[Peace-discuss] Health Plans and Death Plans

[C. G. Estabrook]

"Since the major preoccupation of liberals for 30 years has been the right to 
kill embryos, why should they not be suspect in their intentions toward those 
gasping in the thin air of senility? There is a strong eugenic thread to 
American progressivism, most horribly expressed in its very successful campaign 
across much of the twentieth century to sterilize 'imbeciles.'"

	Health Plans and Death Plans
	By ALEXANDER COCKBURN
	"Medicine is nothing but a social science.
	Politics is nothing but medicine on a large scale."
	--Rudolf Virchow, reflecting on the revolutions of 1848 in Europe.

The first illusion to chase off the stage is that the great debate here has much 
to do with health. So far, as public health is concerned, many of the biggest 
battles were fought and won a hundred years ago, at the end of the nineteenth 
century, with better nutrition, birth control, the change from wool to cotton 
clothing, the introduction of modern sanitation in the urban environment and – 
most important – clean water.

Between 1900 and 1973, American life expectancy went from 47 to 71, but most of 
this rise had taken place by 1949, when the average life span reached 68. Much 
of the upward curve could be attributed to improved survival rates for infants 
and young people. Prohibition helped, since people drank less alcohol, ate more, 
and hence TB rates dropped sharply, well before the introduction of sulfa drugs.

Health in America is class-based, naturally. The poor die sooner, starting with 
black men who tend to drop dead in their middle 60s, usually from stress and 
diseases consequent on diet. The better-off folk drink less than they did in the 
1950s, take a bit more exercise, and sometimes live longer. The poor get fatter 
and fatter. A real health plan would start with public executions of the top 
thousand CEOs and owners of the major food companies and fast food franchises. 
It would continue with serious penalties for health workers not washing their 
hands or merely holding them under the tap without using soap.

The plagues of America today are beyond the reach of the modern medical system, 
and that system is itself a peculiarly outrageous example of antisocial 
imperatives: high technology health care which serves fewer and fewer people. 
Part and parcel of this system are the drug companies, working in concert with 
the hospitals and insurance industry. Doctors have long since been shoved to the 
side as major players.

Mostly shunned in all this are the major causes of modern disease, which are 
environmental. Between 70 and 90 per cent of all cancer is environmental in 
origin. Heart disease and stroke – the largest killers today – are largely 
caused by hypertension and stress, which are derived from social conditions.

America is very efficient in promulgating Death Plans –- tobacco, sugar 
additives, excessive salt, nitrous oxides out of power plant chimneys, nuclear 
testing in the 1950s, industrial accidents, speed-up at work and lengthening of 
the working day, rush-hour traffic – launched in the hope of making a buck and 
protected fiercely until, very occasionally, the mountain of corpses gets too 
high to be occluded by even the most refined techniques of the PR industry and 
the most lavish contributions to politicians. Thus it was with tobacco.

Health reform in the 1930s, in the Roosevelt era, came mostly in the guise of 
the Wagner Act – a better deal for unions and workers – and Social Security. Old 
people got something to live on in their later years. Health reform in the 1950s 
and 1960s came with better wages, a shorter working week, more leisure, plus 
Medicare – the federal health plan for older people – driven through Congress by 
the most consummately cunning and accomplished politician of the postwar era and 
maybe of the twentieth century (unless you make the case for FDR), Lyndon 
Johnson, who really did care about poverty, having seen a lot of it up close in 
Texas.

Since then, we’ve gone nowhere. Nixon declared war on cancer and founded the 
Environmental Protection Agency – but corporate pollution continued virtually 
unabated, courtesy of the energy industry and modern, chemical-based 
agriculture. In 1977, the Senate Select Committee on Nutrition, chaired by 
George McGovern, issued a splendid special report on recommended dietary goals 
for the United States. It swiftly provoked the virulent hostility of the medical 
establishment and the food industry. The former contested the idea that diet 
might have any particular bearing on health and hotly denounced this particular 
application of the notion of preventive medicine. The latter, for obvious 
reasons, saw no reason to welcome the Committee’s recommendation that Americans 
eat less meat. The injunction was axed from the Report a year later.

The neoliberal attack on regulations has been a health catastrophe.  Take 
accidents  -- injuries and deaths – at the work place. As JoAnn Wypijewski wrote 
in this site earlier this year, “Because of under-reporting, the number of 
injured workers every year is likely closer to 12 million than the official 4 
million. The 50,000 to 60,000 who die from occupational diseases each year 
cannot be a hard estimate; cancer, for instance, doesn’t usually come with a 
pedigree. Even the precision of deaths on the job (40,019 workers between 2001 
and 2007, the latest year for which there are figures and not counting the 9/11 
dead) has to be qualified; the number does not account for the fates of 8.8 
million public sector workers not covered by OSHA. It does not include deaths in 
the underground economy. Not the street dealers killed by rivals or police, and 
not the hookers and massage artists murdered in the line of duty by the likes of 
the Craigslist killer.”

Typically, Democratic presidents like Clinton and now Obama commit during their 
campaigns for some kind of “reform,” usually meaning some pledge that the 
“disgrace” of  45 million or so uninsured Americans will end. In 1993 the 
Clintons tried  “health reform”– a monstrosity that I described at the time as 
looking like a collaboration between Mondrian and Jackson Pollock - and the 
insurance industry and lobbyists ate it for breakfast. The radical reformers 
argue for a national insurance scheme, like Canada’s or the NHS, where the state 
can use its purchasing weight to drive down drug prices, set rates, clean up the 
system. This plan  go back to the Health Service Act introduced by Ron Dellums 
in Congress on May 4, 1977, providing for comprehensive , community-based health 
services with progressive national financing. The Dellums bill had been under 
discussion  since the early 1970s when the Medical Committee for Human Rights 
proposed a set of principles for a national health plan.

It’s not going to happen, any more than Obama will nationalize the banks and 
tell householders to repudiate their mortgages. The insurance industry, the drug 
industry, the real estate and finance sector  are the most powerful forces in 
the country.  They’ve just got Obama to commit $23 trillion to their enduring 
welfare. They’re not going to surrender the treasure trove known as healthcare 
without serious blood-letting on the barricades. They own the Congress. Men like 
former Democratic senate leader Tom Daschle spring to do their bidding. So, 
Obama finally produced a timid compromise, whereby uninsured people would be 
herded under various health insurance umbrellas with “a public component.”  Even 
if the health industry’s hired man, Senator Max Baucus, had not deep-sixed the 
public component, the insurance industry could swallow it like a python 
swallowing a field mouse. Though Obama sometimes confides that the public 
component of his plan is the springboard to full-bore single payer national 
health, this is transparent fantasy. In present political conditions, the 
publicly insured component would soon become a ghetto, offering minimal care to 
the indigent, and gradually shriveled into some sort of punitive maintenance scheme.

It’s sometimes argued that a decent single payer system would be functional to 
U.S. capitalism, since industries like the auto sector would be liberated from 
the burden of health costs. There are scores of decent policies that would be 
functional to US capitalism. But the soul of US capitalism is wedded to 
indecency. Consider  torture and the death penalty. Critics of these procedures 
sometimes argue that they don’t work, or are inefficient. People spout out lies 
  amid their torments. Innocent people die in the gas chamber and the justice 
system is injured in reputation thereby.. But the real allure of torture and 
capital punishment for the owners of the system is to instill  fear and 
compliance precisely by the demonstration of vindictive irrationality.

Fear never fails. Americans, burdened with the worst and most exploitative 
health system of any advanced country, are now being expertly stampeded by the 
right's campaign that Obama's health plan means that state-licensed executioners 
will make the unilateral decision to give granny her final morphine shot 
whenever they think fit. The present system means that granny gets her final 
morphine shot once her money runs out.

The liberals are howling bout the unfairness of these attacks, led by Sarah 
Palin, revived by her “Death Panel” talk and equipped with a dexterous new 
speech writer who is even adding footnotes to her press releases.

But what is a conservative meant to think? Since the major preoccupation of 
liberals for 30 years has been the right to kill embryos, why should they not be 
suspect in their intentions toward those gasping in the thin air of senility? 
There is a strong eugenic thread to American progressivism, most horribly 
expressed in its very successful campaign across much of the twentieth century 
to sterilize “imbeciles.” Abortion is now widening in its function as a eugenic 
device. Women in their 40s take fertility drugs, then abort the inconvenient 
twins, triplets or quadruplets when they show up on the scan.

In 1972, a year before the Supreme Court’s Roe v. Wade decision legalized 
abortion on demand nationwide, virtually all children with trisomy 21, or Down 
syndrome, were born. Less than a decade later, with the widespread availability 
of pre-natal genetic testing, as many as 90 percent of women whose babies were 
pre-natally diagnosed with the genetic condition chose to abort the child.

One survey of 499 primary care physicians treating women carrying these babies, 
however, indicated that only 4 percent actively encourage women to bring Down 
syndrome babies to term. A story on the CNS News Service last year quoted  Dr. 
Will Johnston, president of Canadian Physicians for Life, reacted to the 
American College of Obstetricians and Gynecologists (ACOG) pre-natal testing 
endorsement as another step toward eugenics.“The progress of eugenic abortion 
into the heart of our society is a classic example of “mission creep,’ ” Johnson 
said. “In the 1960s, we were told that legal abortion would be a rare tragic act 
in cases of exceptional hardship. In the ’70s abortion began to be both decried 
and accepted as birth control. In the ’80s respected geneticists pointed out 
that it was cheaper to hunt for and abort Down’s babies than to raise them. By 
the ’90s that observation had been widely put into action. Now we are refining 
and extending our eugenic vision, with new tests and abortion as our central 
tools.”

So if we have mission creep  in the opening round, what’s to persuade people 
that there won’t be mission creep at the other and the kindly official 
discussing living wills won’t tiptoe out of the ward and tell the hospital that 
the old fellow he’s just conferred with is ripe to meet his maker. The author of 
the provision – now dropped – in the health bill before Congress – for  “end of 
life” counseling was Democratic Rep Earl Blumenauer of Oregon. Blumenauer has 
denounced the “death panel” description as a  “terrible falsehood.” Maybe so. 
But Blumenauer is hot for “death with dignity”, as a speech he made in Congress 
in 2000 makes clear: “A major concern [in an attempted revision of the Balanced 
Budget Act]is a provision that would criminalize decisions doctors make on pain 
management for the most seriously ill and overturn Oregon's Death with Dignity 
Act. Oregonians have twice voted to support the assisted suicide law. H.R. 2614 
not only is an attack on the Democratic process, but also threatens to pain 
management. There is evidence that doctors are increasingly hesitant to 
prescribe pain medications to terminally ill patients for fear of being accused 
of unlawfully assisting a suicide. The on-going attempts by Congress to 
criminalize the doctor-patient relationship are a threat to pain management in 
all fifty states.”

For forty years, every American president has deprecated the powers of 
government to improve the public weal. Why now should Americans believe that any 
government-backed “health reform” will do them any good, as opposed to assigning 
them the appropriate lifespan, relative to their income and contributions to the 
corporate bottom line, which is what the present system amounts to?

http://www.counterpunch.org/