(Photo, 17 year-old Nataline Sarkisyan, who died due to the denial of treatment by her insurance company, CIGNA.)
The Case for Socialized Medicine in the United States,
and the Struggle to Achieve It
By Steven Argue
As someone without healthcare, I support the idea of socialized medicine for the United States. Socialized medicine will bring healthcare to everyone. Besides legitimate self-interest, my personal position comes from being an advocate for social justice with a vision of an egalitarian society. As such, I not only see universal access to healthcare as a basic human right, I also see that socialized healthcare will mitigate some of the racial and class inequalities in our society. In addition, socialized medicine is cheaper than the costs of current system of for-profit capitalist healthcare. It also looses the profit motive of insurance companies to deny needed procedures. From this knowledge, and these personal convictions, I am strongly in favor of socialized healthcare in the United States like that established in Europe as well as established in Cuba with the 1959 revolution. Short of a fully socialized healthcare system I see that the single payer system (i.e. socialized health insurance run by the government), like in Canada, would be a significant step forward for the United States.
In the United States there’s a lot of confusion on terminology. With a system of socialized medicine hospitals are directly owned by the government and doctors are government employees. It’s a universal system where everyone is covered and all health care is paid for by the government. Under a single payer health care plan, health care is universal and paid for by the government, but it is a system still largely based on private hospitals and private physicians.
Two main arguments are encountered when discussing socialized medicine. One argument is that it will cost too much. The second argument is that socialized medicine doesn’t work to provide adequate healthcare. Neither argument stands up to scrutiny.
Socialized medicine and single payer medicine actually cost less than the United State’s current for profit capitalist health care system. Both statistics and common sense back this up.
According to statistics from 2003, the United States spends $5,711 per capita per year for health care while Canada spends about half of that, $2,998 per capita per year (Kaiser Family Foundation, 2007). In fact, the costs per capita are much cheaper in every other developed country with some form of socialized healthcare. In other examples Sweden spends $2,745, Germany $2,983, and the United Kingdom $2,317 (Kaiser Family Foundation, 2007). In addition, Cuba, with their well known socialized healthcare system, spent only $251 per capita on healthcare in 2006 (United Nations World Health Organization, 2006).
The reason socialized insurance is much cheaper and more efficient than private health insurance is because single payer eliminates the health insurance racket with all of its waste in capitalist profits, paperwork, and overpaid CEOs. In addition, such insurance practices as routinely denying needed medical procedures to keep profits up are eliminated, thus reducing capitalism as being the cause of death.
Socialized healthcare does work. It is working very well in Cuba. Cuban life expectancy in 2006 was 77.6 years, while the life expectancy of the United States for that same year was slightly less, 77.5 years (United Nations Development Program, 2006). It is interesting that poor Cuba with a history of poverty before their 1959 socialist revolution, and a devastating U.S. imposed economic blockade since, is able to provide good healthcare for everyone through socialized medicine. Cuba, unlike the United States, does not let people die in the emergency rooms without treatment, turn sick people away from receiving healthcare because they lack insurance, or allow insurance companies to decide, based on profit motive, whether the insured actually receive the care they paid for and need. The Cubans have done this by taking the profit out of illness and injury and providing healthcare as a basic human right.
Canada, like Cuba, has a higher life expectancy than the United States. In 2004 the life expectancy of Canada hit 80.2 years (Statistics Canada, 2004). With Canada’s socialized health insurance system, like Cuba’s socialized medical system, every single person is covered. In the United States 45.8 million Americans do not have health insurance (U.S. Department of Health and human Services, 2005).
On another key indicator of health, infant mortality, the United States is also nearly the worst in the developed world, only worse than the recently turned capitalist country of Latvia (Green, 2006). The infant mortality rate in the United States in 2002 was 7.0 deaths before the age of one per every 1,000 live births (Center for Disease Control, 2005). In comparison, other advanced countries with forms of socialized medicine and socialized health insurance have lower infant mortality. This includes rates per thousand births in Japan of 3.2, Germany with 4.4, Italy with 4.5, France with 4.6, and the United Kingdom with 5.6 (Treasury Board of Canada, 2003).
Cuba, with their system of socialized medicine has an infant mortality rate of 6.2 per thousand live births, a rate much lower the United States rate of 7.0 per every thousand live births (BBC News, 2002). This is also lower than every other Latin American country (BBC News, 2002).
The only other country in the Americas with an infant mortality lower than Cuba is Canada with their system of socialized health insurance. The Canadian infant mortality rate in the year 2000 was 5.3 (Treasury Board of Canada, 2003).
In addition, a United Nations report on the status of Native Americans in Canada has credited Canada’s relatively recently established socialized health insurance system with drastically reducing an extremely high infant mortality among Native Americans (United Nations, 1993). In 1979, that death rate for Canadian Native Americans was 27.6 per thousand live births, but by 1999 it had dropped to 8.0 deaths per thousand live births (Treasury Board of Canada, 2003). These improvements coincide with Canada’s passage of the Canada Health Act in 1984 that brought their socialized insurance system to the entire country at that time (Health Canada, 2002).
For Blacks in the United States between 1995 and 2002, the infant mortality rate was 13.9, more than double the rate of 5.9 for whites in the same time period (Center for Disease Control, 2005). Canadian statistics are a strong indication that a socialized insurance system in the United States could both decrease the infant mortality rate of the general population and dramatically decrease the infant mortality of oppressed and impoverished minorities such as Blacks, as it did for Canadian Native Americans.
The statistics show that socialized medicine is cheaper, saves lives, and helps alleviate class and racial inequalities in healthcare.
Behind the statistics of a shorter life expectancy in the United States are horrific human tragedies. One example is the death of 17-year-old Nataline Sarkisyan in December 2007. California Nurses Association/NNOC statement about her death due to care denied by her insurance provider, CIGNA:
“The California Nurses Association/National Nurses Organizing Committee today blasted insurance giant CIGNA for failing to approve a liver transplant one week earlier for 17-year-old Nataline Sarkisyan, who tragically died last night just hours after CIGNA relented and agreed to the procedure following a massive national outcry.
“On Dec. 11, four leading physicians, including the surgical director of the Pediatric Liver Transplant Program at UCLA, wrote to CIGNA urging the company to reverse its denial. The physicians said that Nataline ‘currently meets criteria to be listed as Status 1A’ for a transplant. They also challenged CIGNA’s denial which the company said occurred because their benefit plan “does not cover experimental, investigational and unproven services,” to which the doctors replied, ‘Nataline’s case is in fact none of the above.’
“’So what happened between December 11, when CIGNA denied the transplant, and December 20 when they approved? A huge outpouring of protest and CIGNA’s public humiliation. Why didn’t they just listen to the medical professionals at the bedside in the first place?’ asked Geri Jenkins, RN, a member of the CNA/NNOC Council of Presidents who works in a transplant unit at the University of California San Diego Medical Center.
"On Thursday, CIGNA was bombarded with phone calls to its offices across the country while a rally sponsored by CNA/NNOC, with the substantial help of the local Armenian community, drew 150 people to the Glendale offices of CIGNA – all of which produced the turnaround by CIGNA to finally reverse its prior denial of care."
“CNA/NNOC Executive Director Rose Ann DeMoro called the final outcome ‘a horrific tragedy that demonstrates what is so fundamentally wrong with our health care system today. Insurance companies have a stranglehold on our health. Their first priority is to make profits for their shareholders – and the way they do that is by denying care.’
"’It is simply not possible to organize major protests every time a multi-billion corporation like CIGNA denies care that has been recommended by a physician," DeMoro said. “Having insurance is not the same as receiving needed care. We need a fundamental change in our healthcare system that takes control away from the insurance giants and places it where it belongs – in the hands of the medical professionals, the patients, and their families.’"
Prospects for Socialized and Single Payer Medicine
Presidential candidate Hillary Clinton has declared, "It's time to provide quality affordable health care for every American, and I intend to be the president who accomplishes that goal finally for our country" (CNN.com). This is the same promise that Bill Clinton made when he ran for office in 1992.
After being elected, in Bill Clinton’s first State of the Union address, he said, “And on any given day, over 37 million Americans -- most of them working people and their little children -- have no health insurance at all.” Yet, despite Bill Clinton’s campaign promise of universal health care, his defeated proposal to congress would not have provided health care to every American, nor did it address the other fundamental problems of private health insurance. After his health care proposal was defeated, Clinton dropped the issue. In fact, the Bill Clinton administration was opposed to a bill for single payer health care introduced by Wellstone, Conyers, and Mcdermott that actually would have provided universal health care. By the time Bill Clinton left office, an additional three million more Americans were uninsured.
Today Republican candidate Mitt Romney has declared of Hillary Clinton’s promised health care plan, “It’s a European-style socialized medicine plan, that’s where it leads–and that’s the wrong direction for America” (Shulte).
Yet, unfortunately, Clinton’s plan has nothing in common with socialized medicine, neither of the European variety, nor the Canadian single payer. Her plan is to keep the broken and expensive capitalist system of health care, a system that keeps the insurance industry in charge of life and death questions of whether or not we receive health care when we need it.
In addition, the Clinton plan would make the purchase of health insurance by America’s uninsured mandatory for those who do not get insurance from their employer and who do not qualify for government assistance. Yet, the problem for America’s nearly 50 million uninsured is not that we don’t want to have insurance, the problem is that we can’t afford it. Clinton’s plan of making us criminals for not purchasing health insurance will not resolve this fundamental problem.
By making the purchase of health insurance mandatory Clinton makes the false claim that hers is a plan for universal health insurance as compared to the plan of Obama. Neither would provide universal health care. John Edwards has taken the absurdity of forced insurance purchases one step further, detailing a plan that would include the necessity of showing proof of health insurance at the time of paying taxes, with penalties for those who do not provide that proof.
In a similar fashion as Mitt Romney, Republican contender Rudolph Giuliani has extended false accusations of socialized medicine to other Democratic hopefuls stating, “Whether it’s HillaryCare or ObamaCare or EdwardsCare, the idea that it’s not socialized medicine is a trick. It’s a massive growth of government control of medicine” (Rovner).
The truth, however, is that the only presidential candidates of the Democrat and Republican Party that are for single payer health care are Democrats Dennis Kucinich and Mike Gravel, and none are for full socialized medicine. The other major candidates, who oppose single payer, enjoy massive contributions from the insurance and pharmaceutical industries.
In addition to being excluded from money, the Kucinich and Gravel campaigns have also been excluded from debates. Most recently, for the 2008 election, CNN and the Des Moines Register made the decision to exclude both Dennis Kucinich and Mike Gravel from a key debate in Iowa. Yet Biden and Dodd, who are behind Kucinich in the national polls, but who reject single payer health care, were allowed into the debate. This kind of undemocratic shenanigan is to be expected of CNN, a corporate media source that was forced to publicly apologize for a number of lies they told about Michael Moore’s pro-socialized medicine film “Sicko”.
While Kucinich has alienated the corporate power structure with his stand for single payer health care, he has also alienated much of his natural base by voting for Bush’s “War on Terror”, voting for the U.S. travel ban against Cuba, and by voting against Mumia Abu-Jamal.
In 2001 Kucinich voted in favor of the US travel ban against Cuba. The travel ban does not allow U.S. citizens to spend any money in Cuba, basically making travel to Cuba illegal. It is under the travel ban that Michael Moore has been harassed by the U.S. government for bringing sick 9/11 rescue workers, who were unable to receive medical treatment in the United States, for medical treatment in Cuba. The United States has had hostile relations with Cuba ever since the 1959 Cuban revolution overthrew the U.S. backed Batista dictatorship, nationalized the United Fruit Company owned by the Rockefeller family, ended Jim Crow style racist segregation, and began providing free socialized health care and education.
In contrast to Kucinich’s support for U.S. measures against Cuba, Mumia Abu-Jamal recognizes the gains Cuba has made in areas such as health care. Of the U.S. and Cuban health care systems, Mumia Abu-Jamal stated May 2nd, 2003:
“What about the human right to health care? In the US, you can obtain excellent health care if you can afford it. Cuba, meanwhile, boasts the largest number of doctors per capita on earth. They provide medical care to people all around the world. Indeed, there are more Cuban doctors working in other countries than the UN’s World Heath Organization. Millions of men, women and children in this country have no medical insurance and no real prospect for decent medical care.” (Abu-Jamal 5/2/03)
Mumia Abu-Jamal is a political prisoner in the United States whose trial, according to Amnesty International, was not fair and “did not comply with international justice standards” (Amnesty International). Yet, in 2006 Kucinich voted to condemn the French City of St. Denis for naming a street after Mumia. The resolution boldly proclaimed Mumia’s guilt, despite international recognition of the injustice dished out to Mumia, and despite the fact that the courts are still reviewing the case. Despite the injustice represented by this resolution and despite 31 members of Congress voting against it, Kucinich voted for it.
Showing a similar lack of support for the needs of the people, Kucinich voted for Bush’s so-called “War on Terror”. This was a vote that effectively gave Bush the power to invade any country at any time. That vote could have been used for anything, and was used by Bush to invade Afghanistan. Likewise, despite pretending to be a peace candidate, Kucinich’s calls for a strong and efficient military do not address the fact that the United States is the most aggressive and dangerous nation in the world.
The tremendous lack of judgment on these three votes alone, along with Kucinich’s promotion of the pro-war, anti-single payer health care, and corporate controlled Democrat Party, have alienated the left from Kucinich’s campaign.
Presidential candidate Mike Gravel doesn’t have a recent voting record, but was actively opposed to the Vietnam War in Congress, voting to cut off funding for the war, and helping to release the Pentagon Papers that exposed many wrong doings by the U.S. government in Vietnam. On the issue of health care, Gravel states on his website that he proposes “a universal healthcare system that provides equal medical services to all citizens, paid for by a retail sales tax (a portion of the Progressive Fair tax)” (Gravel website). Yet, sales taxes are not fair taxes. They are regressive taxes that charge the poor a much higher percentage of their income than they charge the rich. While it is true that the rich are not paying their fair share under the current tax system, Gravel’s proposal is even worse.
Sadly for those who think solutions could come from the Democrat Party, Kucinich and Gravel are the best the Democrat Party could produce.
While the mainstream of the American political establishment rejects any form of socialized medicine, all political parties to the left of the Democrats and Republicans support some form of socialized medicine. This is true from the Green Party and Reconstruction Party to the various socialist parties who run candidates, including the Peace and Freedom Party, Socialist Action, Socialist Party, Workers World Party, Party for Socialism and Liberation, Freedom Socialist Party, Socialist Workers Party, and Socialist Equality Party.
Breaking from the pro-war anti-health care Democrat Party is former Georgia Democratic Congressperson Cynthia McKinney. In a video news release declaring her candidacy for president she says, “The Democrat is no different from their Republican counterparts, eat out of the hands of corrupt lobbyists and feed at the same corporate tough” (McKinney). McKinney is running for president on the Reconstruction Party ticket as well as in the Green Party primaries.
On health care McKinney states, "I've supported every universal single payer health care plan. She goes on to state, “People who rail against `socialized medicine' in Canada and the UK have to explain why life expectancy is longer in Canada and the UK, why infant mortality is lower in Canada and the UK" (Deeth). McKinney further denounces the war in Iraq stating that the money being squandered could be better used on social programs such as rebuilding New Orleans, child nutrition, and health care, stating in part, “one billion dollars a day can provide medical care for the 47 million Americans who don’t have health insurance” (McKinney).
Another Green Party candidate, Kent Mesplay, declares on his website:
“Medical attention is a human right not yet recognized by the United States government. Nearly every other industrialized country on the planet has National Health Care. We are tied with South Africa for last place. In the same manner that we have a socialized military that at best provides for some aspects of our physical security, single payer health insurance is necessary to ensure that all people within our borders receive at least a basic level of medical and dental care.” (Mesplay).
While this may be a good position on single payer health care, it ignores the fact that the U.S. military does not provide physical security to the people of the United States, but is instead used to kill and terrorize the people of the world for the security of the profits of American corporations.
Also supporting single payer health care, Green Party candidate Kat Swift states:
“Hillary Clinton, Barack Obama, John Edwards, and other prominent Democrats are the greatest obstacle to universal health coverage. Except for a few mavericks like Rep. John Conyers [D-Mich.], who has regularly introduced single-payer bills, Democrats have joined Republicans in favoring HMO and insurance corporations over guaranteed publicly-financed quality health care for every American. It's a safe bet that the 2008 Democratic nominee will -- like Bill Clinton, Al Gore, and John Kerry before them -- follow the same pattern.”
Likewise, Green Party candidate Jared Ball, a Black free-lance journalist and college professor who calls for freeing Mumia Abu-Jamal, Leonard Peltier, and all political prisoners states, “Medicine for profit cannot be sustained as a model of managing health care for any progressive society” (Ball).
To the left of the Green Party is Elaine Brown, a former Black Panther Party member and activist for social programs for the poor and for prison reform. On health care she declares herself for, “Full and free health care for everyone, as exists in most civilized countries.”
Elaine Brown was a candidate for nomination as Green Party candidate for president until, on December 28, 2007, she broke with the Green Party, pointing out it was a capitalist Party and accusing the Green Party of racism. In her public statement Brown declared, "In effect, the present Green Party leadership promotes a kinder, gentler capitalism, a moderated racism, an environmentally-sustainable globalism, which I cannot support." On racism in the party she declared she intended to use her campaign “to bring large numbers of blacks and browns into the Party, particularly from the hood and the barrio” but that the Green Party “hierarchy seemed utterly fearful of the prospect of a massive influx of blacks and browns into the Green Party". Brown has given no indication that she now intends to continue her run as a candidate to the left of the Greens.
To the left of the Green Party are socialist candidates that call for full socialized medicine, like in Europe and Cuba, but who also see that single payer health care would be a step forward. These include likely Socialist Equality Party candidate Bill Van Auken, who calls for full socialized medicine, and says of the Canadian Single Payer system as an imperfect form of “socialized medicine”.
Likewise Peace and Freedom Party candidate and Socialist Party USA nominee for vice president, Stewart Alexander states,
“I favor a fully socialized medical care system, with as a first step a single-payer system similar to Medicare, but covering people of all ages. I favor eliminating the "co-pays" that are such a burden, and keep people from seeking needed care. We should take the profit out of the health-care system, and fully fund it. (The money now spent on health care in the USA is about twice as much per person as is spent in Western Europe, with less effective delivery of care. No additional money would actually be needed, but taxes on the wealthy few should be used initially to help fund improvements.) Eventually, I favor a fully-socialized system, funded from the surplus of the socialized economy, with an emphasis on prevention and public health.” (Alexander)
Also advocating full socialized medicine is Socialist Party USA nominee and Peace and Freedom Party candidate Brian Moore. In the California Voters Guide he states that he would, “establish guaranteed minimum income, housing and socialized healthcare for all”.
Not mentioning socialized medicine, but supporting single payer, Party for Socialism and Liberation nominee and Peace and Freedom Party candidate Gloria La Riva states, “The three main focuses of my campaign will be to oppose the racist attacks on immigrants; to propose a massive jobs program and increased social spending as an alternative to anti-crime hysteria and new prisons; and to give strong support for Single Payer Healthcare” (La Riva).
While generally being a good activist party, a strong concern among many on the left towards the Party for Socialism and Liberation is their uncritical support for undemocratic communist models, a problem that will cause many to instead vote for non-Stalinist candidates such as Stewart Alexander or Brian Moore in the Peace and Freedom Party primaries, or for other anti-Stalinist socialist parties that may run candidates such as the Socialist Equality Party, Socialist Workers Party, Socialist Action, or the Freedom Socialist Party.
In contrast to some of the anti-democratic positions of Gloria La Riva’s party, presidential candidate Stewart Alexander states,
“Socialism is the common ownership of the means of production, but I like to be more specific. There are, have been, and can be many forms of socialism, but I believe that the best, strongest and most beneficial form of socialism, the kind of socialism I personally work for, is common ownership of the economy coupled with its democratic control by working people.” (Alexander)
Obviously, there are clear alternatives to the capitalist Democrat and Republican Parties that are working hard to promote a workers agenda that includes either fully socialized medicine or single payer healthcare. Yet, almost all of the unions of the United States remain committed to endorsing and financing Democrats and only Democrats in elections. A good number of unions, such as the SEIU, even endorse Democrats that are opposed to single payer health care and help fund the same campaigns that are being funded by the big insurance companies. These endorsements of the anti-worker politicians of the Democrat Party are a blatant violation of the interests of the membership. Such endorsements hurt attempts at building alternative parties that represent workers interests, and hurt the ability of workers to protest and strike against such politicians that are not representing our interests. Some other unions, such as the California Nurses Association, take the stand of only endorsing candidates who support single payer health care. This is a step forward, but many on the left see that a full break by labor from the corporate controlled Democrat Party will be necessary.
Ultimately, what is needed is the building of a spirit of resistance among workers, the unemployed, and students, where we no longer passively agree to politicians and union leaders who pretend to be lesser evils, but are rarely even that. We must challenge and change the organizations we are part of, and when that fails, break away and build new ones. Most importantly, we must fully resurrect the use of political strikes and demonstrations to force the bosses and government to give us what we need, as is often done in countries with socialized medicine such as France. It is this kind of resistance that won socialized healthcare in Europe after the Second World War, and it will be this that will bring socialized medicine to the United States.
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