US Health Care: The Sickness Industrial Complex

Oakland CA homeless encampment Source SF Chronicle

Richard Mellor

Afscme Local 444, retired

I posted a piece to this blog yesterday about the increased flaunting of extreme wealth in the US alongside growing inequality, alienation and outright misery for million of Americans. I meant to include one other statistic as I added some data about the health system here in the US.

But first, what made me think more about this was as my wife and I were walking in our neighborhood yesterday we came across an older woman maybe in her 70’s. She was standing on the sidewalk getting her breath and she had one carrier bag in her arms and two large plastic bags on the ground beside her containing what looked like her clothes and other belongings. Her face was wrinkled and she was very thin, looked quite frail and it was difficult to understand her as she had no teeth in her mouth. This gave her face an even deeper gaunt appearance. I asked her if She was OK and if she needed help.

I did manage to figure out that she was going to the shelter which meant the church about five blocks away. I know they feed homeless people there. I asked if I could carry her bags for her and began to walk alongside her but she was pretty slow. I was amazed she had gotten that far as I found both bags pretty heavy. I asked her if she’d mind if I walked ahead with the bags because they were heavy and I walked faster than she did. She was fine with that. Unfortunately, the folks at the church were not there yet so I had to leave her with a guy who worked there as I had to be somewhere myself.

I can sympathize with people who put the reality of the world aside, complain about others like me being too political, or they think it is aside but it is not; it manifests itself in depression and alienation. In other examples people turn to drugs or become obsessed with religion and the chance of a heavenly rescue. I know they do this not because they don’t care or they aren’t concerned about the state of the world we inhabit but because they see no way out. People do not believe they can make any change so they put their nose to the grindstone and get on with it. I think that is especially so here in the US where the ideology and propaganda from big business can be overwhelming and there is no unified social force at this point that they can turn to but, I should qualify that this is changing.

So I forgot to add this little detail in my previous post to this blog. We often hear talk in the mass media of the “powerful” trade union movement or “powerful” union leaders as if organized labor acts as a dictatorship over our lives here in the US. But compared to what genuinely is a dictatorship of capital through the institutions of capitalism or the various associations that represent different branches of private industry, it’s clear that there is no comparison. Workers’ power is in our numbers and ability to stop production and in that sense the trade union movement has real power. This is the case even here in the US where the percentage of workers organized is down to around 12%. The private sector around 7% and the public 35% or so.

But if we take the sickness industrial complex we call the health industry in the US, the money and power is staggering.  Let’s not lose sight of the fact that the pharmaceutical industry and the insurance industry are major components of the health industry.

I pointed out in yesterday’s commentary, “Meanwhile, one million people were added to the number of Americans without health insurance in 2018 for a total of 30.7 million. As pathetic as Obama’s Affordable Care Act is, it did offer some respite to the uninsured, increasing coverage to a further 20 million people and I think we cannot underestimate what this meant to those folks. The problem is that the ACA left the insurance companies intact.”

Despite this minor adjustment to a very poor for profit health care system that actually allowed insurance companies to raise prices, the, associated industries went nuts and spent massive amounts of money to block ACA. We have all witnessed the repeated attempts of the right wing in the US Congress to repeal it. This is state violence; there is no way around it.

The US hospital sector is a $1 trillion business and it has a huge lobbying (bribing politicians to vote in their interests) arm as do all the major industries. But there is considerable pressure in society to do something about the price of health care which is a commodity like any other here; it’s a business. After all, most bankruptcies are related to health care and thousands of Americans go to Canada or Mexico to get drugs that they cannot afford to pay for here in the US.

What the industry has been fighting now is legislation that would force the hospital industry to have hospitals make public the “confidential” prices they negotiate with insurance companies. They naturally resist this as business and profits are sacred.

Up to now, the American Hospital Association (AHA) that represents the investors in that industry (not the consumer of the service like a union) has been relying on lobbying even adding more money since its war against the ACA. The AHA increased spending by 14% to $19.9 million, hell let’s say $20 million in 2018. The AHA increased spending 10% in 2014 when ACA expanded coverage and another 8% in 2010 when it became law. Is that the best allocation of capital, the wealth workers create through the labor process?

The AHA has shifted its tactics and is now directing its energy and money in to a legal war in the courts.  Consider that there are literally thousands of organizations like the American Hospital Association representing different sectors of capitalist industry whose only goal is to ensure their industry is profitable.

This confirms that the heads of organized labor giving their members hard earned dues money to the capitalist Democratic Party, billions of dollars over decades, is a waste of money. We can’t change this situation by playing the capitalist game, by supporting one of their political parties; they have much more money, that’s why we call them capitalists. Workers have made gains by relying on our own strength, our numbers and position in the workplace; not by relying on the courts or any other institutions of capitalism.

I have gone on too long here but I have to admit that I selfishly get relief by expressing my anger at the system in this way.  Imagine the hundreds of billions of dollars spent bribing politicians alone. What would we do with that $20 million? It’s our money after all.

I never spoke too much to that old woman yesterday. But in these situations I often think about the life a person has had, their past and so on. They were once a small baby in a mother’s arms. Hatred and anger is sometimes a healthy emotion as long as it finds collective organizational expression as opposed to individual acts of anger and destructive self-gratification. I hate the system that not only treats a basic need like housing, health care and education as a commodity,  but the human body itself.

It’s not a bad thing that.