August 22, 2000
by Townsend Walker, Sr.
Some ten or fifteen years ago, when serving as President of the Alabama Health and Action League, I had the pleasure of helping bring to Huntsville, Alabama, Professor Theodore Marmor to speak on the need to reform the U.S. health care system. At the time he was still at the University of Chicago -- a distinguished authority on the political aspects of health care and highly regarded nationally by others in the field. A few years later he would recommend to the President of the United States and his wife a single-payer system of health care similar to Canada’s. Mrs. Clinton’s famous, ill-considered and dismissive reply was, "Tell me something interesting" or words to that effect.
Marmor is now Professor of Public Policy and Management at Yale University, and in the upper echelons of those learned people who will understand, and perhaps wince as they do, why I trace the cause of the disastrous health care situation to liars, deceivers, and an ignorant and timid citizenry. With a little imagination by the reader, an article co-authored by Professor Marmor for the July-August issue of The Washington Monthly demonstrates my point. Following are selected excerpts that need to be seared into the thought processes of all working-class Americans (italic emphases have been added):
"Last winter’s flu epidemic overwhelmed emergency rooms across North America. It was an ugly situation and the American press dutifully reported the winding lines...But their reporting of the situation in Canada and the situation in the United States was dramatically different.
"The three major reports on Canada by The Washington Post, The New York Times, and ABC News, used the overcrowding problem as evidence that Canada’s universal health insurance program was critically flawed. The problems of Canadian emergency rooms, in short, indicted Canada’s medicare. The two major reports on the problem in the United States, by USA Today and Time magazine, did not, however, turn overcrowding in American ERs into an indictment of America’s non-universal health insurance system.
"This contrast in press coverage cannot be attributed to obviously better conditions in American emergency rooms. Emergency rooms in both the U.S. and Canada have come under increasing stress over the last decade...and the data we do have suggest conditions are as bad, if not worse, in the U.S. What the disparity does reflect is a tendency among American reporters to state or imply that Canada’s increasingly intense debate about its universal health insurance program is evidence that its program is in ‘crisis’ and that universal, government-financed health insurance programs are bound to fail...
"These three reports weren’t the first time that American reporters gave slanted the coverage of Canadian health care system. In fact, American media coverage of Canada has suffered from two defects for a long time: it is infrequent, and it is often biased. These two problems also, of course, overlap since infrequent coverage is frequently ill-informed.
"Foreign experience thoughtfully portrayed would help Americans participate intelligently in the great debate about how to reform our medical care arrangements that still leave over 44 million Americans uninsured. Readers would turn to such stories for the same reason they buy Consumer Reports: to read about cars, prescription drugs, and other complex consumer items.
"Why don’t our journalists practice such careful reporting more consistently? What explains their penchant for using a single story to suggest system-wide problems without providing comprehensive supporting evidence? Part of the answer is that they are generalists, not specialists in Canadian (or international) medical care. And there’s a well-documented tendency for journalists to look for one hot scandal and then expand it into what they think is a universal point...The problem is compounded because the American media are not terribly interested in foreign experience with public policy, and when they turn to such a subject, it is often because American actors are using such experience to praise or blame some domestic U.S. initiative, program, or point of view. Domestic interest groups provide the spur to such stories, and the richest of such groups overwhelmingly want to attack the Canadian model...Precisely because Canada has achieved comparatively good value...through a government program, it represents an ideological threat to a number of interest groups in the U.S.
"That’s too bad. There is a real health-care crisis in this country and if America is going to solve it, citizens must understand the differences between democratically controlled and corporate-controlled health-care systems. And if Americans are to understand those differences, reporters must consistently report the whole truth -- not little truths, semi-truths, and falsehoods...If they did that, the average American would finally be able to understand what we really can learn from Canada."
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Many of us are altogether too familiar with the horror stories about the British universal health care system that are paraded perennially across the pages of American periodicals. By now most of us should know the motivation behind the propaganda -- to protect those who use health care as a cash cow: the insurance, hospital and pharmaceutical industries, for example. Unfortunately, the horror stories, however transparently false or exaggerated, still function effectively enough to keep in office Congressmen and Presidents who bask in the health-care industry largess.
I therefore found of interest a three-page article in England’s venerable Manchester Guardian Weekly (June 29-July 5) on "International Health: You can’t afford to leave home without it." It seems that the editors of the Guardian were fearful that citizens of Britain, having become accustomed to health care as a right at home, were unprepared to deal with a system such as they might encounter in the U.S. or elsewhere. "Expatriates living in the U.S., in particular, will need health insurance that provides a very high level of cover, because U.S. healthcare is often extremely expensive."
You may find the introductory paragraphs of the article edifying, especially since they are written from the point of view of an informed English citizen. (Note the up-front acknowledgment of the imperfections of the system they love!)
"Long waiting lists, bed shortages and dilapidated hospital buildings are just a few of the litany of complaints about Britain’s National Health Service. Anyone who has even a passing acquaintance with the British media will be familiar with the horror stories that have savaged the reputation of the country’s healthcare system.
"Nevertheless outside of the U.K. the NHS is unrivaled in terms of the care it offers. No other country -- developed or developing -- has a system that delivers free care whenever you need it so simply. The NHS may be creaking but if you have an accident or fall ill, well-trained doctors and nurses offer high-quality treatment. And they won’t give you a bill once you’re back on your feet."
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Maybe you noticed this item from the Associated Press: "The U.S. spends more per person on health care than any other country, yet in overall quality its care ranks 37th in the world, says a World Health Organization analysis." The study concluded that France and Italy ranked #1 and #2, respectively. United Kingdom is ranked 18th and Canada 30th. Enough said, even allowing for error.
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The July issue of Labor Notes carries one of the most refreshing and encouraging notes we’ve seen in ages. It justifies our thinking that within the American labor movement there are still courageous men and women, perhaps on the order of a Eugene Victor Debs, determined to resist a failed political wisdom and strike out in new directions, with a new vision and a new voice. Such a person, it seems, is Dan McCarthy, President of the United Auto Workers Local 417, and a member of the Labor Party’s Detroit Chapter. Following are excerpts from his article "Why I’m Voting for Nader":
"I would like to be able to vote for candidates who have organized labor’s endorsement. I really would. But that would mean supporting Al Gore for President in this fall’s election. That I will not do. No, this year I’m counting on finding Ralph Nader’s name on the ballot...Only Nader is pushing for the kind of reform that could change things where we need it most: in our workplaces. Labor law reform emerges in the Nader campaign in the context of an overall program that is compelling to all the jaded, the disenfranchised, the angry, the disaffected (let’s see, that’s about all of us now, isn’t it?) for its underlying analysis. To wit, ‘The unconstrained behavior of big business is subordinating our democracy.’
"Can I see the hands of all of you who were hoping Gore would say that first?...[Nader continues:’ ‘Today we face grave and growing societal problems in health care, education, labor, energy, and the environment. These are problems for which active citizens have solutions, yet their voices are not carrying across the democracy gap. We have generated a tremendous capital of ideas, information, and solutions to the point of surplus, while our government has been drawn away from us by a corporate government. Our political leadership has been highjacked.’
"You will hear that we might ‘spoil’ the chances of Democrats this fall. Wait a minute! There’s a reason they both support the tight-money, low-wage program of ...Alan Greenspan. There’s a reason we work longer hours but for less pay than in 1979...Am I throwing my vote away? No, I did that in 1992 when I voted for Bill Clinton. I savor the chance to vote, instead, for a man who chooses to quote Supreme Court Justice Louis Brandeis: "We can have a democratic society or we can have great concentrated wealth in the hands of a few. We cannot have both.’"
All this -- and more -- from a worker now a member of a newly formed Labor Party whose number one priority is a universal health care system that makes the very idea of "health insurance" obsolete.
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Townsend Walker, Sr. of Huntsville, Alabama has been active for universal health care since his retirement some twenty years ago, and now edits New Voices/New Vision on that connection. Send correspondence to 7608 Saxon Drive SW, Huntsville, AL 35802; email: NVNV1@aol.com.