Democratic Socialism and your health

My best friend in boyhood was haunted. His mother would often tell him that the Boogie Man would get him if he was bad — defined as swearing, lying, teasing his siblings or not paying rapt attention in church.

He must have been a saint, because his Boogie Man never showed up. My friend’s still with us today.

In my house, the Boogie Man was just as ethereal, but even more fearful. It was invisible and powerful as it whirled around outside our house, the town, the country.

It was Communism, a nefarious something that I first heard my parents speaking about when I was very young, then morphed into a pervasive evil that I read about in pamphlets my parents gave me.

Its existence took on concrete form when my father built a fallout shelter in the basement. The metaphor became complete in a cell of concrete block walls and storage of many weeks’ worth of canned food. It had a door and window that closed with panels lined with lead. It was an ominous thing that bayonetted our eyes each time we went into the basement to play or watch TV.

I tamed this beast with the help of sibling rivalry. I convinced my parents to let me leave the room my brother and I shared and take up residence in the fallout shelter.

In my concrete cubicle I did my homework, learned to love jazz and slept soundly following my after-school job as an orderly at the local hospital. My room and I dreamed the Boogie Man into vapors of myth.

For many years, Russia was the Evil Communist Kingdom and some guy named McCarthy was an overweight Don Quixote tilting at the Boogie Man in some far-away place. Otherwise, everything was Coca Cola and sandwiches of peanut butter and marshmallow fluff in my cozy shelter.

We learn.

With the years and travels from Indiana to Europe, from New York to South America, from Georgia to Cuba, from California to Haiti, from the cloistered life of the university to the intimacy of people’s deepest secrets in clinics and hospitals, we learn.

From wars in Korea to wars in Iran, from watching U.S. embassies’ behaviors in other countries to learning from patients in mosquito-infested clinics and hospitals where dogs wander the corridors, we learn. I learned about poverty that was inescapable in spite of body-crushing hard work.

And I learned about the political systems that maintain both poverty and extreme wealth. Where large numbers of people have little or no access to healthcare while a privileged few are attended by modern medical miracles. Sins more grievous than any imagined by a mythical Boogie Man.

Patterns evolve.

I learned that the opposite of Communism is not Democracy. Communism is an economic system. Democracy is a political system. The opposite of Communism is Capitalism. The opposite of Democracy is Authoritarianism/rule by a single party or dictatorship.

Democracy is widely considered a good thing.

The economic systems get mixed reviews.

Communism — common ownership of production, distribution of goods and services is based on need. No upper class or lower class — all equal. Sounds good in theory, but power hungry humans get greedy and become oligarchs.

Capitalism — private ownership of production for purpose of profit. The profit motive drives creativity. Workers are paid a wage and usually don’t share in profit. There’s a worker class and an entrepreneur class. Goods and services are available in a free market for purchase. Sounds good in theory, but the upper class humans can get greedy and become oligarchs.

Social Democracy/Democratic Socialism — democratic system gradually expanded throughout all classes including working class to curb inequality, universally accessible services including healthcare, regulation of the economy in the public interest. Seems like a good middle ground.

You’d think that in a society as wealthy as ours (30 percent of all world wealth controlled by just 4.5 percent of the world population) there would not be people without houses to sleep in, people who sometimes don’t have enough money for food, people who can’t afford healthcare.

You’d also think that a society afflicted with such situations would not waste taxpayer money on gold trim, reflecting pools or a voracious Military-Industrial Complex (Eisenhower’s words) that can’t pass an audit.

But, of course …

So, here we are, perched at a crossroads, hearing a lot about Democratic Socialism as a movement.

But we never want Socialism in America !

Apparently, we do because it’s already here:

1. Social Security — tax dollars being returned to you when you need it most.

2. Medicare – as above.

3. The VA healthcare system.

4. Bailing out the banks with your tax dollars when they screw up.

5. Subsidizing big oil (aka corporate welfare), farmers, others with your tax dollars when it’s politically advantageous.

There are three big problems with our insurance company based healthcare in the U.S.

1. Many people don’t have access. In 2010, 46.5 million people were uninsured. By 2016, the Affordable Care Act had reduced this number to 26.7. But during the 2017 to 2020 administration, the number of uninsured rose to 29 million. Currently it’s at 26.7 million again.

The number should be zero.

2. It’s too expensive. We spend $14,855 per person per year on healthcare. The most in the world. (Kaiser Family Foundation.)

3. The results, in terms of health, are lousy. As I documented on these pages in June, compared to other industrialized countries, our life expectancy is lower, maternal death and infant mortality rates are higher. Among all countries in the world, an analysis by World Population Review ranks the U.S. at a lowly number 59, well behind many European countries with Social Democracy — led by universal healthcare.

There’s an increasing call for universal healthcare in the USA. It’s been a platform issue for Democratic Socialists for a long time. If we had it, that would mean that every taxpayer would get a basic level of healthcare.

Everyone seems to like Medicare. I have yet to find someone who has rejected it. The overhead/administrative costs of Medicare are very low (the exception is the scam called “Medicare Advantage” which is not Medicare — it’s a for-profit insurance ripoff I discussed in depth in these pages in June.

So… Medicare for all would be the ideal way to provide universal healthcare.

How would we fund it?

1. Cut out the waste in our current system. Eliminate taxpayer funding of for-profit insurance and their multi-million-dollar CEOs (looking at you, for-profit hospital corporations and “Medicare Advantage”).

2. Prioritize the spending of taxpayer dollars. It’s your money and you should get at least a basic level of healthcare for it.

3. Continue to allow people to purchase private insurance to supplement the Medicare-for-all if people wish to.

Universal healthcare is not a one-size-fits-all issue. There are many different ways we could incorporate universal healthcare into our society. If we look at other industrialized countries, we can see how Social Democracy and universal healthcare are being implemented.

• Iceland – One-hundred percent of the population is covered, funded mostly by taxpayers and service fees. The system is de-centralized for services, provided by the municipalities. Cost is approximately $7,200 per person, quality of health is ranked #10 in the world (Commonwealth Fund).

• Norway — Everyone is covered, funded by taxpayers and payroll contributions. Enrollment is automatic. Services include mental health. Municipalities provide clinics, the national government provides hospital and specialty care. Cost is $9,493. Quality rank # 6.

• Germany — Developed national health insurance in 1883. Employers also contribute, paying 50 percent of workers’ health insurance costs. Clinics are private practice, hospitals are nonprofit. Cost is $9,365. Quality rank # 14.

• U K – Has national health insurance for all residents. A mixture of tax money and fees fund it. Private health insurance companies also operate. Cost $6,747. Quality rank # 34.

• Canada – Has public health insurance, mostly publicly funded. Services are provided by private providers. Doctors work on fee-for-service basis (just as my grandfather, father and Mariposa Family Medicine did). Cost $ 7,301. Quality rank # 38.

Ignore the BS trying to confuse Democratic Socialism as Communism. Ignore also the fear mongering that we can’t afford universal healthcare — it’s just a matter of priorities. Other countries are doing it at a lower cost than our current spending (and wasting). Let’s get rid of the Boogie Man of Fear and make it so.

Dr. Charles Mosher, M.D., M.P.H., was Mariposa’s county health officer from 1988-2014. Prior to his work at Mariposa County, Mosher served in the Peace Corps, worked for the state of Georgia and served for 11 years with the Merced County Health Department. He can be reached at author@greaterstory.com.