To Live and Die in America: Class, Power, Health and Healthcare

Robert Chernomas and Ian Hudson To Live and Die in America: Class, Power, Health and Healthcare London, UK: Pluto Press; Winnipeg, Canada: Fernwood Publishing, 2013Reviewed by Howard A. DoughtyEvery contemporary liberal democracy from Austria to Australia has some form of publically supported universal health insurance system. These advanced nations take some pride and their citizens take some solace in the fact that principles of equity, excellence and accessibility are claimed as essential to the care and treatment of the ill and infirm. No doubt some healthcare systems perform their duties better than others. No doubt improvements could be made in all of them. Only in the United States of America, however, is there significant opposition to the foundational premise that it is duty of the state to ensure that everyone is given the best care possible without regard to individual economic circumstances. Like education, healthcare is regarded as a right and not a commodity to be sold to the highest bidder and to be denied to the poor and the indigent.Yet, in the United States, even President Obama's Affordable Care Act, which leaves millions of Americans uninsured and allows for-profit insurance companies to dominate the healthcare industry, is regularly denounced in state legislatures and by state governors, condemned in the United States Congress, and challenged in the courts-including the Supreme Court of the United States. Bitterly fought cases have not been abandoned despite the failure of the critics to succeed (so far) in overturning what is contemptuously called Obamacare by its rancorous critics.The strength of corporate interests and the relative weakness of unions have given the United States a bloated and inefficient health care system. The result is a system that at great cost provides people with a level of care that is often worse than countries which spend half as much.- Dean Baker, Center for Economic and Policy Research, Washington DCTo many outsiders, with the exception of intransigent, doctrinaire neoliberals, Americans' hatred and/or fear of socialized medicine are unfathomable. To be fair, prior to the crafting and passing of Mr. Obama's reforms, public opinion polls commonly found that ordinary citizens favoured some form of single-payer system akin to the one that has been available in Canada since the 1960s and that has been common in part of Europe for a considerably longer time (Brohinsky & Schulman, 2009, July 29). Moreover, in one way or another, both Republican and Democratic presidents at least since Teddy Roosevelt have sought to introduce and expand the people's right to medical care.Thanks, however, to immense pressure from health insurance providers, pharmaceutical companies, private hospitals and also to inflammatory rhetoric and recklessly implausible fear-mongering by politicians affiliated with the far-right faction called the Tea Party, hopes and expectations for a measure of that would being the USA significantly closer to other OECD countries have been foiled.Of course, also to be fair, it must be recognized that President Obama himself displayed timidity from the outset and hastily took the concept of a single-payer, universal insurance program off the negotiating table before discussions with the opposing party and the private-sector healthcare providers had even begun. By doing so, he left some of his supporters disconsolate, confused and wondering if the progressive new president wasn't a defender of the status quo rather than the vehicle for hope and change that he had claimed to be on the campaign trail of 2008-an uncertainty that has remained throughout his presidency. Moreover, the vitriolic objection to Obamacare was also at least partially the result of gross administrative incompetence when the program was rolled out. For whatever combination of reasons, however, this allegedly historic and legacy-defining legislative reform has had the double effect of harshly disappointing authentic healthcare reformers and of further infuriating those who preternaturally resent government interference in the lives of taxpayers (formerly known as citizens). …

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