The issue dominating American politics today is not West Bank settlements, but Obama's proposal for a major reform of the health-care system.
By PINCHAS LANDAUhealth care obama plan 248.88 ap(photo credit: AP)
Although you might not believe it from reading the Israeli and American-Jewish press, the issue dominating American politics today is not how many caravans Israeli settlers can shunt around West Bank hilltops. Rather it is President Barack Obama's proposal for a major reform of the health-care system.
The issue is immensely important - after all, if this isn't a matter of life and death for the average citizen, then what is? - and incredibly complex. However, the debate surrounding it is proving to be a very sad and telling reflection on American society, politics and media.
Most of the arguments put forward, by people on both sides, are simplistic or dogmatic. But to most non-Americans, the arguments and claims of the opponents of the reform are almost incomprehensible. They reflect a massive gulf between the way the American political and social Right views the issue of public health and the way the rest of the developed world views it.
Probably the most fascinating aspect of how the debate is playing out in the public arena, is the way in which intelligent Americans, obliged to come to grips with the basic facts about their county's health system, gradually have their eyes opened to its huge flaws and are reluctantly forced to stop mouthing the mantra that "the US has the best health-care system in the world."
What are these basic facts? First, at the macro level, it is clear that the US spends nearly double the share of its GDP on health-care than do other large developed countries (UK, France, Germany, Canada, Japan, etc.). Yet its "critical data," especially life-expectancy rates, are among the lowest of the developed countries. As you drill down into the data, you get to understand why this is so and discover more amazing facts.
A huge proportion of the population - at least 25 percent to 30% - has no health-care insurance. That's also pretty macro, but try this: An estimated 20,000 people die every year because they have no medical services accessible to them. These facts are the flip side of the claim that the US has the best health-care in the world. Both are true. For those who can afford the best, it is more readily available than anywhere else; but for those who can't afford anything, there is nothing.
The truly incredible thing, though, is how many people who consider themselves intelligent, empathetic and moral, find nothing wrong with this situation. The world's richest country, in terms of total resources, wastes mind-boggling quantities of money on frivolous procedures and on dealing expensively with medical problems that could and should have been addressed far more cheaply by preventive measures, such as the treatment of diabetes in the hordes of obese Americans.
Yet the idea that the government has a basic obligation to use the national wealth to provide basic medical services to the poor and needy is regarded as anathema. Indeed, many otherwise rational people become apoplectic over the very concept of government involvement in the provision of medical services and start screaming about "socialized medicine."
Whether such people actually believe that America of 2009 has no truck with "socialized medicine" or other "socialized" services is not clear - to me, at least. Granted, some right-wing extremists want to abolish Medicare and Medicaid entirely, and there are those (on the extreme Left) who claim that former president George W. Bush shared this dream. But it's hard to believe that all those who oppose the current proposals on the specious grounds of "socialized medicine" are in this camp. On the other hand, what are they thinking? Indeed, are they thinking? Or do they become totally irrational on this topic?
In a way, it's a throwback to the McCarthyite 1950s and even to the "Red scares" of the 1920s. But the old slogan "Better dead than red" was supposed to be a political war cry, to do with liberty and so forth. In its current incarnation, it would seem to mean: "Better that they (the poor, elderly, etc.) die, than that we use part of our massive wealth to provide them with health services commensurate with our country's capabilities."
The tragedy is that the entire effort may prove to be in vain. It looks increasingly as though Obama's proposal will not be adopted, or, if it is, it will be massively "doctored" along the way. But that's not the main point. It may well be that the goal of universal health-care is now unreachable in the US, at least for the next generation. Not - or not merely - because of political intransigence, but because the resources needed for it are no longer available.
Had the Clinton proposal, or something like it, been passed 15 years ago, the country would have better health, now and in the future. Instead, it has "underwater" home owners and bust banks. It's gone red right enough: red ink.
landaup@netvision.net.il
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