The other day Facebook reminded me that a little more than a year ago I wrote, “Why are we still having television debates when the U.S. president won’t even agree to a peaceful transfer of power?”
Thom Hartmann, author of The Hidden History of American Healthcare, was in a similar mood when he wrote the preface to his book, establishing that his publisher had said no changes could be made to it after November 3rd, 2020, despite being set to be released in Spring 2021.
“If Donald Trump was reelected or somehow managed to remain president after January 20, 2021, then we must take to the streets. This is most likely democracy’s last stand,” Hartmann wrote, trapped as he was behind the shroud of the past awaiting an election.
Anyway, we know what happened instead. After four years of repeatedly signaling that he would try to disregard the result of the presidential election if he lost, in the fall of 2020 Trump did exactly as he had said.
Now with the powers of president, he pressured state officials to get him the votes he needed to call himself winner of the Electoral College, including changing the totals, having Republican state legislators just disregard the popular vote, and suing everything everywhere to fundraise and sow distrust.
When all that failed to effect the outcome he wanted, Trump called upon a popular mob to come to the U.S. Capitol where he encouraged them to lynch the vice president (then Mike Pence) and members of Congress that were in the process of affirming Joe Biden’s presidential victory.
The flaws in asymmetric media polarization have never been starker than watching how “the liberal media” has failed to treat a violent, attempted coup with the same level of interest it did a Democratic presidential candidate’s private email server or the fruits of a Russian email hack of a national political organization.
Now, that is a lot of introduction for a book that is shorter than two hundred pages, and shorter even than that given that it’s a 5“x7” paperback.
Hartmann moves quickly. He spends the first section of the book describing how bad the U.S. healthcare system is, zeroing in on the decision by Joe Lieberman to join with Senate Republicans in killing the Patient Protection Act’s public option and what that resulted in: a Rube Goldberg machine that still kills and bankrupts people so insurance companies can make profits and payout bonuses.
After about forty pages, Hartmann pivots to go back to the origins of America’s sickness-for-profit system, contrasting the path of the United States with that of Imperial Germany.
And it’s here that the author’s warning, given the benefit of hindsight, really echoes loudly because Hartmann describes the way Otto Von Bismarck, the “Iron Chancellor”, was the primary figure in government responsible for pushing through Germany’s universal healthcare system in the 1880s, along with workers compensation and old-age pensions.
This became the model for the rest of Europe and later East Asian liberal democracies. But the reason Bismarck, arch-conservative Junker that he was, pushed such measures was because the pragmatist had no other choice.
Bismarck “didn’t develop the program out of some enlightened sense of human dignity or workers’ rights,” Hartmann writes.
“Workers in the streets pushed him to it.”
The Social Democratic Party of Germany was banned, but they, anarchists, and other socialists were still active and so threatening in their appeal to the people of Germany that a Prussian minister in an autocratic regime felt compelled to mollify them and prevent revolution.
Although their explicit reasoning is much different (e.g. “real America”), reactionaries in the U.S. seem to have recognized this same dynamic much more than U.S. liberals and the left. Decades of organizing, of weekly political meetings (though they’d call it “church”), and yes, also gobs of money have led to a moment where all sorts of unpopular ideas are able to dominate federal politics. That was true even before politicians and mobs started colluding to take over capitols, and actually this time I’m talking about Oregon.
Because there is no “return to normal” ever coming to us.
Of course, unlike Germany, the United States had and has anti-Blackness built in as a fundamental structure of society and government.
Hartmann writes of how scientific racists, and one in particular — Frederick Hoffman — justified the conditions of deprivation and mistreatment of Black Americans at the end of the 19th century by saying that without the “protection” of slavery, Black Americans would naturally die out unless propped up by unnatural and ultimately fruitless healthcare services.
When segregation-in-the-law came to an end in the United States in the 1960s and 1970s, public services like swimming pools were simply shut down or privatized rather than integrate. This spiteful, self-injuring hatred did and continues to motivate many poor whites to work against their economic and bodily interests. Because, to them, their “real interests” are to maintain their place in a racist hierarchy and continue receiving the psychological wages that pays out.
But for the rich, who are also disproportionately white, there’s a lot of very real wages paid out to them, too. And stock options. And bonuses.
You can make a lot of money off of services people need to stay alive and keep their family alive, and you can use that money to “exercise your free speech rights” in influencing politicians to think that the best thing for everyone is maintaining a system where you keep making that money and they keep getting elected. It is very hard to believe a system isn’t working well when you see it working well for you and those around you.
This is not an especially ambitious book, I don’t think. Its purpose seems to be that it can be read in a single comfortable sitting and be understood while providing you with minimal scaffolding necessary to make sense of healthcare as an industry in the U.S., what’s wrong with it, and how that could be fixed, as other nations have fixed some basic problems. Hartmann makes a compelling case for one simple but counter-intuitive solution to U.S. healthcare problems: just have the government buy the insurance companies.
At around $1 trillion, it might sound profligate but is still just what the U.S. wastes in overpaying for healthcare every single year.
But this won’t come about by voting, and it won’t come about by signing petitions, or by permitted marching from here to there.
The days when those signified impressive organizational acumen, implying the ability to accomplish other things, has long since passed.
Instead, we’ll have to start treating our lives and health as valuable as they actually are, and, for whites, start choosing that as a more important interest than racial solidarity that allows relative privilege.
You want to believe we can manage this after seeing how disposably our bosses, landlords, and governments have been willing to treat us and our health during COVID-19, but unfortunately, reactionaries in the United States seem to be the ones with all the urgency, and they’re certainly under no misconceptions that the transitions of power in the future will be peaceful.
Like conducting a debate amid lingering threats of political violence or publishing a book about healthcare as you see signs of a coup happening out in the open, it’s difficult to talk about universal healthcare as you’re watching a fascist movement gain steam and be treated as unseriously as if no one learned any lessons since 2015.
But if we aren’t organizing and mobilizing with sufficient seriousness to counter a violent white nationalist movement intent on seizing control of government by force, not only will we lose out on a chance to be bribed with universal healthcare to mollify us, we’re likely to lose a lot of other things, too.