Monday, August 03, 2009

Looking on with something akin to horror

I have been asked on occasion why I pay so much attention to American politics on this blog and not so much to Canadian. There are a couple of reasons, perhaps the biggest one being that it goes more or less hand in hand with my academic specialization—I am an Americanist, and one who focuses on issues in postwar and contemporary American literature and culture. Given that my approach to literature is broadly historicist, much of what I teach and study is thus necessarily politically inflected. (In teaching a 20th-century American novel course last year focused on issues of race and identity, it would have been an egregious elision not to couple it with material on civil rights and the legacies of slavery, to say nothing of the immediate context of Obama’s historic campaign and election).

There is also the significant factor of being the outsider looking on at times with something akin to horror. There are those who characterize Canadian politics as boring, which is not an evaluation I agree with at all; that said however, we do seem to lack the extremes of American political discourse and the virulence with which those extremes are expressed. Which is not to suggest that Canadian politics is genteel (just watch your average Question Period), but that we have a broader ground for consensus.

The ongoing debate about health care south of the border has really brought this into sharp relief. I have found it extremely educational, while with every passing day making me not just proud but relieved to be Canadian. So much of the debate seems to me fraught with nothing less than profound cognitive dissonance, but then that probably betrays my own cultural prejudices—as a Canadian, the right to health care is a no-brainer. Nor is this a specifically Canadian sentiment, but one shared by most of the developed world, in which even our most conservative governments won’t scale back public health care. The U.S. is the odd man out on this issue. Advocates of a public option or single-payer model in the States must grind their teeth in frustration at the specter of the rest of the developed world looking on in puzzlement at America’s apparent inability to enact what Europe and Canada have had for decades.

I really have been watching the debate unfold with something akin to horror, and that has proceeded less from the ideological argument than the fact that what we’ve been seeing is not ideological so much as rabidly partisan. The ideological argument would at least be interesting, and would be educational in what it would have to say about the social contract. However, from where I sit it seems to me that the opponents of public health care would have difficulty making the ideological argument—the position they can’t make candidly is the principle that health care is not a right, but a luxury.

As far as philosophical positions go, this one is fair enough. I obviously disagree vehemently with it, but would have more respect for American lawmakers if they would at least be honest. However, this is not a tenable position, considering that poll after poll shows an electorate that wants, at the very least, a public option, and I can’t imagine standing up telling people they don’t deserve health care because they’re not wealthy enough would result in many victories come election day—especially considering the fact that employees of the federal government have about the best health insurance in the country. Further, the free-market fundamentalism espoused by the American right, which hews to the dogma that private business is invariably more efficient, cost-effective, and competent than government-run anything founders on the reef of the actuality of the American health insurance industry. We must always remember that private insurance companies make their money in not paying out claims; if you grant the principle that health care is a right, the horror stories one hears of people being denied coverage for major surgery based on inaccuracies or elisions in the way they filled out their policy—or the cynical practice of writing legal loopholes allowing the company to deny coverage into the policy—become that much more egregious.

I firmly believe that health care, like education and really anything that protects the health and well-being of citizens (ranging from water treatment to the police force), needs to be firmly in the public sphere, for privatization of these sectors of society puts the focus on profit rather than where it should be—namely, the citizenry these sectors serve. The conservative argument would contest this with the position that the bigger government this necessitates is inefficient, wasteful, and intrusive, and that private ownership would result in a situation not only more streamlined and effective but also one in which individuals’ access to these services would be proportional to their own success and hard work.

Well and good. I’m happy to have that debate with any comers, but again, if we’re seeing these positions articulated in the current American health care debate, it happens obliquely at best.

There are two principal arguments being made against “Obamacare,” one valid and the other cynically mendacious. The valid argument is over paying for health care reform, and while the numbers have been twisted and spun on both sides, at least it proceeds from a genuine concern.

The second argument isn’t so much an argument as a strategy, as it contains a multitude of arguments of varying degrees of untruth. This strategy is, very simply, to smudge and obfuscate the Obama administration’s message, and if it also manages to scare the crap out of some people, so much the better. A representative selection:

—under Obama’s plan, you will be denied treatments that a faceless government bureaucrat deems too expensive or unnecessary

—the government will dictate your choices in everything from hospital to doctor

—public-run health care is socialism

—access to your doctor will be complicated by a series of government bureaucrats you’ll have to get through first

—seniors will be visited by government employees and made to decide how they want to die

This last one is my favourite, and seems to have been the falsehood that has—predictably—gone the most viral (so to speak).

All of these claims are at the best disingenuous and at worst cynical falsehoods, and can all be disproven by the simple expedient of looking at the public health-care options already provided by the federal government—Medicaid, Medicare, and USVA coverage. Medicare in particular is an excellent example of an extremely popular public program, to the point where any legislator seeking to repeal it would be committing political suicide. In fact, in a misapprehension that would be comical if it weren’t indicative of the disconnect at work in this debate, many seniors have expressed their fear that the Obama health care reforms would eliminate Medicare.

The right has done a good job of propagating such misunderstandings, and while the deliberate falsehoods are appalling enough, the cynical political brinksmanship on display is breathtaking. The Republicans, probably correctly, see that a loss for Obama on health care would cripple the administration, and so are doing everything in their power to block, slow, dilute, and crush the nascent legislation. Meanwhile, public support for the Obama plan has been eroding steadily, pretty much in direct proportion to the loss of progressive elements—that is to say, each hint that the public option will be weaker or gone altogether denudes support, which of course the right wing opportunistically points to as evidence that the electorate doesn’t want health care reform.

As I said at the outset, all this makes me happy, proud and above all relieved to be a Canadian. Our health care system is by no means perfect, but it is an extraordinary comfort to know I’ll never have to take out a second mortgage to pay for a procedure because I was denied health insurance for leaving off my childhood bout with chicken pox.

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