Dave Lindorff

When it comes to reforming America's disastrous health care "system," there are two issues that need to be considered: access and cost.

The so-called reform proposals being offered by the Obama White House, the House and the Senate, are failing on both counts, and deserve to die.

No progressives should allow themselves to be suckered into promoting one or the other.

Here's the problem. As long as the health insurance industry is permitted to be the primary paymaster, the cost of medical care will continue to soar, not least because the insurance industry is so concerned about minimizing its own outlays that it is forcing the system to devote nearly 30% of every health care dollar spent to administrative costs (compared to 3-4 percent for Medicare, and even less for single-payer systems such as Canada's). That's true whether there is a so-called "public option" government-run health insurance plan or not. Note that 30 percent of America's $2.5-trillion health care bill per year is $750 billion a year, a sum that does absolutely nothing to make a single person more healthy or less ill. Even if one were to assume that the lion's share of those administrative expenses were only for the private funded portion of America's health care system, and for Medicare, the state-run but partly federally funded portion that is famous for its paperwork mess, and the uninsured, who also consume a lot of paperwork when they do get treated at hospitals under mandated free-care provisions of at the expense of local governments, we'd be talking about 30% of $1.5 trillion, or about $450 billion going to administrative costs every year -- still a staggering sum.

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Reports are starting to appear suggesting that laid-off or underemployed Americans, and the long-term unemployed, are losing patience with the Obama Administration's and Congress' economic stimulus plan, which thus far has not done anything to arrest the growth of unemployment, now at close to 20 percent of the U.S. workforce, at least as unemployment used to honestly be counted in the 1970s and early 1980s.

While millions of jobs have been lost since the beginning of this year alone, the number of jobs that have been created as a result of the Obama Administration's signature $780-billion stimulus spending package is under 150,000 -- a far cry from the 3.5 million that were promised when the bill was being put before Congress.

There has been a lot of hype from Washington sources, dutifully reported with little analysis or criticism in the corporate media, suggesting that the recession is bottoming out. One example was a report last week that the number of people receiving unemployment had, for the first time in six months, dropped slightly. Unmentioned was the hard reality that the reason for this drop was that many laid-off workers are now reaching the end of their 26 weeks of unemployment benefits in states that do not offer any extended benefits program. On inspection, that is hardly good news.

There is also a mantra, trotted out regularly by administration officials, that unemployment figures are a "lagging indicator," and thus are no indication that the recession is continuing to worsen. The problem with this sleight-of-hand is that unemployment itself, when it is rising rapidly as it has been now for a year, is a cause of deepening recession. When one in five workers is unemployed or unwillingly underemployed, that represents not only a huge drop in consumer demand for everything from basic necessities to luxuries, but also a huge dark cloud of anxiety that hangs over most of the rest of the public, leading everyone to cut back on their spending, thus dragging down the economy further.

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The Obama Administration and the Congressional Democrats are finally hitting the inevitable wall that was bound to confront them because of the president's congenital inability to be a bold leader, and because of the party's toxic decades-old decision to betray its working class New Deal base in favor of wholesale corporate whoredom.

The wall is health care reform, which both Barack Obama and the Democratic Party had hoped would be the ticket for them to ride to victory in the 2010 Congressional elections and the 2012 presidential election.

But you cannot achieve the twin goals of reducing health care costs and providing access to health care to 50 million uninsured people, while leaving the profit centers of the current system -- doctors, hospitals, and the health insurance industry -- in charge and in a position to continue to reap profits.

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President Barack Obama, referring to the violent attacks on protesters against the controversial election results in Iran's just-completed presidential election, this week lectured Iran's government, saying, "Peaceful dissent should never be subject to violence."

Referring to the tens and hundreds of thousands of frustrated and angry Iranians who have taken to the streets accusing Iranian authorities of rigging the election in favor of incumbent President Mahmoud Ahmadinejad, Obama said that "the Iranian people and their voices should be heard and respected."

But there is a certain hypocrisy going on here.

Just days ago, the ACLU of Northern California issued a press release announcing that it had filed a complaint over a Pentagon anti-terrorism training manual. That training manual, aimed at Pentagon personnel, describes domestic protests as "low-level terrorist activity."

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If you want to fix the disaster that is called the American healthcare system, the first thing to do is to clearly point out what its major failings are, and there are two of these.

The first is cost.  America is the most expensive or one of the most expensive places in the world to get sick or injured. The corollary of that is that it is one of the best places to make a killing if you are in the medical business, whether as a doctor, a hospital company, a pharmaceutical firm, or a nursing home owner.

The second is access.  One in six Americans -- a total of 50 million people at latest count -- have no way to pay for that care. Too young for Medicare, too "well off" for Medicaid, but too poor to buy private health insurance or too sick to be admitted into a plan, or employed by a company that doesn't provide health benefits, these people get no medical care until they get so sick that they are brought into a hospital emergency room where they get treated (often too late) at public expense, or at the hospital's expense, with the cost shifted onto taxpayers or onto insured patients' premiums.

Any reform of this atrocious "system" must address these two major failings or it is no reform at all.

And that's where all the various versions of Obamacare fall flat.

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My bank, a small regional institution that was not involved in sub-prime lending, and that was not a recipient of any TARP bailout money, cut off my home equity line of credit two weeks ago. They did it abruptly, with no notice -- I only discovered it had happened when I tried to get a $500 advance from it to cover a payment I was making on my credit card. When I asked what was going on, the local branch manager informed me that "we are closing out a lot of credit lines while we reassess the value of houses in this region, which have been falling."

Now in my particular case, this was ridiculous. First of all, in our county, just north of Philadelphia, property prices have been static, but not falling. Furthermore, I had taken out a $160,000 mortgage 12 years ago, and it was now paid down to $60,000, and my balance on the home equity credit line was pretty small, so there was no way that we were in any way "under water" -- in fact our equity in our home is much higher than it was 12 years ago.

The bank informed me that it was no problem. I could simply take out a new credit line, at no charge, and transfer the balance on the current line over to the new one. The only hitch: Instead of paying one percent over prime as I had been, I would be paying nearly 4 percent over prime on that balance, effectively doubling the cost of borrowing money.

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If the government were to actually take charge of GM, instead of playing the pathetic role of passive owner, the bankrupt and seriously troubled auto giant could move beyond just making more cars and more problems to become a forward-thinking pioneer in actually solving problems.

Instead of just cranking out more and more steel dinosaurs and contributing more to the greenhouse gas crisis and the country's reliance on imported oil, a state-owned GM could start making and selling a line of electric vehicles, maybe marketing them as a package deal to car-buyers together with installed solar panels or wind generators, so that each car buyer would have his or her own source of off-the-grid electric power.

By selling solar and wind units in the millions, GM could bring down the cost of personal power generation to reasonable levels, making a huge dent in the nation's carbon footprint.

GM, by becoming a major alternative power producer, would also have a whole new source of revenue and domestic jobs, as well. It might even become an exporter again.

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Just imagine for a moment that you are a retired contractor, struggling to get by on your pathetically shriveled 401(k) when your ne-er-do-well child suddenly comes to you saying he's got this idea to start buying derelict homes and rehabbing them for resale. He asks you to stake him with a $100,000 loan (about half of what you've got left in your retirement fund), promising to repay you when he sells his first couple of houses. You know the kid's flat busted and has been laid off from his job as a dishwasher, so you want to help, but you've also seen his carpentry skills: the doghouse he build in high school fell apart on a windy day, and his own house has a leaking roof, needs repainting, and all the plumbing leaks. You've also seen his business skills: He plays the Lotto excessively, hasn't saved a penny, and buys most of his supplies at the local 7-Eleven.

Would you front this kid half your money?

Well, if you really loved the kid, and if he was in danger of losing his house, you might want to help. But the smart thing to do would be to offer to go in with him in the business, acting as the contractor, so that you could train him in the necessary business and contracting skills, and at the same time make sure the rehab jobs got done properly.

That might work out. Your son might never learn to be a master carpenter, but at least you'd have a good shot at getting your investment back.

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Sunday's cowardly assassination of abortion doctor George Tiller demonstrates once again that the U.S. is not all that different from Pakistan.

One thing that these two violent societies share is having a group of rabid religious fundamentalists who are each on a jihad against those in their nation with whom they disagree, and who are ready to kill and maim their enemies without mercy or hesitation.   The other thing -- perhaps the more dangerous thing -- that they share is a government apparatus in which certain elements are overtly or surreptitiously supportive of the jihadists, and in which other elements are cowed into silence and inaction.

In Pakistan it is the Taliban and related organizations and groups that have the tacit support of some elements within Pakistan's military, police and intelligence services, and political parties.  These elements encourage, assist, and protect Taliban terrorists in their attacks on the larger society.

In the U.S., groups such as Operation Rescue and other militant anti-abortion groups and the violent American "jihadists" who are attracted to them, have terrorized women seeking abortions or abortion counseling, and that have terrorized the doctors and nurses who have bravely tried to provide women with the health care they want and need, including the constitutionally protected right to an abortion.  And political officials such as Phillip Kline, attorney general in Kansas from 2000-2006, and who during that time repeatedly harassed and initiated criminal investigations against Tiller and his women's health clinic in Wichita, are ones who incite these groups to violence.  

Randall Terry, a founder of Operation Rescue, even after Tiller's murder, called the victim, who was slain as he handed out brochures as a volunteer at his church, "a mass murderer" and "an evil man" whose "hands were covered with blood."

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I don't know at this point whether Judge Sonia Sotomayor is a good choice for Supreme Court Justice or a bad one.

She certainly is a lousy judge for writers and other creative people, having ruled (and been overruled by an appellate court and then, when that reversal was upheld, by the U.S. Supreme Court in a case called New York Times Inc. v. Tasini) that the Times and periodical publishers could reprint, without any additional compensation, any freelance works they contracted on the basis that they had a general copyright on each entire issue they publish.

And she appears to have rarely met an insurance company that she didn't feel was more deserving of court succor than any insured person suing an insurer. In a report in the Philadelphia Inquirer, reporter Joseph N. DiStefano quotes an insurance attorney named Randy Maniloff as saying that in cases involving insurance companies and insurance policyholders "It's insurers by a landslide."

Such a pro-corporate position would put her in league with the Roberts/Alito/Scalia/Thomas wing of the court, and would be consistent with her pro-corporate stance vis-à-vis writers and artists and copyright law. (In fairness, Sotomayor did rule against an insurance firm and in favor of a policyholder's family in 2005.)

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