News & Opinion » Columns

Our real crisis


The big Social Security crisis the Bush administration is keeping in the headlines is serving as a big distraction. The real crisis resides with Medicare/Medicaid. Yet the administration hardly ever mentions this fact. We wonder why. Given the mendacity of Bush and the mentality of his top advisors, it should not be hard to figure out.

Recent statements by the Republican Social Security Commissioners (the Democratic commissioners were not invited to the news conference) emphasized the coming Social Security "crisis" in 2042. They neglected to mention the exhaustion of the Medicare trust fund in 2017 due to the spiraling cost of US health care.

The reasons are obvious: Fixing Medicare/Medicaid will not provide money-making opportunities for Wall Street. Fixing Medicare/Medicaid will work against the interests of the drug companies, insurance companies, HMOs, and other health-care providers, all of which are heavy contributors to the Bush administration and supporters in Congress. Now more than ever, US health care is a profit-driven enterprise, and putting any restrictions on health-care inflation will hurt the bottom line. Therefore, this crisis is left unattended.

The business approach to health care is fixed in the neocon mindset. And it's a philosophy completely at odds with the rest of the developed world. Virtually every other developed country has universal health-care coverage, either government run or paid for. America is also set apart by the fact that 45 million people here are lacking any form of coverage.

The neocon philosophy calls for everything to be taken care of by the private marketplace, which, as the theory goes, is the most efficient system ever devised by the mind of man. In most economic activities, this theory has some credence. In health care, the evidence points in the opposite direction.

The US spends 78 percent more on health care as a proportion of GDP than the average of all the other nations in the G-8. It costs doublefor the average American to receive health care compared to people in other G-8 nations, which would begin to make sense if the health care we receive is twice as good. Well, sadly, public-health statistics prove that the US is no better --- and in many cases much worse --- than other G-8 countries.

In longevity, cure rates for serious diseases, disability rates, and any number of other indicators, the US is no better than the middle of the pack. In infant mortality, the US is dead last. Even Cuba and China, not G-8 countries, have better statistics on infant mortality. And the US statistics are getting worse with time, as more mothers are without health insurance and lacking prenatal care.

If the US had just the average infant mortality rate of the other G-8 countries, 11,000 babies per year would be saved. Where is the Christian Right on this issue?

These problems will only get worse. Draconian cuts in Medicaid are being passed on to the states, which will inevitably hinder our public-health performance. In the last two years, the increase in Medicare payments by retirees has risen 34 percent. So it's obvious the administration wants retirees to pay for health-care inflation.

Last year, the Bush administration and Congress had a great opportunity to make progress on the issue of escalating drug costs. They failed miserably when the new prescription drug bill was passed. The bill specifically bars the government from using its vast negotiating power to lower drug prices and it blocks drug importation from Canada. The glee from the pharmaceutical industry could hardly be contained.

The apologists for a laissez-faire approach to health care claim high profits in the industry are needed to provide for technological advances and new drugs. But that argument falls flat when the unseemly relationship between the industry and the current administration is there for all to see.

The pharmaceutical industry spends more on advertising than research, putting into question the theory that high profits are needed for research. The US is the only developed country that allows consumer advertising for prescription drugs, a domain that should be left to doctors. And the recent FDA scandals --- where drugs were approved before a thorough review --- are an additional indicator of how regulators and the regulated are in lockstep, protecting the bottom line.

How can this sham that passes for political leadership be in bed with an industry charged with the health of the nation? When will the congressional junkets, campaign contributions, political action committees, and assorted payoffs be reigned in? As long as this gravy train keeps moving, the costs of Medicare and Medicaid will keep moving up to be paid for by ordinary Americans.

There is only one way to end this scandal: Vote the people responsible for it out of office. With the entrenched positions and pervasive influence of money in the political process, it will be difficult. But this is the real crisis.

Last week I detailed some of the lies and falsehoods being perpetrated to justify Social Security privatization ("Social Security: lies, lies, and damn lies," April 6-12). One of those lies was that the Social Security trust fund is an "illusion." Since that was written, President Bush, in what must be considered one of the most reckless and irresponsible acts ever by an American president, decided to have a photo-op.

With great showmanship he posed in front of the vault containing the US government bonds of the Social Security trust fund and declared that they were "not real assets" and just worthless IOUs. This will certainly be news to the foreign governments, mutual funds, insurance companies, banks, and millions of US citizens who own them and who all believed this was the world's safest investment. Of course, sophisticated people know this was just a publicity stunt by Bush. But the Big Lie Technique is aimed at the uniformed and gullible.