With Democracy So Sick, Medicare for All Will Be Uphill Battle

"Both the Affordable Care Act/"Obamacare" and various Republican Congressional proposals are all private, corporate-dominated systems that enrich all parts of the medical industrial complex - from hospitals, to drug corporations to insurance corporations." (Photo: Joe Brusky/Flickr/cc)

With Democracy So Sick, Medicare for All Will Be Uphill Battle

Why a massive social movement will be required to humanize and democratize our health care system

The promotion of human health in all its dimensions (i.e. physical, mental, emotional) is among the most important single indicators of a just society. The availability and affordability of comprehensive health care to every person, regardless of income or other factors, is defined by many nations as a basic human right. This is the foundational principal of the Medicare for All Act introduced this week by Sen. Bernie Sanders.

"Ending corporate constitutional rights is the ultimate cure to our critically ill health care system and democracy."

Article 25 of the 1948 United Nations' Universal Declaration of Human Rights asserts, "[e]veryone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services." President Franklin Delano Roosevelt called for a Second Bill of Rights in 1944 that identified the "right to adequate medical care and the opportunity to achieve and enjoy good health" as one of several fundamental conditions to achieve human happiness and well being.

Recent polls indicate Americans feel health care is one of the nation's biggest problems. The US spends the most per person on health care than any other nation, has the worst health care system among high-income nations, and has overall poor population health. Nearly 26 million Americans remain uninsured.

3 ways corporations have captured health care:

1. Framing health care as a commodity, not as a right

The U.S. health care industry defines health care within the domain of the private (i.e. corporate), not public realm. It's created a mindset, if not culture, that that "the market" is the most efficient and affordable means to provide the highest quality health care in the world. It's asserted that the prospect of mammoth profits from being the first to develop and patent drugs, procedures or devices are what drive corporations to new discoveries that the public sector would never achieve.

Health care is currently less a basic "right" than a commodity, less a public good than a corporate opportunity to peddle drugs, tests, equipment and procedures focused less on prevention (which isn't profitable) and more on treatment (which is highly profitable, regardless of payer). The business model of so-called "health care" corporations is to minimize coverage and treatment while maximizing premiums, deductibles and co-pays - all of which maximize profits. Despite the rhetoric, insurance agents, not doctors or patients, largely determine basic health care decisions.

2. Investments in lobbying and political campaigns to gain political influence

The so-called "health care" sector was #1 in political spending in 2016, according to OpenSecrets.org. More than $500 million was raised to employ 2700 lobbyists to influence legislation. The money came from corporations representing pharmaceuticals/health products ($245,812,399), hospitals/nursing homes ($94,875,553), and health services/HMOs ($77,966,304). Health professionals chipped in another $84,829,148.

Campaign political "contributions" (more like investments) was a separate category. Health Care Political Action Committees (PACs) invested $55.7 million in federal candidate campaigns (60% to Republicans, 40% to Democrats) in 2016. An additional $53.8 million in "outside" political spending (e.g. largely for advertising) was invested, led by health care-related insurance corporations ($19 million) and pharmaceuticals/health products ($15.8 million).

What have these contributions/investments bought? We've seen laws promoting "tort reform," limits on class action medical lawsuits, patent protection, and massive federal subsidies (i.e. government research) to the medical industrial complex. What we've not seen is neither a single payer system nor any form of "claw back" of excessive compensation of Big Pharma or insurance CEOs.

3. Misuse/abuse of corporate constitutional rights

Corporate constitutional rights have been used to promote corporate interests over human health and safety and/or to deny health coverage. Examples

  • 1st Amendment religious rights

The Supreme Court in its Burwell v. Hobby Lobby decision prohibited the Department of Health and Human Services from requiring closely held, for-profit secular corporations to provide contraceptive coverage as part of their employer-sponsored health insurance plans under the Affordable Care Act if it violated the corporation's 1st Amendment "religious rights and beliefs." To extend and pretend that private, personal religious rights apply to entities such as business corporations is a breach of a constitutional firewall with potential widespread discriminatory implications.

  • 4th Amendment search and seizure rights.

Tens of thousands of deaths annually are attributed to occupational disease while several million people report work-related injuries and tens of thousands of work place fatalities. Corporate 4th Amendment search and seizure rights, affirmed in cases like Marshall v. Barlow which prevented inspectors from the Occupational Safety & Health Administration onto corporate property, threatens worker health and safety.

  • 14th Amendment due process rights

From 1905 until the mid 1930s the Court invalidated Approximately 200 regulations protecting the health and safety of workers, consumers and children were invalidated from 1905 until the 1930's alone under various Supreme Court cases affirming corporate rights under the due process clause of the 14th Amendment

Current health care debate

The current "mainstream" political and media debate on health care place takes place within a narrow space - the entirety of which falls within the corporate sphere. Both the Affordable Care Act/"Obamacare" and various Republican Congressional proposals are all private, corporate-dominated systems that enrich all parts of the medical industrial complex - from hospitals, to drug corporations to insurance corporations.

Limiting the range of information, discussion and debate has been corporate "mainstream" media. Single payer health care is not on the table. Corporate agents have made this decision. Yet the public owns the airwaves. TV and media stations lease these public "commons" from us.

It's in this political and media environment that the Medicare for All Act has been introduced. Pharmaceutical and insurance corporations will surely double down, if not quadruple down, on their political lobbying and political contributions/investments to protect their massively profitable sick-care industry.

"Corporations won't give up their massive influence and profit without a massive fight."

The corporate media will do its part by disproportionately providing airtime to politicians, pundits and sick-care industry shills fear mongering about supposedly excessive taxes, inadequate treatment and government sticking its nose in between you and your doctor. The corporate media will also gladly accept the throngs of paid ads from the sick-care industry distorting, distracting and discombobulating the reality of the Canadian and other Western European health care systems - all of which provide much more universal, comprehensive and affordable health care to its residents. By contrast, the voices of advocates for the Medicare for All Act will be marginalized and drowned out.

Move to Amend and We the People Amendment

Healthy individuals and a healthy democracy are inextricable connected. Removing the corporate cancer from our health care system is possible without killing our body politic. Eliminating corporate influence and the incredible profits and human toll from private doctor-patient decisions, workplace safety decisions and all public policy decisions is the prescription. Ending corporate constitutional rights is the ultimate cure to our critically ill health care system and democracy. This requires much more than simply (un)elected public officials. It requires a constitutional amendment.

Move to Amend's We the People Amendment to the U.S Constitution will make clear that only human beings have constitutional rights and end constitutional "personhood" rights of corporations as well as end the spending of money in elections as constitutionally protected "free speech." It's a fundamental elixir to achieving the basic public right to decide.

The powerful grassroots social movement directed at Congress in the spring/summer of 2017 to prevent the repeal of the ACA demonstrated both the universal concern of health care and the political power of organized people for a common cause. A larger social movement will be required to humanize and democratize our health care system in the direction of single payer, including the Medicare for All Act, which Senator Sanders acknowledged in calling for a "political revolution" to enact his bill. Corporations won't give up their massive influence and profit without a massive fight. The same it true of the massive "corporatization" of education, transportation, energy, criminal justice, food and other basic spheres of our lives. Working against each of these single-issue examples of corporatization and for passage of the We the People Amendment reinforces and legitimizes one another.

The implication is clear: the need to join together to build and sustain a powerful and authentically diverse democracy movement that by eliminating corporate constitutional rights and money as speech, as well as other measures such as guaranteeing the right to vote, will guarantee just and peaceful policies and programs - including a universal, affordable, accessible and comprehensive health care system for every person.

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