'Socialized medicine'? Don't believe the hype.

To be a self-described 'real American' is to believe the hype. Every star-spangled, Yankee-doodled word of it. Home of the free, land of the brave. A land of milk and honey, peopled by warriors of freedom who uphold principles of truth, justice and the American way.

I know, 'cause I'm always throwing this crap at my Indo-Fijian-Aussie wife.

"Bloody American," is her usual response, though she knows I'm joking. Mostly. (I can't deny feeling privileged to have been born and raised in the USA -- another 'typically American' trait, I've been told.) Life in Australia is good; I'm slowly morphing into a contented ex-pat. A sign of my acclimation into antipodean society is a habit of 'whinging' about Australian politics (silly), media (sophomoric), ambition (non-existent), binge drinking (rampant) and so much more. Australia is a wonderful place to live ... but overall pales in comparison to the United States. I can state unequivocally that my appreciation for the 'American way' has, like a typical American waistline, expanded greatly since moving here in May 2006.

With one planet-and-a-coupla-moons-sized caveat: Health care.

It's no contest. In the United States:

• Health care costs have been rising significantly faster than the overall economy or personal incomes for more than 40 years.
• Over 47 million US citizens are without health insurance.
• Another 25 million are under-insured.
• As many as 14,000 Americans lose their health coverage each day.
• Up to 36% of Americans who tried to buy insurance on the private market were discriminated against by health insurance providers in the past 3 years, usually because of pre-existing conditions.
• The US is heading towards a health care bill of 20% of GDP.
• The great majority of Americans with comprehensive health insurance have it through their employers. In a shaky world economy, that means millions of workers have more to lose than a livelihood if their employer shuts down.

In Australia:

• Every legal resident has access to affordable health care.
• Everyone carries a Medicare card (not to be confused with US Medicare, which covers senior citizens and the disabled) that's accepted at place of service or used for financial reimbursement at a Medicare office, which are found in abundance.
• Aussies who can afford it carry private insurance, too. Why? Because public insurance covers basics and emergencies with minimal out-of-pocket expenses, while private covers a wider range of services with virtually no out-of-pocket expenses.
• This disparity between public and private insurance maintains an incentive for citizens to better themselves and afford a higher standard of health care for themselves and their families.

Simple. Not perfect; Australia's indigenous population lags far behind non-indigenous in every possible health category. (Has anyone spied the lamentable living conditions of a typical Native American reservation, however?) Granted, Australia's population of 22 million is a fraction of the US's 360 million, but the US economy (and tax revenue) dwarfs Australia's by billions & billions of dollars.

Consider this: There's more than twice as many uninsured US citizens as there are Australian citizens in total.

Sadly, a 'real American' couldn't give a rat's fanny about how other countries look after their citizens. Much of this is blind nationalism, but the media are to blame as well. Nobody's hammered the failings of the US media better than Baltimore's Bob Somerby, a former teacher & journalist. In a brilliant essay called 'GREETINGS FROM NORTH KOREA!' -- which I'm going to quote at length because he wields an unforgiving hammer on right-wingers and liberals -- Somerby describes how "North Koreans aren’t told about foreign lands. Today, North Korea is us.":

You see, citizens of North Korea inhabit a thoroughly landlocked culture. They’re forbidden to know about other lands. So are modern Americans.

Question: How many Americans have ever really heard about the size of their country’s spending on health care -- the over-spending which Pearlstein says contains enormous waste? If you want to see real 'conflicting impulses and confusion' -- if you want to see total cluelessness -- just conduct a survey in which you ask American voters about health care in other lands. Ask them how much their nation spends per person, as opposed to other developed nations. Ask them about the health outcomes in those other countries -- the ones which spend half as much as we do. Few voters would have any real idea of the facts behind that statement by Pearlstein. Like good North Koreans, we live inside a political/journalistic culture which seems to work with exceptional zeal to keep us barefoot and clueless about all foreign lands.

Below, you see the comparison one could derive from David Leonhardt’s recent New York Times piece. (And yes, you had to derive this stunning comparison -- Leonhardt presented the data quite poorly.) Question: How many respondents to the New York Times/CBS poll would have had the first minor clue about a gong show like this?

Annual cost of health care, typical household:
In the United States: $15,000
In other rich countries: $8500

Pearlstein says he would pay for universal coverage out of that extra $6500 per year per household. But how many respondents would have known about the size of that over-spending? Trust us -- very few. How many would have been able to discuss the health outcomes in those other rich countries -- the ones which spend so much less? Fewer. Like good North Koreans, American citizens know next to nothing about the way their homeland compares to others. American institutions, including the New York Times, seem to work extremely hard to keep us proles from knowing.

Consider:

We are currently in the middle of what is called a health care discussion. In theory, we’re trying to figure if we can somehow control the massive costs of our health care. But every other developed nation has found ways to do just that; a rational person might expect to see that situation explored in the New York Times (and the Washington Post). In a rational world, you would expect to see a series of front-page reports explaining how other countries have done it.

You might also expect to see a series of articles explaining where all that extra money is going -- that $6500 extra per household per year. Other countries get equal results at much less cost! So who’s draining off our extra money? But you haven’t seen those front-page reports either. In the U.S., that ain’t how we roll.

We’ve focused here on the failure-to-perform of our major news organs. Others have played key roles in the rise of this Pyongyangian culture. The hapless Democratic Party, for one. And our utterly hapless 'liberal leadership', which is, in reality, an organ—a chew-toy—of the Washington Post. We’ve had 15 years since the failure of Clinton’s health plan to prepare the public for this current debate. Go ahead! Name the liberal leader, journal or organization which has told the public the things they needed to know -- the things which would have given them a chance to react as Pearlstein does in that highlighted passage.

What liberal journal told them about the mountains of money that are being looted? What liberal journal told them about the health outcomes in foreign lands? Who told them where all that extra money is going? Who built a skillful framework through which an angry public might insist on real change, this year?

Your liberal journals haven’t done that. Their leaders have had their lips locked on NBC’s keister; they have been praying for jobs at the Post. But the Post performs oligarchical journalism, as they showed us this past week in a small but unfortunate case.

At the Post, they defend the people who might be found at Lady Weymouth’s high table. If you’re waiting for jobs with them, you can’t roll up sleeves and fight.

That said, Greetings from North Korea! Back in Asbury Park, some were blinded by the light. Here, as in the streets of Pyongyang, the blinding is done by dear leaders. We love their smiles, their genial ways. We thrill to what they’re doing.

I wrote to a friend recently that the number of uninsured Americans is a national disgrace. He responded that this was my opinion; not fact. This friend is a caring, educated, family man. In no way do I claim moral superiority over what he believes because I know him to be a genuinely compassionate, thoughtful person. Our fruitless back & forth made me wonder: How can even a truly compassionate citizen of the world's richest country be aware of so many fellow citizens fending for themselves and not be ashamed?

I believe the answer lies in the 'real Americans' mindset. Like citizens of all the world's countries, holders of this variant of nationalism pick through their country's history for words, phrases and principles that fit a national image they've cheered in movies and applauded during presidential sound bites. It's a practice brought to shimmering, disingenuous life on the Fox News Channel. No brand in US history has ever insinuated itself in the minds of 'real Americans' like the Rupert Murdoch-owned FNC. Waving flags, stern-faced eagles and soaring music represent its brand with the subtlety of Tony the Tiger bellowing 'They're great!' at a box of Frosted Flakes.

FNC's poster boy is a man who started his career on AM radio in New York City named Sean Hannity. A heavily made-up and blow-dried caricature of American machismo and belligerence, Hannity is the piper of a perfectly pitched dog whistle that pricks the ears and wags the tails of like-minded 'real Americans'. These tail-wagging patriots -- almost exclusively white and coddled in leafy suburbs -- are kept in constant fear by Hannity & Co. that 'their America' is disappearing.

If only it were so.

Nothing changes in 'real America'. As a matter of fact, 'real Americans' pride themselves on being cocooned from change. An outside world of dark-skinned, funny-sounding people is to be exploited, bullied and bombed -- but otherwise ignored. Even Canada -- CANADA! -- is portrayed by right-wing fear-mongers as a shambolic hellhole riddled with wacky notions and dangerous, 'socialist' ideas, regardless of the US-Canada relationship being closer to a single country with an arbitrary border and a couple of lakes between them.

'Socialism'. A word tossed about by FNC talking heads like 'sinner' at a Baptist tent revival, and a simple-minded, one-size-fits-all label to slap on President Obama's initiatives -- initiatives that won him the presidential election by a clear majority of US citizens.

Obama is about as welcome among 'real Americans' as a killer bee in an elevator. 'Real Americans' take pride in a stagnant status quo; President Obama promises change. 'Real Americans' dislike educated 'elites'; President Obama carries himself with the dignity and confidence of an intellectual who can nail a 15-foot jump shot. 'Real Americans' don't trust 'foreigners'; President Obama carries Kenyan blood and is greatly admired around the world as America's first global president. 'Real Americans' believe President Obama is a Muslim, a mindset strengthened by the president's efforts to engage with countries that Cheney/Bush preferred to childishly ignore.

In this context it's easy to understand the 'birther' movement: Terrified by an educated black man promising change, they resort to denying the president's status as a legal citizen of 'their America'. Jon Stewart neatly destroyed their message a few weeks ago:

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Only a small minority of right-wingers are birthers -- conspiracy theorists cut across all political ideologies, after all -- but it's my opinion that much of the heft behind the opposition to President Obama's plan to make affordable health care accessible to all Americans is driven by a broad, right-wing fear of Obama's 'otherness'.

In other words, he just ain't a 'real American'.

Seeing this irrational fear manifest itself in the health care debate is puzzling and enormously frustrating to liberals (ex-pat or otherwise). We know America's health care crisis isn't segregated by politics or geography. Yet, because so many right-wingers fear the 'otherness' that Obama represents, they want him to fail. They've been led to believe (by FNC/Limbaugh/Malkin/Beck/Coulter/Buchanan ... the right-wing media's lunatic fringe) that Obama is taking 'their America' down a dangerous path: HE MUST BE STOPPED. A pathetic and sadly prescient Republican senator even called President Obama's quest to bring universal health care to the American people as the president's "Waterloo" and that Republicans stood to make great political gain by 'breaking him'.

Playing to the base, it's called. Meanwhile, Americans of every stripe die or suffer needlessly due to lack of access to affordable health care. Nary a word of outrage is heard from politicians or town hall protesters about these avoidable deaths in the world's richest country. 'Real Americans' don't do that. Their outrage must make them feel good about themselves, not bad. They're not shouting down fellow citizens attempting to practice democracy -- they're defending 'their America' from socialists! Or, like the clip below, they're comparing President Obama to Adolf Hitler.It's no better in the policy weeds. Right-wingers rely on mangled logic and outright lies to denounce the president's yet-to-be-finalized plan:

• Obama wants to kill your grandma!
• Health care reform is unconstitutional!
• Health care reform is socialism!
• Obama wants to give health insurance to illegal immigrants!

Much time and newsprint has been wasted refuting these charges, but no one's framed the health care reform debate better than Paul Krugman. Read his brilliant series of health care reform columns here, here, here and here.

I understand why some on the right would take pleasure in seeing a man they called 'The Chosen One' during the presidential campaign be cut down a few notches. Politics is sport, after all, and no one likes to watch an opponent's victory parade, especially one lasting many months. But how does the 'real American' crowd justify doing nothing about their nation's inability to provide health care to its citizens?

I think I've got a unique vantage point. I entered the US workforce in the '80s when smoking was allowed in the workplace, Reagan's anti-employee philosophy hadn't yet infected America's business bloodstream, and company insurance benefits were almost universally generous. At that time I was privy to an insider's view of group health insurance as a claims processor with Prudential. I even represented Prudential at a factory in South Carolina, answering workers' questions about the details of their coverage. I've worked for companies that viewed employees' insurance as a ripe source of cost savings. I've been self-employed and unable to afford health insurance. I've had a girlfriend offer to marry me so I could be covered by her company's health insurance. I've gone without health insurance for years at a time. I was born into a world that equated employment status with accessibility to health insurance. That world has undergone enormous change, yet among fearful 'real Americans', this mindset remains.

I moved to Australia and learned there is a better, fairer way. 'Socialized medicine'? No. Just a system that puts the health of its citizens ahead of the profits of massive insurance bureaucracies.

If you think that's a naive statement, watch the following video clips. The first is from the Rachel Maddow Show and features an interview with a former health insurance executive-turned-whistle blower named Wendell Potter.

The second is an interview between CNN's Rick Sanchez and 'Conservatives for Patients' Rights' Rick Scott, a staunch opponent of health care reforms whose cost-cutting measures at HCA made him a very rich man but whose company was later found to have defrauded US taxpayers for more than a decade and had to pay a record fine of $1.7 billion.As Sanchez said, this guy is a poster child for everything that's wrong with America's health care system. He's fraudulently lined his own pockets, degraded the quality of health care AND knows exactly which words will appeal to 'real Americans'. He is a disgrace -- and is therefore a perfect spokesperson for the deplorable state of health care accessibility and affordability in the richest nation in the world.

President Obama seems willing to forgo a public plan. Not surprising as, despite full-throated wingnut protestations to the contrary, the president is a centrist at heart. Not a surprise that a multi-billion dollar insurance industry is opposed to it, either. A public plan would bring accountability to the table and offer consumers a choice.

In other words, a public plan would embody robust capitalism (don't tell this to the flag-wavers at Fox News -- their finely coiffed heads might explode) and guarantee access to affordable health care to all Americans ... even the 'real' ones.