In the United States, a welfare program for the poor was dismantled in 1996 by the Republican congress and President Bill Clinton, with the (highly fallacious) motive that it encouraged “fraud, wasteful spending and misuse.” Thirteen years later, the reform proposed by Barack Obama will not fundamentally alter a lame health care system because those who currently profit from it have bought the favor of members of Congress. The welfare program dismantled in 1996 equaled about one percent of the U.S. budget; private insurance companies are so well protected that they eat up the greater part of 17 percent of national wealth.
The president of the United States is paradoxically one of the best prosecutors of the method he has chosen. Day after day, he tells “the story of people who used to work hard and are now being held hostage by insurance companies that refuse to cover their expenses, or canceling their policies when they need it the most, or requesting additional fees they cannot afford in exchange for treatments they desperately need. We have a health care system that works better for insurance providers than for the American people.” (1)
The initial project promoted by Obama was a two-fold reform process. First, it planned to make health coverage a requirement for 46 million Americans currently without any form of coverage, while subsidizing the poorest. Second, it envisioned the creation of a public insurance system able to offer less expensive fees than those of private trusts (2). These trusts in fact spend a huge amount of resources to figure out legal tricks to avoid paying for their customers’ treatments once they become ill. And what is the political right wing so alarmed about, expressing its fear through a violence that can at times leave one speechless? “If a ‘public option’ is created,” complains the Republican governor of Louisiana, “it will thrust a disloyal competition upon private insurance companies and lead them to bankruptcy” (3). Other bankruptcies, more dramatic, could have caught his attention, particularly in Louisiana, one of the poorest states in the country.
U.S. politics have been so corrupted by money from industrial and financial lobbies that only tax cuts are easily passed in Congress. To impose anything on banks, insurance companies or the pharmaceutical industry is a huge challenge. In the case of health care reform, the (Democratic) president of the Senate Finance Commission, Mr. Max Baucus, whose collaboration is necessary for the reform to be adopted, is also the senator who receives the most donations from hospitals, insurance companies and private practitioners. His main financial backers are not very concerned with the problems of his small, rural state of Montana: 90 percent of donations received by the senator, as it happens, all very legal and clearly identified, come from elsewhere. Have we already guessed that Mr. Baucus is opposed to an overhaul of the current health care system?
One year after the crash of liberalism, the (small) panic of the oligarchies has dissipated; the political game seems to be frozen to their advantage. From time to time, a more corrupt – or especially unlucky – executive lands behind bars; the magical words are then repeated: moralization, ethics, regulation, G20. But then it just starts all over again.
Questioned on the colossal bonuses earned by traders of BNP Paribas, Mrs. Christine Lagarde, French Secretary of the Economy and former corporate lawyer in Chicago, refused to blame them. “If we say, ‘let’s forbid bonuses,’ what will happen is that the best teams of traders will simply go and live elsewhere” (4).
Hidden in a political system that protects them and which they protect, benefiting from general cynicism and public discouragement, traders and medical insurance companies can only persevere in their role as parasites. Misusing the system is not a deviation from their trade, but its essence. What is needed is not a “reform” to which they could consent, but their removal from the system so they can no longer cause any harm.
(1) Public speech in Montana, 14 August 2009.
(2) In fifteen of the fifty states, more than half of the market is owned by a single private (medical insurance) company. Cf. “The tight grip of health insurers,” Business Week, New York, 3 August 2009.
(3) Bobby Jindal, “How to make health-care reform bi-partisan?”, The Wall Street Journal, New York, 22 July 2009.
(4) Europe 1, 7 August 2009.