As the Great Recession rolls on after three years, without signs of relief on the horizon, a growing army of many millions of Americans is finding it impossible to gain access to necessary health care that is affordable. Meanwhile, class warfare is gaining intensity with a widening gulf between the left and right over the major issues of the day, including the future of U.S. health care. As political gridlock continues, the battlefield is littered with many preventable deaths, many lives wounded by the ravages of untreated or under-treated disease, and growing stress in affected families.
The public discourse is reaching new levels of ugliness, as illustrated by an audience at a GOP campaign event cheering the idea that that those without health insurance should just be left to die. GOP presidential hopefuls have no solutions to offer except the "freedom to choose" (your own fate!) and the private marketplace (which increasingly excludes those who cannot pay its rapidly increasing costs). In fact, they exacerbate the problem, under the guise of fiscal responsibility and austerity, by cutting government safety net programs while at the same time trying to exploit Medicare and Medicaid by further privatization.
These are some markers that show some of the impacts of this war:
• According to the U.S. Census Bureau, in 2010 49.9 million Americans were uninsured (which understates the problem since anyone with insurance for even a small part of the year was considered insured), the median household income was $49,445 (a drop of 2.3% from 2009), and 46.2 million people (including 22 percent of the nation's children) were in poverty (the highest number in the 52 years for which estimates have been tracked).
• In his recent editorial in The Progressive, Matthew Rothschild notes that, over the last 40 years, the top 0.1 percent of the population (152,000 people making more than $5.6 million a year) skyrocketed by 385% while the income of the bottom 90% (about 137 million people) dropped by 1%. In the last 10 years, the median income of working-age households has dropped by more than 10%.
• According to a Gallup poll, 18 percent of Americans state they did not have money to buy food at all times in 2010.
• The median household wealth of white families has fallen by 16% since 2005; Hispanic families dropped by 66%.
• At the top 1 percent of the society, corporations exploited tax havens and often paid less tax than most of us pay; as an example, General Electric, one of the largest and most profitable corporations in the world, generated $10.3 billion in pretax income in 2009, paid no U. S. taxes and actually recorded a tax benefit of $1.1 billion.
• Based on a definition of the middle class as those between the 30th and 70th percentiles of the income distribution, one-third of Americans dropped out of the middle class over the last 30 years.
• The average annual premium for health insurance for a family of four reached $15,073 in 2011, 9% higher than in 2010 -- an unaffordable level, about 30% of the median family income, or twice the proportion of income that seniors paid for health care when Medicare was enacted in 1965!
• In the most recent study of mortality attributable to health care in 16 high-income nations, the U.S. led the field with the most preventable deaths and with the least improvement over a 10-year period. The authors concluded that this poor showing is likely due to "the lack of universal coverage and the high costs of care."
• The consumer confidence level is now only 45%. Despite all this pain and suffering, the political process continues to ignore this national catastrophe in the name of austerity as the debate continues over the budget deficit, targeting federal spending for education, health care and other important public programs (but avoiding bigger issues, such as major defense cutbacks, real financial reform, campaign finance reform, and tax increases for the wealthy). The extreme right-wing of the Republican Party, activated and hobbled by the Tea Party, continues to hold Congress and the Obama administration hostage as it pursues its nihilistic agenda, focused on winning further power in 2012 despite its lack of a plan to address these kinds of problems.
The present situation in health care boils down to a human and moral crisis that seems beyond the reach or concern of our current political leaders, conflicted as they are by enormous amounts of corporate cash that perpetuates our present, increasingly cruel market-based system. In our next post, we will explore whether we still can draw on a long-standing self-image that we as Americans care about each other.
John Geyman, M.D. is the Professor Emeritus of Family Medicine at the University of Washington School of Medicine and author of Hijacked! The Road to Single Payer in the Aftermath of Stolen Health Care Reform (Common Courage Press, 2010). For more information, visit Copernicus Healthcare.