EASTSIDER-Both political parties have been running the other way over the issue of healthcare for all, whatever flavor you choose to talk about.
The Republicans call it “socialist” (BAD). The Democratic establishment calls it “left” (BAD). Too bad, since now that we have COVID-19, turns out that it would have been our savior (GOOD).
I have spent a large part of my professional life negotiating private/public sector union contracts (including healthcare), mediating those contracts, and these days serving as a factfinder between the parties with healthcare invariably a major sticking point.
At the detail level, healthcare issues get incredibly complex, be they administered by a union trust fund or contracted out to one or more healthcare service providers. Let me give you two basic simple issues, without getting too technical.
First, the contractual healthcare provisions are only good for the life of the contract, which is typically three years. After that, everything is back up for grabs during the next negotiations.
Second, while employee healthcare is the big issue at the table, healthcare benefits for retirees are also up for grabs every time, since retiree benefits are a mandatory subject of bargaining on behalf of the current employees. That means that as a practical matter the retirees themselves have no place at the bargaining table and are ineligible to vote on any contract settlement.
These days, more and more unionized healthcare negotiations consist of a balancing act trying to keep their existing retiree benefits while struggling to get any overall increases in wages at all. To be fair, healthcare cost increases are not trivial and always are going up.
Of course, in the nonunion sector it’s all simple. The employer can change current and/or retiree medical benefits any time they want. And they do.
Health Insurance Back on the Table
Now that Elizabeth Warren has been taken out by a combination of the news media talking heads and the Democratic establishment, and Bernie is barely hanging on by a thread (or may suspend his campaign), comes a real life example of why they are right on the issue of ensuring that all Americans have health care. . .
The Coronavirus (COVID-19) Pandemic, has totally exposed all the built-in holes in our private healthcare system, even as it melts down. The real, factual truth is that the meltdown occurs because our private healthcare system will not authorize treatment, tests, and care until they know “who is going to pay?” After all, they are for profit corporations, and their duty is to their shareholders.
And apparently, even if someone (like the federal government) woke up today and turned on the tap, we would still be screwed because the difference between the patient load and what the current health system can handle does not provide enough slack to meet much of a patient load increase when there’s a crisis. Even if Daddy Warbucks, which Donald Trump is not, turned the federal money spigot on for the people at the bottom of the economic ladder, it’s already too late to simply stop the virus with a vaccine. There is none.
Capitalist efficiencies, of course -- why build a lot of excess capacity and warehouse a bunch of supplies that must be paid for? Where’s the profit in that? Even as the White House (appropriately named at the moment) refuses to step up in a timely way.
Well gee, just maybe we are living through the answer as to why Medicare for All is a big deal. The existing system is so complex both in terms of entities and payment systems, as well as exclusions and gaps, that a true medical crisis is enough to crash it, as well as the financial system, and tank the stock market to the tune of 20 or 30%.
Not to mention disrupting the life of almost every American, as people are barred from both working and congregating in any number. Zap, a zillion jobs are lost, and god knows how devastating the crisis will become for you and me in terms of both our health and our economic lives.
So, finally it is becoming clear that the Trump Administration, having gotten rid of all those expensive Administration jobs like Pandemic Preparedness, have absolutely no idea what they are talking about, and every time they pop up on TV it becomes apparent that their only refuge is to lie, lie, lie.
An Extraordinary Event
On Friday, March 13, 2020, I witnessed a truly extraordinary event. The President of the United States, under the cloak of a “National Emergency,” announced the sale of our Country to a preselected group of private sector corporations, no doubt selected based on enriching the family fortunes of Donald Trump and family. Google and other tech companies are to do a website portal, as well as partner with large corporations like Walmart, Target, Walgreens, CVS and the like to help with the testing.
Of course, later on it turned out that the promises were incoherent and mostly untrue, but there it was. My personal favorite was that the Energy Department will purchase a bunch of crude oil from the Strategic Petroleum Reserve. Just as the price of crude oil has gone from around $50+ per barrel down to less than $30. I’m still trying to figure out the link between helping the frackers and a virus pandemic, but there you are.
And yet later when the Administration declared a National Emergency, he basically has unfettered powers to do what the heck he wants to do -- just like he has prayed for ever since taking office.
The Real Issue
The Pandemic has exposed something that just wasn’t talked about regarding our private healthcare system -- it is totally inadequate under stress and assumes that something like 20% of our population will not have access to it.
After all, as private businesses are interested in making a profit, the disparate pieces of the system have no interest in massively overbuilding systems capacity; it would cost them too much. So, it appears that now, as we are under stress from the virus, there is only something like a 20% margin between ICU capacity and system overload.
To be blunt, the private healthcare system is failing because it is designed for profit, not for growing a capacity to handle major dislocations such as a pandemic -- or for that matter, a sudden big spike in acute care patient load, including all the expenses involved with isolation and big time equipment.
Whether you call it Medicare for All, Obamacare Plus, Obamacare if you want it, or “oh sure you can have private insurance if you want,” Sanders and Warren have demonstrated that we currently have a health care system that excludes a significant chunk of the population, and that the “private insurance” industry will simply not now or ever cover everything for members, even as you lose that insurance if and when your job goes bye-bye.
Anyhow, it is apparent that there will be an election between the reincarnation of P.T. Barnum (“The Greatest Show on Earth”) Donald Trump, and everyone’s “Uncle Joe” Biden, representing a return to “normalcy.”
Either way, watch carefully between now and November. It’s clear that the financial services industry will get the real bailouts, not you or me. And track the chaos of our private healthcare system as it melts down in the face of this killer virus. See just how quick and nimble the political establishment really is to meet this medical challenge.
Then remember, there was a fundamental choice once upon a time, and before there is another healthcare crisis, think back and reconsider the advantages of a political system which provides healthcare for all.
Just sayin’. . .
(Tony Butka is an Eastside community activist, who has served on a neighborhood council, has a background in government and is a contributor to CityWatch.) Photo: AFP via Getty Images. Edited for CityWatch by Linda Abrams.