6 Diseases That Could Skyrocket or Become Far More Deadly If the Affordable Care Act Is Repealed

PERSONAL HEALTH
Bernie Sanders may have been underestimating when he said 36,000 per year will die if the health care law is dashed.

Photo Credit: Shutterstock.com

When senators Bernie Sanders and Ted Cruz debated the merits of the Affordable Care Act of 2010, aka Obamacare, on February 7, Sanders had a dire prediction: “We are moving into an era where millions of people who develop terrible illnesses will not be able to get insurance, and God only knows how many of them will die.” The Vermont senator, who favors a single payer or “Medicare for all” system, was right to be concerned. It remains to be seen when or how Republicans in the U.S. Senate and the House of Representatives will repeal the ACA; Sen. Rand Paul has been complaining that repeal is taking much too long and that fellow Republicans don’t appear to be in a hurry to repeal it. But the Urban Institute estimates that if and when Republicans do repeal the ACA, “The number of uninsured people would rise from 28.9 million to 58.7 million in 2019, an increase of 29.8 million people”—and Sanders has predicted that “36,000 people will die yearly as a result.”

Sanders is not exaggerating about the potential death toll; if anything, he is being optimistic. In 2009, a pre-ACA Harvard Medical School/Cambridge Health Alliance study found that almost 45,000 Americans were dying annually due to lack of health insurance. Shortcomings and all, the ACA—according to Gallup—has reduced the number of uninsured Americans aged 18-64 from 18% in 2013 to 11.9% in late 2015. And that includes millions of Americans with pre-existing conditions such as diabetes, heart disease and asthma. The ACA has not only made it illegal for insurance companies to exclude people due to pre-existing conditions, but it has also emphasized preventive care and screenings, which can prevent chronic conditions from developing or at least treat them after a diagnosis. Without those protections, it stands to reason that diabetes, heart disease, cancer and other potentially life-threatening illnesses will be on the rise.

Here are several diseases that are likely to increase or have much worse outcomes if Republicans succeed in abolishing Obamacare and render millions of Americans uninsured.

1. Diabetes

According to the American Diabetes Association, 30 million Americans suffer from diabetes, while another 86 million have prediabetes. For those 116 million Americans, access to health care is crucial; diabetes, if not managed and controlled, can lead to everything from amputations to heart disease, stroke and blindness. And when prediabetes is managed, patients have a much better chance of avoiding full-blown diabetes. Bearing those things in mind, the American Diabetes Association sent members of Congress a letter in December warning them how dire the consequences could be for Americans with diabetes or prediabetes if the ACA is repealed without a suitable replacement.

“The ACA,” the American Diabetes Association told Congress in the letter, “ended fundamental inequities in access to adequate and affordable health insurance that separated Americans with diabetes from the tools they needed in the fight against the horrific and costly complications of diabetes, including blindness, amputation, kidney failure, heart disease, stroke and death. Repealing the ACA will create huge access barriers for millions of Americans, especially if no fully defined replacement is put in place immediately to meet the health care needs of individuals with chronic health conditions like diabetes.”

In 2016, medical researchers Rebecca Myerson and Neda Laiteerapong examined the ACA’s possible effects on diagnosis and treatment of Type 2 diabetes. The physicians found that 23% of American adults, aged 18-64, with diabetes lacked health insurance in 2009/2010, but said it was “likely that a significant fraction became insured in the subsequent years due to ACA provisions.”

2. HIV/AIDS

Jennifer Kates, director of HIV policy for the Kaiser Family Foundation, has described the ACA as a “watershed moment” for Americans living with HIV, and the Centers for Disease Control called it “one of the most important pieces of legislation in the fight against HIV/AIDS in our history.” Kaiser research has indicated that 200,000 HIV-positive Americans may have gained coverage through the ACA, and according to the AIDS Foundation of Chicago, the ACA brought insurance to 12,000 HIV-positive Illinois residents.

With HIV treatment, one of the goals is avoiding full-blown AIDS. In a recent article for The Advocate, Carl Schmid, deputy executive director of the AIDS Institute, warned that ACA repeal could be devastating for Americans living with HIV and that access to treatment can be a matter of survival.

“If Congress repeals the ACA without simultaneously replacing it with programs that ensure comprehensive health coverage for the same, if not more, individuals, the private insurance market will become unstable—and people with HIV and others would lose access to the care and treatment that they rely on to remain healthy,” Schmid said. “People with HIV, who depend on a daily drug regimen, cannot risk losing access to their health coverage—not even for a single day… We cannot afford to go backwards by eliminating or destabilizing the health care that the ACA provides.”

3. Cancer

In January, Gregory Cooper and his colleagues at University Hospitals’ Cleveland Medical Center in Ohio released a study that compared access to cancer screenings before and after the ACA, which they found was making it easier to obtain mammograms but needed to do more to encourage colonoscopies. Cooper, reflecting on GOP plans to repeal the ACA, stressed that the U.S. needs more cancer screening, not less, saying, “If you take away people’s health insurance and they’re going to pay out of pocket for health care, are they going to get a mammogram, or are they going to buy food? People are going to do what gives them the best benefit in the short term, which is food and shelter.”

Amino, Inc., researching 129 insurance companies, has offered some estimates on possible out-of-pocket costs for cancer screening in a post-ACA environment; in Alaska, for example, the costs could be almost $500 for a routine mammogram or $2,565 for a colonoscopy. And as Cooper pointed out, Americans will put off or avoid potentially life-saving tests when they become cost-prohibitive.

4.  Blood Pressure and Hypertension

In 2015, researchers at George Washington University School of Public Health released a study on the effect the ACA was having on hypertension, a major factor in heart disease and stroke. The researchers reported that 78 million Americans suffer from hypertension and that “lack of insurance coverage is a critical barrier to better treatment of hypertension,” and they predicted that if ACA expansion continued, it “would lead to a 5.1% increase in the treatment rate among hypertensive patients.”

5. High Cholesterol

In 2015, the Harvard T.H. Chan School of Public Health published a study that linked the ACA with better outcomes for three conditions: diabetes, high cholesterol and high blood pressure. The study found that uninsured people suffering from any of those conditions were much less likely to find out they had a problem, whereas insured people had a 14% greater chance of finding out if they had diabetes or high cholesterol and a 9% greater chance of finding out they had high blood pressure. And for those who those who were diagnosed, the Chan School found, being insured greatly improved one’s chances of controlling blood sugar, total cholesterol or systolic blood pressure.

Joshua Saloman, a senior author of the study, said, “These effects constitute a major positive outcome from the ACA. Our study suggests that insurance expansion is likely to have a large and meaningful effect on diagnosis and management of some of the most chronic illnesses affecting the U.S. population.”

But instead of insurance expansion, Republicans could significantly reduce coverage. Even John Kasich, right-wing governor of Ohio and one of the many Republicans who lost to Donald Trump in the 2016 GOP presidential primary, sounded a lot like a Democrat when he said that while there is “room for improvement” with the ACA, he was worried about what would happen to “these people who have very high cholesterol” if it is repealed without a solid replacement.

6. Asthma

Before the ACA, the term “pre-existing condition” as defined by health insurance companies was far-reaching; anything from multiple scleroses to kidney disease to anemia was grounds for rejecting an application for coverage. For people with asthma, obtaining health insurance was difficult or impossible. 17.7 million adults, according to the Centers for Disease Control, suffer from asthma in the U.S., and when asthma is not treated or controlled, it can become life-threatening (in 2014, CDC attributed more than 3600 deaths annually in the U.S. to asthma).

In 2013, a Harvard Medical School study cited lack of health insurance as the main reason asthma care for young adults deteriorated when they turned 18; emergency room visits became more frequent, and medications often became cost-prohibitive. But with the ACA’s implementation, young asthmatics could stay on their parents’ health plans until 26—and asthmatics, regardless of age, could not legally be refused coverage because of their condition. With full ACA repeal, however, it could once again become legal for insurance companies to deny coverage to asthmatics. And even partial ACA repeal could make asthma care cost-prohibitive.

While ACA repeal is likely, it remains to be seen what, if anything, Republicans would replace it with. Rep. Steve King has made it clear he couldn’t care less if the ACA is repealed without a replacement. However, Rep. Tom Price, President Trump’s nominee for secretary of the U.S. Health and Human Services Department, has proposed replacing it with a plan that would eliminate Medicaid expansion, thus making coverage more expensive for Americans with preexisting conditions. And President Trump has promised that after the ACA, Americans can look forward to more comprehensive coverage at much lower prices. But it’s an empty promise because he has yet to offer any specifics.

In other words, Republican plans for an ACA alternative range from terrible to woefully inadequate to nonexistent. To make matters worse, Rep. Paul Ryan is still pushing for Medicare privatization, meaning that Americans who suffer from ACA repeal could be facing additional hardships if they live to see 65. With Republicans going out of their way to make access to health care difficult or impossible for millions of Americans, the future looks grim for anyone suffering from cancer, HIV, hypertension or other potentially deadly illness.

Alex Henderson’s work has appeared in the L.A. Weekly, Billboard, Spin, Creem, the Pasadena Weekly and many other publications. Follow him on Twitter @alexvhenderson.

http://www.alternet.org/personal-health/6-diseases-could-skyrocket-or-become-far-more-deadly-if-affordable-care-act-repealed?akid=15228.265072.2xuNye&rd=1&src=newsletter1072659&t=4

Republican health care plan guts Medicaid, shifts funds from poor to rich

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By Kate Randall
18 February 2017

House Republican leaders on Thursday briefed rank-and-file members on the outlines of their plan to replace the Affordable Care Act (ACA). Speaker Paul Ryan, Health and Human Services Secretary Tom Price and two House committee chairmen reported to the press on the “talking points” presented at a meeting in the House basement.

Though short in details on how the proposals would be paid for, the plan takes aim at Medicaid, the government health care program for the poor and disabled jointly administered by the federal government and the states. It would also shift the burden of health care costs even more heavily on the working class. Republican leaders provided no estimates of the number of people who might gain or lose insurance under their proposals.

Donald Trump met at the White House Thursday with House Republicans who backed his presidential bid who were looking for his support in repealing and replacing the 2010 legislation commonly known as Obamacare. At a news conference following the meeting, the president said, “We should be submitting the initial plan in March, early March,” appearing to refer to a House bill that could move forward by then.

From its inception, the ACA’s aim has been to cut costs for corporations and the government, while shifting the US to an even more heavily class-based health care system than what previously existed. Obamacare’s key component, the “individual mandate,” compelled those without insurance to purchase it from private insurance companies under threat of a tax penalty.

Outlines of the Republicans’ replacement plan would further boost health insurers’ profits. The ACA’s modest government subsidies to low and middle income people would be replaced with tax and other mechanisms that would favor the wealthy and provide little to no assistance to the vast majority of health care consumers.

The Republican plan would repeal the individual mandate and penalty, but it would also eliminate fines on employers for not providing their workers with insurance coverage. Sources familiar with the proposal told the AP that a new tax might be imposed on individuals receiving health care from their employers valued above $12,000 for an individual or $30,000 for families. That is, it would penalize those receiving decent employer-sponsored health insurance.

It would also roll back the Medicaid expansion under the ACA, which has newly insured an estimated 10 million people. Republicans have long eyed the program—which provides vital health coverage to families, seniors and people with disabilities—for destruction. This attack on Medicaid would go a long way toward this aim, and it is among the most vicious of the Republicans’ proposals.

While providing no dollar amounts or details, the House outline calls for converting Medicaid to either a per capita cap or a block grant to the states. All past Republican plans, including those of Ryan and Price, have featured deep cuts that would grow steeply over time. It would be impossible for states to absorb these cuts without cutting coverage for people who should qualify for benefits.

Currently, Medicaid funding adjusts to meet need, whether from a public health emergency like the opioid crisis or the Zika virus, or the growing health care needs of aging baby-boomers. A block grant or per capita cap would deliberately stop this automatic response to increased need, forcing states to decide who should be denied benefits, or how benefits should be rationed among the most needy.

The Republicans’ “talking points” also confirm that “Obamacare’s Medicaid expansion for able-bodied adults [sic] enrollees would be repealed in its current form.” Their proposal would end the ACA’s enhanced federal matching funds for the currently enrolled Medicaid expansion population after a limited period of time.

While states would be “free” to continue to cover the 10 million people, plus those who would become eligible in the future, under Obamacare’s Medicaid expansion, by a set date they would have to pay between 2.5 and 5 times as much per person to do so, according to the Center on Budget and Policy Priorities (CBPP). The massive cut in federal funding would force states to choose between covering low-income adults and covering children, seniors and the disabled.

The savings from the cuts to Medicaid would likely go toward “relief from all the Obamacare tax increases,” as outlined by the House Republicans. According to CBPP, based on previous plans, these savings would “go to help fill the hole created by cutting Medicare taxes for high earners and eliminating drug company, insurer, and other fees” that helped finance Obamacare’s coverage expansion.

The resulting tax cuts would average $50,000 per year for households with incomes over $1 million, according the Urban-Brookings Tax Policy Center.

In place of the ACA’s refundable premium tax credits (subsidies) that are currently helping more than 9 million people afford coverage, the Republican proposal would offer a flat credit determined by age, regardless of income, with the biggest financial benefits going to older Americans.

This would mean that a 25-year-old earning $25,000 a year would receive less of a tax credit than a 65-year-old multimillionaire. The end result would be that many low- and middle-income people would be unable to come up with the money to pay the gap between their fixed tax credit and the cost of a health insurance plan.

The Republican proposals would also expand Health Savings Accounts (HSAs), which allow people to put aside money tax-free to pay for out-of-pocket health care expenses. These HSAs are obviously of little help to families struggling to pay rent, utilities and put food on the table and have nothing to set aside. The tax benefits for the wealthy, on the other hand, would be substantial.

The House Republicans’ plan calls for the creation of unspecified “State Innovation Grants” to supposedly aid states in covering costs for diversifying the risk pool and covering people with pre-existing conditions. CBPP notes that previous “high risk pools” have failed to provide affordable, quality health coverage for sicker individuals.

 

WSWS

Depression Is an Unlikely Advantage in the Fight Against Fascism

CULTURE
Life under the yoke of depression is frighteningly similar to life in Trump’s America, and knowing one can teach you how to approach the other.

Blurred photo of sad man in his room
Photo Credit: Atlantis Images/Shutterstock

If you’re one of the more than 16 million human adults in America affected by depression, and the current advent of fascism feels like a one-way ticket to hell, know that you’re not alone.

Watching the country I now call home unravel one headline at a time knocked me off my feet for most of January, threatening to undo my attempts to rebuild my life after I spent more than three years incapacitated by major depressive disorder.

The fog has only intensified since Inauguration Day, smothering America in a thick blanket of bizarre language and threats—doled out in “presidential” tweets and surrogate TV interviews alike—all the better to conceal laying the foundation for dismantling the Affordable Care Act in the middle of the night, among innumerable other heinous policies.

Now, when I can get to sleep at all, I wake up aghast at how quickly the new regime is pushing through executive orders and taking apart democracy.

Much of the time, things feel desperately hopeless.

It mirrors the pain of depression; when it’s become so debilitating that you collapse further into yourself, sometimes the energy required to get out of bed is all you’ve got — never mind getting out in the street — and you end up feeling completely bereft, like you’re somehow failing at being human.

Well, you’re not.

Instead, you’re being defiantly alive in the face of an illness that has the power to kill you.

Amid the rampant confusion of our current times, it’s easy to overlook how similar depression and fascism are. If you understand the mental illness, you understand the political ailment because you already have firsthand experience of living under a dictatorship of lies.

What’s more, if you’re already resisting depression, then you’re automatically equipped to resist fascism — so even if you feel far from well, safe, or strong right now, take heart… because you’ve got this.

Both depression and fascism thrive on fear and terrorizing their host — be it your mind or your country — until you systematically question what your eyes, ears, and heart are reporting back to you; until you no longer trust your senses and either endorse the agenda of that which seeks to destroy you, or just give up.

For its part, depression gradually injects doubt into every aspect of personhood. It may undermine a once competent professional until their skills appear worthless and unemployability certain, or shred someone’s self-esteem until they believe a romantic relationship can only exist out of pity rather than love, or put the kibosh on one’s dreams — because, let’s face it, what future is there for someone who’s such an incapable and unlovable waste of space?

At its most virulent, depression corrodes your sense of self and erodes your identity, and the parasite feeds until only the physical representation of the host remains.

Our fascist leader is having the same effect on America that depression has on an individual. And he’s doing it the same way: by distorting reality, strafing journalists and citizens alike with falsehoods.

In both cases, the aim is for lies to supplant reality altogether.

If the farce endures in its grotesque glory, it’s because it takes initiative, courage, and knowing exactly who you are in order to stand against what you’re being told to accept as the norm, whether by your mind or the new White House occupier.

To the unsuspecting onlooker, when I was in the throes of deepest depression, I looked as I always had. But whenever I opened my mouth, it was clear that it wasn’t me speaking, but depression—through pained, inarticulate self-doubt.

To the unsuspecting onlooker, America still mostly looks like it always has. But whenever our leader opens his mouth, it’s clear it isn’t democracy speaking, but fascism, through absurd sentences almost entirely devoid of syntax or meaning.

Similarly, just as I remember a different life before depression flattened me, many of us remember a different life before our current political regime began normalizing hate.

Now that white supremacists are in charge, they believe that order can be restored by returning anyone who doesn’t fit their norm to their respective sub-human category, ranging from most similar and tolerable (healthy, able-bodied straight American-born Christian white women) to most different and undesirable (anyone else). Plainly put, many of us are now regarded as inferior, as lesser than, based on national origin, immigration status, religion, sexual orientation, skin tone, reproductive choices, physical and mental abilities, etc.

Our leadership would like us to believe that this hierarchy is “normal” — but it is not.

That we should have the audacity to define our own identities and demand equality — because America was founded on the basis of all people being created equal— is to invite shaming, if not mockery.

With depression, too, shaming wields great destructive power.

When depression became larger than life itself, it bullied me into identifying with it. The illness kept me under house arrest, stewing in shame because I couldn’t work, and therefore I couldn’t afford to consume health care and get well enough to work, a conundrum familiar to many sick Americans.

In the eyes of a staunchly individualistic society like ours, in which we’re always supposed to win, to achieve, I didn’t pass muster. I failed to measure up, I was weak, a “ridiculous loser.” Depression also built a wall around me to keep out other humans, chipping away at my self-esteem and declaring isolation as the new normal.

Under such conditions, staying alive — that is to say, performing the most basic human functions required to do so — becomes the greatest act of resistance you’re capable of.

Trite though it may sound, “While there’s life, there’s hope,” and your making it through each brand new day is proof of this.

In America, we’ve now got a Muslim ban, and soon we’ll even have a border wall to keep out other fellow humans. Those of us who refuse to fall in line with the regime are constantly being othered, divided, derided, debased — and yet we keep coming together regardless because we remember life before.

Do not ever discount the hope of better days buried deep inside you. As the intellectual ability to envisage alternatives to what is, hope is one of the most powerful weapons of all.

The modus operandi of the illness and that of the new regime are one and the same: to break you down little by little by destroying your critical faculties until you no longer protest, until you abdicate your own agency and trust them to do what’s in your best interests.

Like protecting you.

Like providing for you.

For the record, here’s what depression did for me — for over three years, it took away my ability to think and write so I could no longer earn a living, convincing me I’d become unemployable and forcing innumerable hardships onto my household.

My downfall was gradual and contradicted everything in my life at the time. On the surface, everything was great — love, marriage, immigration to a new country, a fresh start — but depression took hold regardless because deflecting torrents of abuse and lies is unsustainable in the long run.

It’s exhausting, and it wears you down.

Whether the lies are manufactured by your own mind or your own government, the desired end result is the same: capitulation.

The enemy thrives on confusion.

But remember that the impact of depression can be lessened, as can that of a fascist regime, so long as you resist them.

Your one job is to keep yourself — and the hope contained within you — alive, which has the added benefit of inconveniencing those fascism enablers who may bully you for being a “snowflake.” If you feel up to it or just fancy a laugh, remind them that one of the collective nouns for snowflakes is an avalanche.

Little do they know that depression has made you a veteran of resistance.

National Suicide Prevention Lifeline: 1–800–273-TALK

Read more at The Establishment, and follow us on Facebook and Twitter

 

Butter is actually good for you

February 13, 2017

A team of medical researchers have some good news for those who cook with butter but consider it a guilty pleasure: It might actually be good for you.

While the findings, published this week in the British Medical Journal, are not conclusive, they are compelling: researchers with the University of North Carolina’s School of Medicine (UNC) analyzed a 50-year-old unpublished study out of Minnesota and found reason to believe that cooking with corn oil instead of butter may actually be worse for heart health. It’s an idea that, if one day proven, would upend the conventional nutrition wisdom of the last several decades.

In the last year, a growing number of voices within the nutrition community have been making the case that low-processed fatty foods aren’t as bad for you as once thought. It’s an argument that has shown up in studies from around the world and also in articles challenging national policy decisions based on the idea that fat should be avoided.

In the case of butter versus vegetable oil, the UNC team analyzed unpublished nutritional data gathered between 1968 and 1973 in a controlled study that included more than 9,400 men and women in one nursing home and six state mental hospitals in Minnesota.

The subjects were broken into two groups. One was given a diet in which liquid corn oil was used in place of usual hospital cooking fats (including butter and hydrogenated oils) during meal preparation. The other group received meals cooked with common margarines and shortening. Roughly 57% of the 517 subjects that died during the course of the study underwent post-mortem examinations of their hearts, aortas, and brains. But no analysis of the data had been published until now.

After a review of available data, the UNC researchers determined that, overall, there was a 22% higher risk of death for participants on the vegetable oil diet. They argue that because an analysis of the study was never published, nutrition experts have over-emphasized the health benefits of substituting vegetable oils for butter.

To be sure, debate within the nutrition science community over the pros and cons of cooking with and consuming fats has been robust. Many studies have found cutting out butter and using more vegetable oil to be beneficial, but very few of those have included data from controlled trials—nutrition science can be difficult to carry out because of ethical considerations of testing diets on humans.

“Altogether, this research leads us to conclude that incomplete publication of important data has contributed to the overestimation of benefits—and the underestimation of potential risks—of replacing saturated fat with vegetable oils rich in linoleic acid,” said Daisy Zamora, one of the UNC researchers.

There’s a growing body of evidence that butter is actually good for you

Sanders ditches “political revolution” in Obamacare debate with Ted Cruz

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By Kate Randall
10 February 2017

Tuesday night’s CNN debate on Obamacare between Vermont Senator Bernie Sanders and Texas Republican Senator Ted Cruz was an exercise in cynicism and evasion.

The most notable feature of the event was the performance of Sanders. Where was the champion of the “99 percent” who railed against the “billionaire class” during the Democratic primary contest? Where was the “democratic socialist” who called for a “political revolution?”

That Sanders was nowhere to be found. He was replaced by a more “reasonable” politician who is more than willing to work with the Trump administration and the Republicans to refashion the Affordable Care Act, keeping its “good” features and revising its problematic ones.

The fact that Sanders even agreed to debate Cruz—an ultra-right Tea Party Republican who stands for a scorched-earth approach to health care and all other social programs—points to an effort to present him as a more “mainstream” politician and integrate him into the leadership of the Democratic Party. The hope is that popular illusions in Sanders that remain from his challenge to Hillary Clinton can be utilized to restore credibility to the Democrats following their electoral debacle. Sanders, who used his campaign to channel mass discontent behind Clinton, is himself fully onboard and highly conscious of his role.

There was nothing genuinely progressive in what Sanders had to propose for reforming the health care system or confronting the health insurance crisis faced by a majority of Americans. As for Cruz, he in turn insulted and patronized questioners from the audience, while dancing around issues as he spouted his pro-corporate, free-market agenda.

Sanders’ job was to allude to the excesses of the for-profit health care industry while offering only the vaguest palliatives as an alternative. After saying that if Obama’s Affordable Care Act (ACA) is repealed, people with cancer, diabetes and other conditions will be charged more or denied coverage, he added, “That’s the function of private insurance.”

He failed to mention that Obamacare is based on and tailored to the interests of the private insurance companies. Its so-called “individual mandate” requires uninsured people to purchase coverage from for-profit insurers or pay a penalty. Sanders never questioned the ACA’s reliance on the private market during the debate.

It was left to Cruz to point out that under the ACA, the profits of the 10 largest health insurers had doubled, to $15 billion. To which Sanders responded: “I find myself in agreement with Ted. He’s right. The function of insurance companies is not to provide quality health care to all people. It’s to make as much money as they possibly can.”

Sanders immediately exposed the unseriousness of his rhetorical attacks on the insurance giants by appealing to the arch-reactionary Cruz to “work together on a Medicare for All single-payer program.”

The WSWS has analyzed in detail Sanders’ “Medicare for All” proposal. It has nothing in common with socialism or socialized medicine. Nowhere in his plan does Sanders propose to expropriate the multibillion-dollar health insurance companies, pharmaceutical firms and health care chains. He knows, moreover, that the health care industry will never voluntarily accept any restraints on its profits.

On the cost of health care, Cruz made the ludicrous claim that Americans pay more for health care than countries such as Canada and the UK with government-run health systems, which he falsely labeled socialized medicine, because, “We get a lot more and a lot better health care.” There is a mountain of factual evidence to the contrary, including a recent survey of adults in 11 advanced countries that placed the United States dead last in access to medical care and affordability.

Cruz also pointed to long wait times for procedures in other countries, which he described as rationing. He ignored the reality that in countries such as the UK, government funding for medical care is being cut at the same time the system is being increasingly privatized, leading to deteriorating care.

Sanders countered: “We have enormous rationing in this country. When you have 28 million people who have no health insurance, that’s rationing.” As a solution, he suggested that a “Medicare-care like public option” be offered on all of the Obamacare insurance exchanges, which would “provide real competition to the private sector.” But, as he well knows, the political establishment, including the Democratic Party, has repeatedly rejected even the fig leaf of a “public option.”

The words “working class” left the lips of the Vermont Senator only once over the course of the hour-and-a-half event. He said of health care in the US: “The way we do rationing is, if you are very rich, you can get the best health care in the world. I believe, right here in the United States. We should be proud of that.

“But if you are working class, you are going to be having a very difficult time affording the outrageous cost of health care.” He added: “Every single year, tens of thousands of our fellow Americans die because they don’t go to the doctor when they should,” and people give as the reason: “I didn’t have any insurance” or “My deductible was so high. I couldn’t go.”

This is indeed the brutal reality of health care in 21st century America. But neither the Affordable Care Act, nor its repeal and replacement by the Republicans, with the collaboration of Sanders and the Democrats, is going to change this state of affairs.

On the contrary, what is coming is an all-out assault on the existing health care programs Medicaid and Medicare. Carol, a woman in the audience suffering from multiple sclerosis, asked Cruz: “Senator Cruz, can you promise me that you and Republican leaders in Congress will have a replacement plan in place for people like me who depend on their Medicaid?”

To which Cruz replied: “Medicaid is a profoundly troubled program … we should have a system that allows as many people as possible to be on the private health insurance of your choice rather than Medicaid, because the Medicaid outcomes are not working and people are suffering.”

In other words, good luck with your struggle with multiple sclerosis, but Medicaid should be junked and the private insurance market allowed to work its magic. Cruz got to the heart of his agenda later in the program, saying: “I want a simple flat tax of 10 percent for everyone and to abolish the IRS. That ends the power of the lobbyists. It ends the power of Washington. That’s a solution that empowers the people.”

Such a regressive tax would deepen the chasm between rich and poor and lead to the gutting of health care and other vital social programs.

Trump’s secretary of Health and Human Services, Tom Price, favors block-granting of Medicaid and privatization of Medicare, the government insurance program for seniors and the disabled that covers some 55 million people.

The Democratic Party has vowed to work with Trump and his administration when they see “common ground.” In the realm of health care, that means maintaining the grip of the for-profit health care industry at the expense of the health and lives of the working class.

What Sanders offered up Tuesday night had nothing to do with “socialism” or fighting the for-profit health care industry. A genuine socialist solution to the health care crisis means nationalizing the giant insurers, drug companies and health chains, expropriating their wealth, and placing health care under the democratic control of a workers’ government.

http://www.wsws.org/en/articles/2017/02/10/obam-f10.html

The Psychology of Fascism

Fear of Father and Fear of Freedom

We  suppose that fascism is a product of a poisoned heart, of hate. That is not really true. Fascism is a product of mind. Immature and stunted mind, that can’t find a way to grow. The fascist mind, I will suggest, is caught in a trap — between fear of a father figure and fear of freedom.

Our first thought is “I”. As we grow, we learn this is a table, this is a chair, and so on. This first requires the thought: I am not that. We learn to separate the world into subject and object.

But not all objects are created equal: some are desirable, prizes, and some are undesirable, threats. As we mature, we become able to to learn the relationship of the “I” to the elements of the world. We think this is appropriate, that is not appropriate, this is desirable, that is undesirable, and so on. For most of us, maturity ends here. We are safe — but now lack meaning in our lives because we never take the next, and most significant step: learning to outgrow the “I” altogether. When we learn to become selfless — not in a small way, but in a real one. Not with little acts of charity, but to feel our emotions and express our feelings, so we can have genuine relationships, give and contribute to the world whole-heartedly, and so on. Genuine maturity is learning that “I” is a limiting way of being in the world.

Now let us come back to fascism. What happens in fascism? The “I” never fully develops at all. Instead of growing into and then through the “I”, the fascist identifies with a father figure. He subsumes his identity, his emotions, his needs, his appetites — everything — in that father figure.

Why does he need to? Because the fascist is profoundly insecure. He is afraid, somehow, of the act of living, of freedom itself. There is a threat out there, a menace, a poison, which outweighs freedom itself. No mind can abide that kind of all pervading insecurity. He must either bury it, which takes constant work and energy. Or he can simply alleviate it through obedience to the father figure. If father says it, then we must do it — that is how everything will be alright again.

That brings us to the first conclusion. You will never convince fascists that they are wrong. Not with reason, facts, logic, or evidence. You cannot. They have replaced inner morality with obedience to begin with. There is no right and wrong for the immature mind of a fascist — there is only obedience and disobedience, only safety and danger. Hence, “fake news” being so credulously spread. Obedience is how they maintain their sense of security, and more importantly, sanity. They have sacrificed their moral and intellectual agency, so how can you appeal to it?

The fascist’s bond with the father figure is the bond of the child with the parent. In many ways, it is even greater — the child ougrows the parent, he learns and plays and rebels. But the fascist doesn’t. The fascist has identified with the father figure to the point that the father figure is the fascist — his spirit, his heart, his will.

That brings me to my second conclusion. The bond between a fascist and a father figure is even stronger than that of a parent with a child. It is not a superficial bond, like the bond of, say, a coach and an athlete, or a patient and a shrink. It is a bond that is too powerful. The fascist, throughout history, has been obedient to a point that it is incomprehensible to us. He will sacrifice himself — the Kamikazes. He will offer up his family — the Nazis. He will destroy everything that a sane person holds sacred, simply for the soothing caress of the father. Most of us would not do these things if our parents asked us, would we?

Why not? Because our moral agency, our consciences — and at last, our instincts for self-preservation — would kick in. Those do not exist in fascists. That is what a fear of freedom really means: you are willing even to give up on self preservation, which, of course, is an essential part of being a self. That is my second conclusion.

Where did they go? Remember the “I”? Our greatest drive in this life isn’t to satisfy the I. But to extinguish it. That’s why chase sex, money, power, and so on. How does the fascist extinguish the “I”? Through the “we”. The fascist loses the boundaries of the self by identifying his whole being with the father figure. That is how he satisfies his drive for transcendence. That is why the bond between the fascist and the father figure is so strong that it defies reason, logic, facts, evidence, argument. How strong is it? So strong that it has broken even the instinct for self-preservation in the fascist.

A mature mind does none of this. It seeks healthy ways to extinguish the I. Healthy means: ways that do not damage any life, including the thinker’s. What are some healthy ways? You commune with nature, you have a child, you read great books, you rise and fall and laugh, and so on. In these ways, we mature by learning the limits of the “I”. As we gain empathy, compassion, forgiveness, mercy, imagination, so we learn how to love. In that way, maturity is the constant act of becoming a more loving person.

But the fascist is stuck. He has regressed to an infantile state, and there he stays. His immature mind does not learn how to become a more loving person. It refuses and rejects the challenge. It simply transfers its anxiety and fear to the father figure, who, in exchange, soothes and calms it. The price is obedience, not freedom, which is the precondition of love.

Father can always withdraw that soothing. The existential fear can return at a moment’s notice. And so father has total control over the fascist. The fascists is caught in a trap — between fear of father, and fear of freedom.

Now the question is: why does all this come to be? Why doesn’t the fascist mature? That is the greatest question of all. Let me answer this in an oblique way.

The presentation of logic and facts seems to have the opposite effect that we intend, doesn’t it? It causes the fascist to grow more attached to the father figure, not less. But that much is obvious: if I come along and tell you, a child, that your parents, the source of your strength and safety, are bad people, you will instantly despise me, and cling to them all the more. Why? I am a threat to the very safety that you value.

That holds a very deep truth about fascism, which is my third conclusion. The fascist is traumatized, and that is why he cannot mature. Only if you were traumatized would you be willing to give up your whole being for safety. Why? Because the threat you are afraid of must be existential, absolute, total. It must be worse than hell if you are willing to give up living. The fascist has regressed to an infantile state — and that infant is himself stunted. He is not just “child-like”. In all the ways that count, the fascist is like a traumatized child. He is ever playing back in his head the reel, real or imaginary, of an existential injury, whichis leaving him paralyzed, enraged, broken, stuck.

The fascist does not mature because he is like a traumatized child who is constantly guarding against the threat of reliving his greatest fear, through obedience to the father figure. Remember, the fascist has no self-preservation instinct. He will sacrifice everything for the father. He is willing to give up the limits of his possibility for a moment of safety. Only the thought of an injury of the deepest kind could produce that fruitless exchange. Hence, when the father figure comes along and offers to soothe it, the fascist desperately sacrifices his whole self for that.

But the flip side is also true, which is my fourth conclusion. There has never been a way in which the fascist has learned to see the “I” in anyone else. The faculties of empathy, curiosity, creativity, compassion have never developed, because the threat of insecurity is total. That is what sacrificing safety for possibility really means: the fascist has never grown as a person, is stuck in the mode of a traumatized child, and as long as the bond between the fascist and the father is the truest thing in his life, he never can.

That brings us my last conclusion. To truly undo fascism, a society must unravel the bond between the fascist and the father figure. Unravel — not break. You can’t break such a bond. If someone comes along and hurts your father, you will only hate them for it. So trying to forcibly sever the bond between fascist and father is an oxymoron. Even if it succeeds, the fascist will stay a fascist, even more susceptible to another father figure.

There is only one way, in the end. Somehow, a society must offer the fascists the safety they are really seeking. No, of course: that doesn’t mean “be nice to fascists”. But it does mean that trying to break the bond of the parent with the hurt child is a waste of time. The only thing that can really break is it, if there is anything at all, another parent. A better one. One that offers not just safety for obedience, at the price of possibility. But who can offer safety from such a desperate need for safety in the first place.

Umair
February 2017

https://umairhaque.com/the-psychology-of-fascism-118c6e7d60fc#.k5ikdxdzy

Intolerant Liberals

“There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that ‘my ignorance is just as good as your knowledge.” ― Isaac Asimov

So Nicholas Christof, whom I am fond of, recently wrote an article that argues that Liberals are intolerant because there aren’t many Christians or conservatives teaching in universities. There is so much to be exhausted about right now, but this article connects too much with several thoughts that have been swirling around in my soul.

They mostly have to do with false equivalency. And relativism. And gas lighting.

Growing up as a conservative Christian, I was warned about secular, liberal relativism. Nothing’s really bad, who knows, it’s all relative. We had to be careful about such slippery slopes. After the gays got us to buy into such poor logic, then would come the goats, then the children, then the Satan worship would follow. But it turns out that this sort of relativism is entirely a myth of the right. The only people who ever try to implore relative logic (at this sort of crass level) are conservatives. Trying to play “gotcha” with liberals. And it’s exhausting.

I have some difficult news for everyone: Progressives aren’t interested in diversity. We aren’t interested in inclusion. We aren’t interested in tolerance. The progressives I know give exactly zero shits about those things.

We have no interest in everyone getting treated the same. We have no interest in giving all ideas equal airtime. We have no interest in “tolerating” all beliefs. I don’t know where this fairy tale comes from, but it’s completely disconnected from every experience I’ve had with progressive liberal folks in my lifetime.

When conservatives cross their arms and glare and shout “It’s not fair! You’re supposed to welcome everyone but you aren’t being nice to me!” it stings about as much as if they shouted, “It’s not fair, you’re supposed to be wearing tutus and juggling flaming donuts!”

The progressive liberal agenda isn’t about being nice. It’s about confronting evil, violence, trauma, and death. It’s about acknowledging the ways systemic power, systemic oppression, systemic evil, work in our world around us. I’m not fighting for diversity. I’m not fighting for tolerance. I’m fighting to overturn horrific systems of dehumanizing oppression.

Here’s a great example of a liberal relationship to diversity: when Ruth Bader Ginsburg was asked how many women on the Supreme Court would be enough, she answered “When there are nine.” In response to the collective gasp of every conservative on earth, she elaborated. “For most of the country’s history, there were nine and they were all men. Nobody thought that was strange.”

Personally I’m not interested in a female president for the sake of “diversity.” Putting a woman in the white house in 2020 won’t mean that gender equality has arrived. We’ve had 43 presidents. It’s going to take 43 women serving as president before we even have a chance to reach parity.

Do you get it now?

If you want to pretend that the racial and gender horror in the world has already been righted, was righted in the 1960’s, is almost righted now, or can hope to come close to being righted in your lifetime (43 female presidents), you’re not getting the picture. We have a collective buildup of hundreds (thousands) of years of injustice to metabolize.

What We’re Actually Confronting

Take a few facts on race. White America is exhausted of Blacks invoking 200-year-old history as an excuse for their problems. They’ve had it just like whites since the Emancipation Proclamation. Or since MLK. Or since Obama made it into office.

Let’s pause on this. I live in Seattle, Washington. A liberal city if there ever was one. Full of cheery whites with “Black Lives Matter” signs in their windows. But in Seattle, Washington, black residents make less money than white ones. 5% less, 10% less? No. The average black Seattlite’s income is less than half of the average white Seattleite’s income.

Less than half.

So, either there are unspoken forces at play that make it twice as hard for black people in Seattle to earn money, or black people are exactly half as intelligent and hard-working as white folks. Take your pick. But be honest about which one you’re choosing.

How’s the country as a whole? Well, on average, white families have more wealth than black families. How much more? Is it 200%, like Seattle’s income disparity? 500%. No. White families in the US, on average have 1700% the wealth of black families.

How much progress have we made on racial equality in America? Well, apparently we’re 1/17 of the way there. Only 16/17 more to go.

I have a four-year-old white son. A black boy his age, in the same income bracket, same level of education, will live, on-average, 5 years less than him. Half a decade. Mysteriously.

That same black boy has a higher chance of spending time in prison than my son. How much higher? 110% the rate? 150% the rate? Nope, 500% as likely to be imprisoned.

Empowering the Oppressed

So am I worried that not enough Christian professors are getting hired at universities?

No.

Every single president of this country has been a Christian. Every. Single. President. Barack Obama’s presidency now means that it’s about 20 times easier to become president if you’re white than black. But it’s still infinitely easier to be president of the United States if you’re a Christian. 92% of the House and Senate are Christians. Try throwing a rock in either building and not hitting a Christian.

When your religion is represented by every President in history, and 92% of the governing body that rules your land, I’d say you’re doing okay in the whole representation thing. When conservative politicians have control of the White House, Senate, House, of the country with the most economic and military power in the history of our planet, I think crying ‘persecution’ of conservatives might be suspect.

But crying ‘persecution’ is what conservatives do with every single step towards gender equality, racial equality, any movement that seeks to treat all humans with the same dignity currently conferred on white men. The conservatives’ definition of a war on their rights is that gay people are allowed to get married and Latinx people are allowed to live in the same zip code. The false equivalency of straight white Christen men’s feelings with everyone else’s lives is absurd.

Poor Nazi soldiers, getting rounded up into prisoner of war camps while those Jewish people are getting let out of prisons by the same Allied soldiers! Jewish people get all the preferential treatment…

Furthermore, conservative Christians have allied themselves with racism, misogyny, homophobia, Islamophobia, mass incarceration, war crimes, death sentences, and gun culture. These Christians work actively to undermine scientific thinking. Anti-evolution, anti-global warming, anti-intellectual, and anti-factual. None of these line up with the values most universities share.

Yes, it’s important to intellectual growth to have variety. It’s important that unpopular ideas get a hearing. It’s important for there to be debate, and changes of heart, and to allow sincere disagreements to continue to wrestle with one another for clarification. I have no interest in our universities being populated by people who think like me. But I do have an interest in them being populated with people who think.

All world views are not inherently equal. Conservative thinking is, by definition, bent on conserving the status quo. It is often regressive. A shrinking, a backward movement, a return to previous points in cultural, political, and intellectual development.

Universities aren’t bereft of conservatives and Evangelicals because of a vast left-wing conspiracy. They’re bereft of those people because people committed to those world views so rarely have anything to offer to an open-minded, inquiring, growing community. Universities are lacking in conservatives and fundamentalist Christians because the amount of education that it takes to become a professor is likely to expose Evangelicals and conservatives to enough good ideas that they’re no longer fundamentalist or conservative.

The fact that humanities departments are exceptionally lacking in conservatives and dogmatically religious people highlights this reality. Psychology, poetry, sociology, political science. People who have wrestled with the human condition, the human soul, literature and art, are the least likely to give credence to backwards ideas that are diminishing to human value and human dignity.

The Left’s Double Standard

When liberals storm the cities’ streets to protest, rally, and yes, riot, in response to a Trump election, conservatives cry foul. They cry double-standard. Liberals expect conservatives to accept election results they don’t like; why won’t the liberals accept election results that didn’t go in their favor? Why won’t the liberals be relativists, like we want them to be, and treat all outcomes as equally valid?

Because all political decisions aren’t equally right. Aren’t equally moral. Aren’t equally recognizing of human dignity and justice and freedom. Because liberals recognize that there are wrong and right decisions, because they parse good and evil, contrary to what my church taught me about them.

Because democracy isn’t the only value we hold. We don’t accept the 51% enslaving the 49% by popular vote. We believe in human rights. We believe in the Bill of Rights. Because we balance the will of the people with the sanctity of each individual life. And no, your right to not sell flowers doesn’t outweigh someone else’s right to get married. Because not all rights are equal.

Because Hitler was brought to power by a democratically elected government. Because American slavery was legal.

The Right is also willing to confront the government with action more direct than voting, holing themselves up with assault rifles to maintain unpaid access to grazing on public lands, or just because the government might seize those assault rifles. If the government takes our guns, we’ll have no way of stopping the government from taking our guns!

The Left meanwhile is roaring in the streets about the countless deaths of unarmed black Americans by the people charged with keeping them safe. Roaring in the streets about environmental devastation that the smartest humans among us agree poses a threat to all human life. Roaring in the streets about an admitted sexual predator being appointed as administer over our nation’s federal law enforcement.

Conservatives not having taken to the streets to riot when Obama was elected doesn’t prevent us from taking to the streets to direct as much resistance to Trump as humanly possible. Because Trump and Obama aren’t equal. Conservatives being deeply outraged and fearful when Obama was elected doesn’t negate or somehow counterbalance the outrage and fear on the Left right now. Because the Right was afraid of ridiculous, imagined fantasies of end times persecution and wildly inaccurate information. When the primary source of terror in living under an Obama administration is that he’s a Muslim, you don’t have one ounce of sympathy from me.

Meanwhile the Left is dealing with Donald Trump’s actually announced plans. To commit war crimes. To imprison his political opponents. Compel a religious minority to register themselves. To gut the First, Fourth, Fifth, and Eighth Amendments. Donald Trump is actually appointing white nationalists to top positions. Actually sexually assaulting women. He’s a man who openly admires the most despotic regimes in the world. His vice president has actually worked to jail homosexuals for applying for a marriage license. Actually worked to redirect HIV treatment funding to Pray-The-Gay-Away™ conversion therapy.

But I have a right to my opinion!

Trump calls Mexicans rapists, liberals call Trump racist. The Right jumps in to defend poor Trump from liberal slanderers. Conservatives want to cry Free speech! Free speech! Forgetting that your right to swing your fist ends at your neighbor’s nose. Forgetting that shouting ‘Fire!’ in a crowded theater is both illegal and immoral.

Hillary Clinton thought Trump’s supporters were “racist, sexist, homophobic, xenophobic, Islamaphobic.” Trump can’t believe Clinton would “attack, slander, smear, demean” those people with those comments. Well, I guess it’s a deadlock. There’s a 50/50 chance that either’s comments are actually harmful. Or Trump may be bad, but Hillary is bad too, don’t forget. She called racism, sexism, homophobia, xenophobia, and Islamophobia “deplorable.” Trump supporters might be racist, but at least they aren’t calling anyone racist.

Trump says we’re in the middle of a crime wave! I say crime’s the lowest it’s been in decades. Well darn. Back to that 50/50 chance either of us is right. We may never know.

Trump says undocumented immigrants are dangerous! I say they’re more law-abiding than citizens. Trump says they’re destroying our economy! I say they’re a benefit to our economy.

We’ll just have to agree to disagree. Because there’s no way to establish concrete facts or objective reality. Shucks.

This exactly the shoddy relativistic thinking my church warned me about growing up Ω


Postscript: I’m a straight white, male. I have a Master of Divinity from an Evangelical Christian seminary. I voted for W both times. I’m speaking from experience. And of course I have dear friends who are exceptions to my critique of Evangelical Christianity. And yes I am deeply, painfully aware of the Left’s failures. Of Hillary’s disappointing limitations. But the overall movement for dismantling kyriarchy, for human dignity, for restorative justice, is so stifled by so much bullshit misdirection and gaslighting.

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