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Time Has Come for Single-Payer Universal Health Care System
With the inauguration festivities of the 44th president behind us, it is now time to look for change, the promise of which helped elevate Barack Obama to the highest office in the land. Change is needed, as the voters have declared in last year's election, and it is needed perhaps most urgently by the 47 million Americans living without health insurance in the greatest and wealthiest country in the world.
We need not listen too closely to hear the cry for real change in our health care system, for each year the number of voices calling for change grows in number and volume. U.S. Census Bureau figures show the number of uninsured Americans has grown each year for the past six years, and that in 2006 alone, 2.2 million citizens added their voices to that call for change. Right now, approximately 16 percent of our population is without insurance, and if we hold to the status quo and stay the current course, that number will increase dramatically in 2009, just as it did in 2008 and in 2007.
When considering the varying health care systems of the world and their resulting health outcomes, the United States has been ranked 39th among nations by the World Health Organization. To many of us it seems obvious that America's health care system is nothing short of an embarrassment: an old, failed relic, broken beyond repair. Yet as millions of Americans continue to suffer solely based upon their lack of health coverage, there are still those who wish to tighten their grip on our failing profit-driven system.
There are alternatives to a health care system that allows insurers to realize unprecedented profit and enforce extraordinary premiums, all the while labeling more and more individuals unprofitable and therefore uninsurable. There are models of health care systems proven time and again to be much more successful in health care outcomes than ours. But these models do not embrace a profit motive, and in fact spurn the idea of capitalizing on our unhealthy mothers, fathers, brothers, sisters and, most of all, children. Therefore, it is no surprise such models are vilified by the mega-capitalists among us.
The solution is a complete paradigm shift away from a profit- driven model in the health care sector to a single-payer system. The trail leading us to this solution has already been blazed, and America is ready to take the first step. Public opinion polls show upward of 68 percent of citizens support such a shift, while 51 percent of American physicians are in favor of implementation of a single-payer system.
Proposals have been drafted, including the much-discussed plan by the Physicians' Working Group for Single-Payer National Health Insurance and U.S. Rep. John Conyers' United States National Health Insurance Act (H.R. 676).
The wheel need not be reinvented, but a simple step forward must be taken.
The benefits are many and widespread. Immediately upon implementation, the number of uninsured men, women and children in Indiana alone would drop from an estimated 871,000 to zero. Nationally, the seemingly ever-increasing number of 47 million uninsured Americans would finally drop to the number our collective moral conscience should demand: zero. The health of our citizens would increase drastically, as all would finally be able to care for their health. The choice of provider would be taken out of the hands of the insurer and returned to its rightful owner - the individual. Health and well-being would trump profit, and in an economy where job certainty is floundering, the certainty of health coverage will not.
The time has come to take that long-overdue progressive step forward and implement a single-payer universal health care model in America. The time has come for our leaders to ensure that no citizen is ever again added to the list of those who have died due to a lack of health coverage, a list that adds 18,000 names each year, according to the Institute of Medicine. The administration of hope and change is in place, and therefore the question must be asked: If not finally this administration, then who? And if not now, when?
- Posted in
74 Comments so far
Show AllIt may be interesting to some that this article is published on the same day that Obama, in a completely unnecessary gesture of "bipartisan" chickenshittery, cuts out funding for family planning for the poor from the 825 billion recession recovery plan. It may be interesting to some others, who bother to take notice, of the incredible welfare handouts being transferred from struggling middle class taxpayers to the rich that have been left in.
Why shouldn't every American be entitled to the same health care as members of Congress? After all, they are suppose to work for us. I guess that makes us pretty stupid!
It is annoying to see John Conyers name mentioned with regards to this legislation. He is nothing but a ruse to deceive the millions of Americans supporting single payer. This bill will not even be considered in a committee he is a member.
He is Chair of the Judiciary! On matters of legislation that he does have real power to move forward he bows to the dictates of Nancy Pelosi. He publicly supported the impeachment bill during this past Congress, yet the bill did not make it out of sub-committee even though there were enough votes to move the legislation forward: Artur Davis – Alabama's 7th, Keith Ellison – Minnesota's 5th, John Conyers – Michigan's 14th, Robert Scott – Virginia's 3rd, Mel Watt – North Carolina's 12th.
Pelosi and Daschle won't even discuss Single Payer. Instead they use decoys like Conyers to ignore real health care reform.
"Time Has Come for Single-Payer Universal Health Care System"
I think this statement is all that needs to be said about health care in our country. Any other discussion is superfulous. The time is now, the place is the United States of America.
Real health care for every citizen of our country.
And what about those 3-5 million jobs in the healthcare and insurance industries? See my detailed comment and let me know because while I love the idea single payer, I'm not so sure it will come easy once you consider the 3-5 million jobs that are at stake.
Terrance Mitchell
Redfield, South Dakota
I'm afraid those jobs in the insurance industry will just have to be sacrificed. It won't come easy because the insurance companies make a great profit from it. They are the ones that started denying coverage to increase their profits.
For every job lost as a result of single payer, 20 US jobs in other industries will be saved as a result of single payer.
Unless single payer is adopted, many US businesses and industries (not just GM, Ford and Chrysler)will continue to not be globally competitive, trying to compete with other nations who have already adopted single payer. Many CEOs have already told us this, and many employees in many businesses are losing jobs, and will continue to lose jobs, until single payer is adopted.
All programs have implementation costs. With proper retraining, some of the insurance company employees could work for the government's single payer program, others could be retrained for other jobs, and some would get a severence package, all paid for by the government, out of the implementation budget. This will be much less costly than the costs of all the lay-offs the current system causes in other industries.
Singel payer is as much an economic stimulus issue as it is a health issue.
"For every job lost as a result of single payer, 20 US jobs in other industries will be saved as a result of single payer."
That is interesting. I would like some more detail on that so that I can convince my otherwise conservative friends and coworkers about the beauty of universal healthcare. What industries in addition to auto are you referring to?
I do understand that single payer would remove the burden of providing the coverage from my employer so that the government will actually represent us citizens properly. I do not believe that neither my employer nor us employees need to be burdened with the hidden costs of the ongoing privatized care. Unfortunately, my rather toughheaded conservative friends and neighbors keep clamoring on about choice and "free markets". In fact, when I wrote to my congresswoman and two senators about the need for single payer, I got a response from Herseth stating that she was weighing my concerns with those who also sent letters against the idea because somehow they loved the idea of picking a provider and that somehow it's not the government's job to give healthcare to people who don't deserve it but that government should "defend" the nation. In fact, some of the conservatives call any attempts to pass it "Satan Care" or "Hillary Care v2.0". I need more ideas so that I can help quell this conservative madness in my community and maybe even the state. Thank you.
Terrance Mitchell
Redfield, South Dakota
I felt a little uncomfortable about the first sentence. The rest I can agree with. I try to tell that to my conservative friends and coworkers who while nice in temperament often react with hostility if I or anyone tries to bring up the issue of single payer healthcare. I get responses such as "Well, millions of jobs will be lost", "People, not government, should decide their own healthcare provider", "If someone doesn't like the healthcare coverage their employer is giving them, they should quit and find another job", "Single payer healthcare is 'SatanCare' or better yet HillaryCare !", etc ... Haven't you come across such people and if so, how do you usually try to get them to listen and consider the benefits of single payer? My friends and coworkers, while conservative, are cool and friendly but neither I or my other friends who are liberal and/or moderate just cannot seem to be able to convince them. Unfortunately, there are more conservatives than there are liberals and moderates combined in my place and even state.
Terrance Mitchell
Redfield, South Dakota
I have, indeed, come across such people. After having discussed the need for universal/ single payer for years, last year I became a victim of the health care "system" when I had to undergo major surgery--no insurance. I thought for sure what I went through would be the turning point for my conservative family members who oppose "socialized medicine." (They won't even listen to discussion when you try to explain the various systems and the basics of single payer.) I've sent articles, statistics (these people aren't even moved by 18,000 annual deaths in our country) and other people's stories- from credible sources- and they still remain rigid in their opinions. But these are people who listen to Rush Limbaugh and watch Fox News, so they're not able to think for themselves. A friend of the family even went so far to say that people who lack health insurance (myself included) are in this situation as a result of "poor planning" and said that, if I want health care like they have in those other countries, I should move to one of them. This woman is retired and benefits from Medicare. I reminded her that there was a time when our country didn't have Social Security or Medicare; would she like to see the US go back to those days? No response, just an insistence that she has had to work for everything she has and thinks that "no one should get something for nothing." You cannot reason with these people.
NMLib
Hi NMLib,
I'm awfully sorry to hear what happened to you. I hope you get better despite the current system. I used to be a rabid conservative too until I found myself going nowhere in life with it and then left the camp. Maybe I need to learn some more from George Lakoff but then again he doesn't deal with rabid conservatives.
Terrance Mitchell
Redfield, South Dakota
Although your point is valid, if Congress keeps on with incremental tries like the SCHIPS bill that is a disgrace, trying to keep the insurance companies involved in some way, then the opportunity will be lost once again. Its either do it or not.
If as it appears in the stimulas pkg., its pork as usual, Obama will quickly lose the middle...if that happens, he loses Congress in two years and he is a one term President.
SCHIPS bill a disgrace? Ok, I need some explanation here because that bill was about trying to help our nations kids receive equal healthcare opportunities and why wouldn't it be a step towards single payer? Besides, Dubya's out and Obama's in so it can't fail this time, no?
I agree that the stimulus package needs serious improvements before it can be passed and I think that it will be modified and hopefully compromises without the pork can be made.
Terrance Mitchell
Redfield, South Dakota
The House SCHIPS bill does away with income limits so someone making 80,000, even in some states 100,000 could enroll their children. It also does away with citizenship requirements also, which allows illegal alien children to access it instead of Medicaid which they can get now, but other children this was designed for cannot.
It also continues CHIPS Peri-natal which takes money from the children and allows it to be spent on pregnant illegal aliens as it has been.
I believe its a disgrace to take money from poor kids and spend it on well to do families and also a disgrace to allow money to be taken from American children and diverted to illegal aliens.
Two Turtles: Thank you for that analysis,hadn't figured it out on my own.Please contribute more,hadn't seen your moniker before.
How awkward that tiny Cuba--impoverished and under economic blockade for decades--still has a far better health care system than ours.
Remind people of that the next time they tell you communism doesn't work.
I don't know about "far better", but Cuba does have a lower infant mortality rate than the US:
http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate
and is 2nd only to Canada in the Western Hemisphere from what I can see.
We could learn a thing or two from Cuba about organic agriculture, too, but that would require getting beyond our Cold War mindset.
Our country's policies on Cuba are about as rational as its policies on marijuana.
Perry, healthcare might be "free" in Cuba, but good I really doubt it, unless you are a party big shot. Don't believe everything Michael Moore says. I hope he really didn't believe the propaganda he was fed.
I'm all for single payer but as Obama knows, this has to be done carefully because if it was pushed on overnight, 3-5 million jobs in the healthcare and insurance industries would already be lost immediately and we cannot afford to create more unemployment and chaos when there's already enough of it. Chances are, there will be a graduated series of legislations towards single payer healthcare to give those folks working in the healthcare and insurance industries the time needed to migrate jobs. It must be remembered and whole-heartedly understood that when you risk alienating 3-5 million voters because their jobs might be lost despite the best of reforms, you create hair-trigger responses. Remember what happened to Hillary Clinton in 1994? Lincoln knew how to get things done gradually and steadily and although there was still instability, he didn't face the worst kinds of hair-trigger responses from his opponents until that tragedy in 1865.
Terrance Mitchell
Redfield, South Dakota
Buckminster Fuller had a solution to this problem forty years ago. Pay people to stay at home. Most jobs in the American economy produce nothing useful, so the less they go driving around to buy, consume and service the worthless crap that is being produced, the sooner we will begin to heal our relationship with the planet that doesn't like us anymore.
"Buckminster Fuller had a solution to this problem forty years ago. Pay people to stay at home."
I like that idea and that's some of what I do when I'm not at work. Kinda nice to be a part time home gardner with my house wife filling in and getting paid to do it if you know what I mean.
Unfortunately, not everyone takes this idea nicely. You should see the way my conservative friends and coworkers would react with hostility. They would hiss and foam at the mouth mistaking people who are paid to stay at home as "welfare queens". They would even keep rambling about their so-called "concerns" about taxpayer money being taken from them and being given to those paid to stay at home. They yell "commie" and "socialist" all too often. How do we convince these people?
Terrance Mitchell
Redfield, South Dakota
I'll bet your conservative friends would be more receptive to the idea of reduced worktime to get these people back to work doing the things that need to be done if this idea were seriously proposed.
I suspect Buckminster Fuller only suggested this to call attention to the fact that most jobs involve doing things that would be better undone.
Some of them work overtime. I noticed that the longer they work, the more staunchly conservative they behave. A couple of them have recently gotten ill due to work stress so maybe they'll ease up on the hours and perhaps lighten up their attitude, I hope.
Terrance Mitchell
Redfield, South Dakota
I know what you mean. I have a few lifelong conservative friends who used to howl like they'd been scalded because a few pennies of their taxes might go to an alleged welfare queen, but they willingly, if not gladly, sponsored the corporate welfare kings with thousands of their hard earned tax dollars every year, the rest of which still gets steam-shoveled into the all consuming fire of the military corporatocracy, which is a emotionally manipulative "patriotic" cover for much of the same thing. Finding insightful economists with plausible plans who will also speak truth to power requires diligent searching. But there are a number of excellent books to equip yourself with, if you haven't already. I'd recommend "Democracy for the Few," by Michael Parenti. Also, an interesting movie that can be watched online, Zeitgeist Addendum at: http://www.zeitgeistmovie.com/ It lays down some pertinent economic groundwork.
Just today I read an editorial written by a Australian religious leader who has done extensive traveling to churches around the world. He writes that he was stunned to discover American Evangelical Christians are the only Christians in the world who support the Iraq war. He found that American Evangelical Christians are the only ones in the world who don’t believe we need to take any steps to preserve our environment. (USA is the only one that hasn’t signed the KYOTO treaty) He was astonished to find that American Christians are the only ones in the world who don’t support a universal health plan. (USA is the only industrialized country without it) The conclusion he came to is that the American Christians entire theology has nothing to do with the Bible or the traditional Christian values anymore, but that American Christian theology is now based entirely on the Republican Party Economic platform. (Wherever there is a profit to be made) This conclusion has helped me to understand why the church, I had attended for nearly 30 years, changed so drastically when it resorted to claiming the GOP theology as the word of God.
I used to be a rabid conservative until I found myself going nowhere with it and then I left the camp. I won't say Christians are perfect even in other countries but the Australian would have to stay a while to see what makes people used to being numbed into religious oppression. It's shocking at first but they get used to it, sad as it is.
Terrance Mitchell
Redfield, South Dakota
We don't convince these people. We tried it their way. Nobody likes it. Now they have tried to steal the whole country. Their own greed ruined the sweet set up they had. Their system failed.
I don't care if they like it or not.
And if meanness is morality, many so-called 'conservatives' are indeed highly moral.
You mean self-righteous, right?
Terrance Mitchell
Redfield, South Dakota
Is it possible to abolish for profit healthcare,isn't that inextricably linked to the insurance question? Only worsening of the insurance crisis over last 30 years-go for broke by demanding both changes?
"...these models do not embrace a profit motive, and in fact spurn the idea of capitalizing on our unhealthy mothers, fathers, brothers, sisters and, most of all, children. Therefore, it is no surprise such models are vilified by the mega-capitalists among us."
The profit-motive in healthcare is the market society's tastemaker when it comes to putting a monetary value on human worth.
No offense to the lower level workers in those sectors,but if you're a part of a bloodsucking industry,and they are-move on ASAP,if you have compassion for the majority who are hurt by your industry.
You think that is really easy to say that to the 3-5 million workers who are employed in these industries? Without them working, they'll be homeless although I do agree that the bloodsucking vampire industries will finally be disciplined. I hope some people can offer ways to convince these people because if you tell them straight up, you're likely to get hairtrigger responses and I for one one don't want to get hurt in the process.
Terrance Mitchell
Redfield, South Dakota
bman
I think it is important to consider other models than single payer. The French system is rated #1 by the World Health Organization. This is a non-profit multipayer system. There are many non-profit "sickness funds" that have different benefits and costs. Everyone has insurance (some subsidized by the government) and no one can be rejected for prior existing conditions. But they cannot make a profit. Germany, Switzerland, Belgium and Japan use this model. (Germany has about 10% of the population in private health insurance). PBS has a website for a wonderful Frontline series that compares the 4 models of health insurance used in the world. There are interviews with experts about the good and bad points of each. See http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/ and explore the differences between the Canadian single payer system, the British so called "socialized" or Belveridge model and the French multipayer system.
In my opinion the single payer system is hampered by being controlled by the government and there being political pressure to avoid raising taxes or fees even when it is necessary for the system to do so. Imagine the battles in Congress about raising the rates every year or so, if it were needed. The multipayer system allows almost as much government control but allows the funds themselves to raise the rates (if I understand it correctly).
We need to really study what is working and not working around the world and come up with what will work in our country. Please check out the PBS reference above.
Multipayer? I don't know although maybe that might work on my conservative friends and coworkers since they always rant about not trusting government to handle anything correctly although I can't completely blame them.
Terrance Mitchell
Redfield, South Dakota
Everyone should get behind this NOW (after reading bman's suggested article). It's not the only thing that needs to be done; it's probably not the most important, but it's as good a place as any to start getting the corporations off our backs.
Not all of those jobs will disappear overnight. Universal single-payer is not going to cover every service people want. Here in Canada most of us have supplemental coverage through our employers or individually for services not covered by our provincial health plans (all of which, incidentally, cover more services than would be required by a strict reading of the Canada Health Act).
My extended health plan includes vision care, glasses/contacts/laser eye surgery, comprehensive dental, drugs, medical equipment, comprehensive travel insurance, podiatry and orthotics or custom-made shoes, chiropractic, naturopathy, massage, acupuncture, physiotherapy, in-hospital private duty nurse (if medically necessary), and more. Obviously there are annual limits per service, and there are deductibles for some services, but all in all it is a terrific plan, and very affordable. Private insurers, and the providers of the services and equipment they cover, are doing quite well here, thank you very much.
I think net job loss estimates are vastly overstated, and even if it weren't, the fact remains that the American health insurance industry is unsustainable, and even moreso in the current economic climate. A great many people associated with it are going to lose their jobs anyhow, as yet more Americans lose their jobs and with them their insurance, premiums rise even more steeply, and in general the country goes to hell in a handbasket, if it can afford one.
Good point. I have much the same via my supplemental plan and it something like 10 bucks per month.
Furthermore the Insurance companies are NOT involved in the medical decisions. Those that provide supplemntal insurance do not call my dentist to approve the work.
The truth of the matter is the US system IS RATIONING by definition.
pk
I can't wait for my healthcare experience to be just like my DMV experience!
Bill Walz
What a crock! Tell me that your healthcare experience has been responsive to you as a human being, efficient and affordable. At least DMV will see you the same day. Tried to make a doctor's appointment lately? Even when sick?! You have to pay obeisance to the grand temples of profit-motive medicine, fill out dozens of forms, surrender your privacy, to be seen weeks later. Then, be shuttled from overpaid specialist to overpaid specialist for what one single doctor, charging a modest fee would have done fifty years ago, put through endless expensive tests and procedures, all to make more money. They won't even let you die with your dignity and your life savings. No, not when there are a few more dollars to squeeze out. Come out from under the covers and pay attention to the research. We pay twice as much for half as much health care as other countries.
Put off by government bureucracy? As it is now, you have to be cleared by your insurance company for care, be excluded for what you really need the coverage for as "pre-existing condition' and pay a fortune either for insurance that will cover the exorbitant expense or if you can't afford cadillac insurance (or don't work for a corporate or government bureaucracy that buys your cadillac policy for you while taking away your freedom of choice in employment) be sent into debt. I am so exhausted with these lame excuses covering up that Americans are being abused by the profit motive. WAKE UP! Capitalism has wrecked this country while the swindlers who run the show (the medical industry included) are stealing us blind. Have you ever considered what it might be like to live in a real society, as in, "for the people"? Medical care is a societal responsibility, every bit as much as education, police & fire protection, infrastructure and defense. America, join the rest of the industrialized democratic world. WAKE UP!
Bravo! Excellent comment. The truth is is that people do not want to wake up; they prefer to go on dreaming the lie they've always dreamed. Somehow, they find more comfort in the pain. Insanity? Of course it is, just not 'clinical' insanity.
Amen! I could write a book in the difference in care from 20 years ago to now. I don't even get my Dr. in the hospital anymore.
We have excellent insurance and I have to wait to get a Dr's appointment. If its the weekend, its the Emergency Room.
The California Nurses Association just did a study using ecomometics which shows that 2.6 million jobs would be created if we went to a single-payer health care system. Estimates have been that 500 billion dollars would be saved a year if we went to an expanded and inproved Medicare for All. We would then join every other industrialized nation in the world and have a national health care program. It is criminal to allow the insurance industry to keep allowing people to go bankrupt and worse, die, from their denials, their high deductibles and copays, and their leaving people out for pre-existing conditions.
For those who think this is socialized medicine, as it seems from some of your comments (like joehope who said, " I can't wait for my healthcare experience to be just like my DMV experience!" ), you need to do a little research so you know what you are talking about. Single-payer means exactly that--one payer. It eliminates the greedy and useless insurance companies which will cut the present 31% overhead and get us down to 5 to 8 percent.
We rank 37th in the world at present. We pay twice as much (upward of 7500 dollars or more) for every citizen, have 47 or more uninsured at an moment, and an equally large number of underinsured who will fall through the crack with a major medical problem. European countries pay anywhere from 3200 dollars to 3700. And an idiot like Sen. Baucus has the audacity to say we need an "America Plan." Well, unless you are Baucus, most Americans know the bottom line and realize that if something works and saves money, you do it. Single-Payer is an economic stimulus package that leave everyone in, nobody out, and is the humane way to take care of one another in a civil society.
For those who think it smacks of socialism, ask yourself who paid for the roads you drive, the sidewalks you walk on, the sewers your waste goes when you flush the toilet, the fire department, the public schools and libaries, the police deptartment, the dog catcher? We have a unique American way at present--it is called effective government working for the people. Now, only if the right wing nut-jobs would quit trying to make government broke and ineffective, we might be able to actually do things like we once did and make our society a more just and humane one.
Single Payer health care is not socialized medecine. The Government does not employ one health care professional you see. You are welcome to buy more care if you please.
The only sane choice, and thanks for the figures from the Nurses Association on job creation.
By the way, H.R. 676, the resolution by Rep. John Conyers has provisions to retrain and pay wages for those who lose their job for two years. Plus, the 2.6 million jobs created already includes the predicted job loss and thus is over and above it. If passed, we will still need to have people handle billing, and it can be done just as efficiently as Social Security is administrered. The righties never want to tell the truth about these programs, for two reasons: 1) ignorance, and 2) they want to privatize everything so that the greedy can milk the system. That is what the Norquist mantra of "small government" is all about. Turning everything over to the profiteers and making government underfunded so that privatization happens. Look at the success of privatizing our military. It costs 10 times more now, and acountability is lost completely.
(http://www.calnurses.org/media-center/in-the-news/2009/january/sick-in-the-head-why-america-won-t-get-the-health-care-system-it-needs.html)
Copy and paste to see a good article on this topic.
It's a great article. What's sick is the avoidance of connecting to something greater within ourselves.
Is Terrance Mitchell a shill for the gop or the insurance profiteers?
She is taking over the comment section of common dreams.
It amazes me the number of people in the US who KNOW just how great our health care system, compared to Europe, Canada etc.
These experts have never talked to anyone from those countries. None of those countries have massive public agitation to go to our system and scrap theirs, but these experts really know single payer would be worse than 39 or 37 when we are number one only in cost.
People I worked with from Canada were reluctant to travel in the US because temporary insurance is too expensive. All my relatives that fish in Canada never worry about health care in Canada.
By the way, the last time I was in the hospital there was no specialist available to see me. I was in the hospital for six days and my family doctor, a general practitioner was compelled to say, "Is this the third world?" to the administration. This was a local trauma center with a very good reputation.
Having been hospitalized several times over the last few years in three different hospitals, I can tell you they are getting worse under our system.
"With the inauguration festivities of the 44th president behind us, it is now time to look for change, the promise of which helped elevate Barack Obama to the highest office in the land. Change is needed, as the voters have declared in last year's election, and it is needed perhaps most urgently by the 47 million Americans living without health insurance in the greatest and wealthiest country in the world."
The author extinguishes the populist fire with nationalist water. It's counter to his presumed goal to attempt to use nationalism to motivate the people to embrace their own better interests. When they try to push for single-payer healthcare, the little nationalist devil inside them steps up and decrees "strength in submission". You can't have your cake and eat it too. If you want the best for yourself, you have to give up loyalty to your oppressors, the elites, who use nationalism and other tools to secure your loyalty against your better interests.