No images? Click here Barely Gettin' By Trump is sick, and so is AmericaOnce again, Donald Trump has sucked all of the air out of the room. We don’t think there’s much point engaging in speculation about diagnosis timelines, the severity of Trump’s symptoms, or what this means for the election. Frustrating as it is, we will just have to wait and see what happens. But while we do, we should treat every piece of information coming out of the White House with deep scepticism. What Donald Trump’s diagnosis and subsequent hospitalisation do put into stark relief is the vast inequities of the American health system. A President who paid almost no tax has received world class, government supplied health care while millions of Americans receive no such thing. The President could blithely tell Americans not to be afraid of a deadly virus precisely because he knows his wealth and power will probably protect him, while coronavirus has left over 200,000 ordinary people for dead. Those numbers are astounding, and worth dwelling on. Also, they don’t include those potentially millions of Americans who will suffer from so-called ‘long Covid’: ongoing, debilitating symptoms including lung damage, heart damage, and fatigue. For many, timely and effective medical treatment will not be available, because of inadequate or non-existent insurance, even ten years after passage of the Affordable Care Act. President Donald J. Trump works in the Presidential Suite at Walter Reed National Military Medical Center, October 3 2020 The failures of the American health system have been glaringly obvious to Australians for a long time—for us, at least since Homer Simpson became President of the Springfield branch of the International Brotherhood of Jazz Dancers, Pastry Chefs and Nuclear Technicians in 1993. Healthcare? Linked to your employment? That’s crazy! We have had universal healthcare in this country since the 1980s. In the other country Americans like to compare their system to—especially in light of the fact that its leader was also hospitalised by coronavirus—universal healthcare has an even longer history. In Britain in 1942, the Beveridge Report laid the basis for a post-war welfare state, including its famed NHS, which made healthcare free at the point of access. The same year was decisive for America’s healthcare system. In 1942, US President Franklin Roosevelt signed Executive Order 9250, freezing wages in the name of economic stability. Employers who had competed for a shortage of wartime labour with wages, started competing on the benefits they could offer workers, including more and more expansive health insurance. After 1945, in a booming US economy, private providers and employers filled a gap in healthcare that, in war-ravaged Europe, could only be filled by the state. What does this mean in the 21st century? In the United States, employer-sponsored healthcare is expensive, regressive, and drives down wages. Yet healthcare reform was, and still is, political poison. After coming to power in 1993, Bill Clinton set up a Healthcare Task Force with Hillary Clinton at its head. It failed. In 2010, Congress passed the Affordable Care Act (the ACA, or “Obamacare”), simultaneously expanding access to government-funded Medicare and Medicaid, mandating individuals to have health insurance, and tightening the rules on what conditions and health services are covered by insurers. President Barack Obama signs the Patient Protection and Affordable Care Act into law, March 23 2010 This is still very, very far from the universal coverage we’re familiar with. The ACA preserves and defends market provision of healthcare, where the traditional welfare state and modern advocates argue that this is too important a right to be handed over to profit-making entities. The operation of markets is often seen as a principle, and the very basis of the American social contract. It’s also, obviously, great business (that’s the point, right?). American healthcare is hugely interventionist and known for overprescribing. 40 per cent of older Americans take five or more prescription medications every day. The overprescription of psychotropic medicines—a useful and appropriate measure for many people—is a longstanding issue, with the use of antidepressants, for example, quadrupling since 1987. And don’t forget pharmaceutical companies essentially manufactured an opioid epidemic. For-profit healthcare companies and pharmaceuticals intrude on Americans’ bodies and lives, well beyond the point of medical necessity. And they have huge political clout. According to one estimate, pharmaceuticals and health products companies have spent $US4.5 billion on political lobbying since 1998, more than any other industry. Medicare For All, the so-called ‘single-payer’ system sponsored by Bernie Sanders in his campaigns for the Democratic nomination, aims at tipping the balance of healthcare provision back to the state. Given the ideological hostility and lobbying money that hangs over both parties in the US, it’s no wonder it’s been treated with disdain. But, in a time of COVID-19, as millions of American eyes turn to its broken health system, and with unemployment spiking and millions thrown off employer healthcare plans, its time may be coming. A recent poll had as many as 87 per cent of Democrats supporting the proposal for Medicare for All. 46 per cent of Republican voters support it too. Taken together, along with independents, that means that 69 per cent of registered voters support Medicare for All. Senator Bernie Sanders rallies for Medicare for All, September 13 2017 Joe Biden has not committed to Medicare For All. He probably never will in those terms, under a name that is closely tied to his critics on the left. But his healthcare agenda does include a public option to compete with private insurers—which was proposed, then taken off the table, in the original ACA discussions ten years ago. Some see this (either fearfully, or in hope) as a path to Medicare For All by stealth, with a viable, popular public insurer bound to drive private providers out of the market. Those private providers will do everything they can to stop that from happening. They have an ally in the Trump administration, which is even now attempting, again, to have parts of the ACA—including protection for people with pre-existing conditions—struck down in the courts. Less than two weeks ago, Donald Trump claimed coronavirus ‘affects virtually nobody’. And (yes, yes, we swore we wouldn’t go there again) that’s another thing about Trump’s diagnosis, and his bizarre behaviour—even by this President’s standards—in recent days: it underlines just how disconnected his Presidency is from the people he purports to represent. Not just disconnected. Actively contemptuous. What we're reading this weekYou may remember Kimberley Guilfoyle’s startling appearance at the Republican National Convention in August. Here, the New Yorker investigates allegations of sexual harassment from Guilfoyle’s time at Fox News. Trump’s ridiculous and harmful claim that he ‘might be immune’ to the coronavirus is yet another example of his personal exceptionalism. In Foreign Policy, Jeremy Konyndyke explains how that exceptionalism plays out at the national scale. Once upon a time, Saturday Night Live was a political force to be reckoned with. But Jim Carrey’s new starring role as Joe Biden just doesn’t seem like it will have the same force as, say, Chevy Chase’s Gerald Ford. In The New York Times: How President Trump Ruined Political Comedy. Follow usListen to all episodes of Barely Gettin' By |