers could not refuse to accept this
insurance because they would have no business. Oh, maybe some doctors and
hospitals could make a living caring for Howard Schultz and Michael Bloomberg
and Saudi sheikhs who pay in cash, but there aren't very many of them, and so even the supplemental insurance we now
buy would be unnecessary. There would be, you see, no deductibles or co-pays.
Everything would be 100% covered. It sounds good. It would be good.
And it is not unaffordable. Currently, the government funds over half of
health care (Medicare, Medicaid, government employees and retirees at all
levels, military), and it is about 60% if you also count the revenue lost
because employer contributions to health care premiums (unlike salary) are
tax-deductible. The majority of the sickest and most needy (elderly, blind, and
disabled) are already in Medicare. Most vulnerable children are in Medicaid or
S-CHIP. To make up the additional cost, employers and individuals would
continue to pay, but in taxes rather than premiums, co-pays, and deductibles,
and for most (maybe not for Schultz and Bloomberg!) it would cost them a lot
less. Most estimates of the excess costs in the US health care non-system are
in the 30-35% range, for profits and administrative costs in the private sector
(Medicare’s are in the 1-3% range). Administrative costs include insurance
companies hiring armies of workers to deny claims, while providers have other
armies to fight them, and demand more. This is money spent for no health
benefit for the population, but it would be a mistake to minimize the extent to
which those – insurers and providers and drug and device manufacturers – who are
pocketing it would go to keep it coming.
Thus the role of the mainstream media, and the mainstream Democrats – to appeal
to the needs (not desires, real needs!) of most of the people for health care
and at the same time not threaten the wealthy and profitable sectors that can
fund campaigns for or against them. Thus the concerns of “don’t people want to
have their private insurance?” and even more ludicrous their choice of insurance company (“I’ve always
been an Aetna man! So what if it costs a little more and I get just as little?
I’m worth it!”). Thus the nonsensical pieces on how much a single payer
Medicare for All program will cost, which ignore the cost of our current
arrangement. And, somehow, manage to not address the fact that this current
arrangement leaves concern for people’s health to last, and so doesn’t deliver it.
I understand that people are worried about change. But the cost, in
dollars and health, of the current system has moved the majority of the
population to want something different, something that meets their needs and
costs less. It is available, if we seek
to do it, if we can resist the pressures from the industries and billionaires
who profit from the current way of doing things.
When we read about the need to overthrow foreign dictators, or hang on to
private insurance companies, we always must remember to ask: cui bono?
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