OCT. 7, 2017

Medicare: It’s A Social Program, But Market Forces Keep Driving Costs Up

When looking at changing policies or reforming existing government programs, it’s always prudent to look at intention and the philosophy behind why they were created in the first place. Medicare was created in 1965 to provide health insurance for Americans over 65 who at the time found it virtually impossible to get private health insurance. Why? Because it wasn’t profitable for health insurers to cover seniors at their most physically vulnerable years. Government stepped in as a moral obligation, a kind of contract government made with its people that health care is a universal right, at least to this segment of society, the elderly. When we look at the intention and philosophy behind Medicare’s creation decades ago, obvious questions come to mind: “Has Medicare kept this contract with the people decades later?” “If changes are made to it, would these changes abandon the original intent and philosophy of Medicare?”

Being a large part of the overall American health care system that is in a cost-crisis, Medicare is not immune to the built in financial challenges of healthcare. Medicare is a single-payer system, a social program. But it does not operate or can be administered in a bubble. The cost of Medicare is greatly influenced by the market forces of the larger American health care system, a model predominately privatized, for-profit, and operates under the assumption that austerity is a consequence for those consumers unable to pay. This is not the philosophy behind Medicare. So, what we have then is Medicare as a socialized sub-model trying to remain financially robust under the larger American health care system model that is facing runaway costs.

The web of economic neoliberalism and the financial burdens found in the overall American health care system naturally over time is further placing a financial strain on Medicare. How? Medicare must continue to raise premiums, copayments, annual deductibles and out-of-pocket costs just to remain viable.

In the short term, Medicare can continue its current course of incremental, moderate, price increases. But in the long term, at some point passing off Medicare’s operational costs onto its beneficiaries will become unaffordable to the people it serves and break that original social contract.

The future of Medicare is ultimately tied to the future of the larger American health care system. House Speaker Paul Ryan and Republicans’ plan for Medicare is to make it more like the rest of the health care system, mimic privatization, slowly, until it has no semblance to what Medicare was intended to be. That is one alternative path for Medicare’s future. The other future alternative is for the Medicare model to become the future model of the entire American health care system -- single-payer for all Americans. This idea, once thought of as too radical or unfeasible, is quickly gaining political acceptance, and could possibly be the main platform for Democrats in 2020. Wildly popular Senators Bernie Sanders and Elizabeth Warren are pushing for it; joining them is the new national political rising star and potential presidential candidate Senator Kamala Harris of California, and even Hawaii’s own Senator Brian Schatz is backing Medicare-for-All.

Medicare and the American health care system at some point could become too costly. We can continue to seesaw with gradients of privatized and socialized medicine for a few years more until we finally realize it’s a failed model.  Americans eventually will need to adopt a new model -- maybe one that is completely privatized or completely single-payer. Weaknesses of the quasi-privatized health care model of today is increasingly becoming apparent. The opposite model, a true single-payer system, has yet to be tried.


Racial Inequity Is the Reason Behind Black Athletes’ Protests, Trump Mischaracterizes Athletes as Unpatriotic

The cultural war continues as President Donald Trump launches yet another salvo at another minority group -- this time, targeting the country’s black community. The divider-in-chief chose to play white identity politics in Alabama by criticizing NFL players for kneeling during the national anthem. Addressing the mostly all-white crowd, Trump demanded in his typical demagogic fashion that NFL owners fire protesting players, even referring to them crudely as “sons of bitches.” Clearly, Trump’s criticism was yet another attempt to bind his right-wing base to his hip at the expense of alienating another minority group.

A few NFL players, mostly African Americans and notably Colin Kaepernick, have taken to one knee during the playing of the national anthem in protest of police brutality and unequal treatment under the law. The NFL has accepted this act as a player’s right to freedom of expression and speech, a constitutional right of the individual. Trump’s recent tirade was an attempt to politicize this act of peaceful protest by mostly Black professional athletes and mischaracterize it into one of disrespect to country, veterans, and the national anthem. It’s an old debate: some conservative Americans believe the American anthem and American flag in no way should be used in protest; while some disenfranchised Americans choose to exercise their freedom of expression, protesting in the backdrop of ceremonious nationalism.

Given the history of Trump’s treatment of minorities and in the context that most of the protestors have been doing it to raise awareness of police brutality of Black Americans -- it’s hard not to conclude that Trump is back to his old trick of race baiting, even though he claims otherwise. To conservative Americans who urge protestors to do so in some other less inflammatory fashion, they need to be reminded that resistance has always been unnerving and uncomfortable. Rosa Parks challenge of segregation by refusing to go to the back of the bus was more than controversial at the time. Martin Luther King Jr. and the civil rights movement challenged the accepted norms and was met with such anger that it resulted in his assassination.

Peaceful protest is an exercise of true freedom and far more meaningful than symbols of freedom, including the national anthem or flag. The very words in the national anthem “Liberty and Justice for All” -- is precisely what these protestors are fighting for (end to police brutality and equal protection under the law) and demonstrates a deeper understanding of the principles behind the national anthem. Critics who don’t get this are placing more importance to the symbol of an anthem and their own personal bias of what patriotism should be. The danger of elevating symbols to “sacred” status is clear. When one class of Americans believe they can monopolize the meaning behind the symbols and set the parameters of allegiance -- that is the first step towards fascism, and completely counter to freedom. Americans have died to protect this true meaning of freedom, not the symbol of freedom.

The NFL should be commended for protecting players in its league to exercise their right to protest. The 200-some players who knelt or raised their fists in defiance during the anthem following Trump’s call to ban such protests were within their rights as Americans and had nothing to do with being unpatriotic.

If debates should arise from this controversy, instead of discussions on whether players should or shouldn’t protest during the national anthem, Americans should explore the real issue at hand -- to stop police brutality and ways to improve societal inequalities.      

San Antonio Spurs coach Gregg Popovich gave a poignant assessment of what’s happening: "Obviously, race is the elephant in the room, and we all understand that. Unless it is talked about constantly, it's not going to get better…There has to be an uncomfortable element in the discourse for anything to change, whether it's the LGBT community or women's suffrage, race, it doesn't matter. People have to be made to feel uncomfortable, and especially white people, because we're comfortable. We still have no clue of what being born white means. And if you read some of the recent literature, you realize there really is no such thing as whiteness. We kind of made it up. That's not my original thought, but it's true.

"It's hard to sit down and decide that, yes, it's like you're at the 50-meter mark in a 100-meter dash. You've got that kind of a lead, yes, because you were born white. You have advantages that are systemically, culturally, psychologically there. And they have been built up and cemented for hundreds of years. But many people can't look at it, it's too difficult. It can't be something that is on their plate on a daily basis. People want to hold their position, people want the status quo, people don't want to give that up. Until it's given up, it's not going to be fixed."

Perhaps, it is this uncomfortable reality that Popovich speaks about that makes it far easier for some Americans to accuse Black athlete protestors as unpatriotic and disrespectful rather than examining why they are protesting in the first place.

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