Thank you for the article on Obama’s attack on the health care of the mass of the workers in the US. I have worked in the health care industry for over three decades now and would like to add just a few points.
Health care is—we were always taught—divided into three factors: primary, secondary and tertiary.
Primary health care consists of things like better nutrition, clean water, early screening, better fitting shoes, early dental intervention—that sort of thing. The aim of primary health care is to prevent disease in the first place. (And here I want to stress that this sort of care does not include things like the T-MAP scam originated in Texas and signed into law by G. W. Bush.)
Secondary health care consists of trying to cure any illnesses, diseases, disorders, traumas, etc. in the most efficient manner that allows the patient to return to their prior health status and functioning—social, physical and psychological.
Tertiary health care is concerned solely with preventing any of the above health dysfunctions getting any worse—in short, stopping the premorbid becoming early morbidity.
It has been calculated that every dollar spent on prevention (primary health care) equals ten dollars spent on maintenance (tertiary health care).
And here for profit driven health care—better described in my opinion as illness maintenance care—lies one of the major problems.
It is far more profitable—far more—to treat illnesses symptomatically rather than attempt to cure them. In the field in which I currently work, psychiatry, we see this all the time. Vast sums are spent in research and promotion of chemicals that do little in the way of cure. Instead, every year we are bombarded with new “wonder drugs” that we are told will dramatically improve the life of our patients.
They will be rid of all sorts of side effects—restlessness, oculogyric crisis, akathisia and so on—without in any way having any of their psychic health returned. That is, they will still be bedevilled by hallucinations, delusions, disturbances of thought and mood, but enough of these will be reduced that they no longer present any risk or annoyance to the population at large or themselves.
But they will still live in substandard housing, still be subject to malnutrition, alienation and lack of meaningful engagement with the world. And, naturally enough, their human spirit will find all of this prejudicial to any sort of social/psychological well being, and they will relapse.
Anyway, this is somewhat off the subject. The point I want to make is that a health care system built around prevention is not only going to be cheaper in economic terms but infinitely more humane.
The profit motive, on the other hand, benefits most from the maintenance of illness and attempts at purely symptomatic control. All sorts of tests, examinations, reviews and medications are routinely given with absolutely no long-term benefit to the patient. (In the book Deerhunting with Jesus by Joe Bageant there is a chilling account of a terminally ill man being resuscitated on his way to X-ray purely for the point of gaining the last cent available from his health coverage. He died properly on the way back from the radiography department.)
The present profit driven system acts as a direct and potent obstacle to health. A vibrant and potent health status across the community (and by this we mean more than just the absence of disease or illness) after all, pays nothing to the institutional health services providers. There is absolutely no advantage to the pharmaceutical and medical corporations in having a healthy population.
A socialist health care system will be totally different from the present. It will put prevention as the priority, there will be more food, more rest, less routine industrial and occupational mayhem, less everyday hazard to living.
Most importantly it will enshrine the sprit that Trotsky speaks about in the last paragraphs of Literature and Revolution: “Emancipated man will want to attain a greater equilibrium in the work of his organs and a more proportional developing and wearing out of his tissues, in order to reduce the fear of death to a rational reaction of the organism towards danger. There can be doubt that man’s extreme anatomical and physiological disharmony, that is, the extreme disproportion in the growth and wearing out of organs and tissues give the life instinct the form of a pinched, morbid and hysterical fear of death, which darkens reason and which feeds the stupid and humiliating fantasies about life after death.”
9 June 2009
Good piece Patrick. You might be interested to know that Canada’s NDP leader Jack Layton is going to help Obama sell this scam too. The NDP press releases are full of it.
9 June 2009
Thank you WSWS for providing unparalleled analysis of the decay of world capitalism. Everything the WSWS predicted about the Obama presidency has been fully vindicated.
The utter bankruptcy of the defenders of US Liberalism, such as The Nation, MoveOn and the ACLU etc, is fully exposed as they continue to portray the semi-fascist Obama administration as a vehicle for change. They are not so interested in democracy and freedom, as they are in preserving the myth of the American dream and American exceptionalism. They are no less engaged in lies and distortions than the neo-cons that they have been so indignant in attacking for their lies and distortions—their deplorable hypocrisy lights the pathway for the working class on the way to revolution.
Mr. Martin’s article succinctly and expertly brings out the overt nature of the degenerate US plutocracy that no amount of posturing by the Obama administration can conceal.
As Trotsky was convinced that the Bolsheviks would come to power through the logic of events in 1917, I feel no less certain that the logic of events will see the SEP leading the working class in victorious world revolution.
Workers—men and women—of all countries, place yourselves under the banner of the Fourth International. It is the banner of your approaching victory!
8 June 2009
Thank you Tom Eley for putting all the dismal economic numbers in perspective and in one place. It seems that I’ve lost most of my friends in the gulf that is separating those who stay abreast of the storm and those who refuse to acknowledge that a typhoon is hitting and isn’t about to abate. As one market analyst put it, “the separation between the smart money and the dumb money is wider than ever before.” This separation is not due to intelligence or lack thereof, but due to human reactions that all too often bury and deny facts rather than face them now and plan accordingly. Never have I experienced the degree of anomie by friends, colleagues and neighbors as I now do. Luckily, there are articles like this one at WSWS that confirm my own observations. Lacking them, I surely would lose my grasp.
8 June 2009
What an excellent article. When I read the original NYT piece, and saw Bumiller’s byline, I had a reflexive reaction: I’ve seen this name before, on this kind of article. Some variety of puff piece re-packaging the Pentagon or administration point of view. There are other similar names: Thom Shanker and Dexter Filkins come to mind. One sees their bylines and senses that they are simply channeling the defense department, the CIA, or some other establishment voice, and in doing so legitimizing and furthering their right wing agenda.
The subsequent “corrections” do not undo the damage done by these articles. (I for one, and I may represent a fair number of people, never even saw the correction.) I rely heavily on the WSWS to highlight and debunk this high-level propaganda, which is not at all “fit to print” in the first place.
9 June 2009
Bill, this is a really fine piece. On the issue of timing you wrote: “Indeed, Bumiller’s piece was published the same day that Obama and Cheney gave their extraordinary opposing speeches, pointing to the deepening crisis within the US state apparatus. And, given its appearance in the supposed ‘newspaper of record,’ it was picked up and echoed as fact by broadcast news outlets around the country.”
Also keep in mind the FBI’s decision to schedule the “terror attack” on the Jewish synagogue with the four street saps they had primed for the occasion just before the Cheney-Obama “debate.” Frank Wizner used to brag of being able to play the media “like a mighty Wurlitzer,” but he omitted that he could also orchestrate the events the media incorporated into its mighty choral performance. In the JFK hit, there are individual performances by major media and political figures that were demonstrable lies (not mere falsehoods) in the course of shaping and confusing public opinion.
9 June 2009