by Stephen Lendman

Obama's Affordable Care Act (ACA) falls way short of promised benefits. It's outrageously expensive.

A new Congressional Budget Office assessment estimates hundreds of billions of more dollars than Obama claimed. Around $300 billion or more.

It's unaffordable for millions. Double what healthcare costs in other developed nations. Marketplace medicine fails. Often when it's most needed. In America, it's a healthcare rationing system. A scam. A scheme based on ability to pay.

A boon to providers. A ripoff to enrich insurers, drug companies and large hospital chains.

Despite high-minded claims, millions are left uninsured. Millions more way underinsured. Buying insurance is mandated. Otherwise, penalties are enforced.

In 2014, it's $95 per person up to 1% of family income. Whichever is greater.

Over the next two years, fines increase exponentially. In 2016, it's $695 per person up to 2.5% of income. Again, whichever is greater.

Exemptions are few and far between. IRS officials are in charge of enforcing 47 new tax provisions.

Imagine having tax collectors involved in healthcare. Only in America. Empowering them is outrageous. Scandalous. Nightmarish. Doing so assures enormous harm.

Americans were scammed. They expected one thing. They got another. On October 13, AP headlined "Poll: Many Insured Struggle with Medical Bills."

Inability to pay healthcare costs is the leading cause of personal bankruptcies in America. Obamacare "is no panacea for high medical costs," said AP.

According to its poll, one fourth of privately insured US adults lack "confidence in their ability to pay for a major, unexpected medical expenses."

At issue are huge deductibles and co-pays. Millions pay 40% or more out-of-pocket.

On top of costly premiums rising exponentially annually. It wasn't always this way. A previous article explained.

In 1960 when this writer finished graduate school and began working full-time, healthcare as a percent of GDP was 5.1%. In 2002, it was 15%. In 2011, 17.9%. By 2020, it'll exceed 20%.

Between 1960 and 2009, average annual healthcare spending rose from $147 per person to $8,086. A shocking 55-fold increase.

In inflation-adjusted 2010 dollars, it rose annually from $1,082 to $8,218 - a 7.6-fold rise.

In 1942, Christ Hospital, NJ charged $7 per day for a maternity room. Today it's $1,360.

In 1980, a typical US hospital room cost $127. Today it's multi-times higher. See below.

A 2011 survey of 11 Ohio hospitals found daily hospital room prices ranged from $688 - $2,425. Cost averaged $1,393. The median price was $1,322.

An average emergency room visit today costs more than a month's rent in America. Hospital room charges and related expenses average over $4,000 daily.

America's most expensive hospitals charge more than $12,500. Bills of $1,500 or more follow simple medical procedures.

Ones many patients easily paid out-of-pocket decades earlier. Prescription drugs were cheap. A small fraction of today's prices.

Insurance providing good coverage was affordable. Polar opposite things today.

According to According to AP/NORC Center for Public Affairs Research's poll results, high costs force Americans to adopt practices detrimental to good health:

• "Nineteen percent of all privately insured adults said they did not go to the doctor when they were sick or injured, because of costs."


• "Among those with high-deductible plans, the figure was 29 percent."


• "Seventeen percent skipped a recommended test or treatment; it was 23 percent among those with high-deductible plans."

"Eighteen percent of all adults went without a physical exam or other preventive care, 24 percent among those with high-deductible plans."

People can't buy what they can't afford. Even when it comes to healthcare. Medications aren't taken as prescribed. Some not at all.

Doctor visits are skipped. So are expensive tests. Many consumers make financial trade-offs. They do so to pay medical bills for vitally needed treatment.

• "Overall, 33 percent said they cut back on entertainment; it was 43 percent among those with high-deductible plans."


• "18 percent said they used up all or most of their savings, 24 percent among those with high-deductible plans."


• "19 percent said they dialed down their contributions for retirement savings, 28 percent for people with high-deductible plans."

Plan-switchers express dissatisfaction. They're paying more for less provide.

Physicians for a National Health Program (PNHP) calls itself "a universal, comprehensive single-payer" advocacy organization.

It supports everyone covered equitably. No one left out. Mandating it in place of today's dysfunctional system.

Hundreds of billions of dollars can be saved annually by eliminating insurer-driven bureaucratic overreach. Excess. Ripoffs. Waste, fraud and abuse.

PNHP has been active since 1987. It has over 19,000 members and chapters nationwide.

It "educate(s) physicians and other health professionals about the benefits of a single-payer system - including fewer administrative costs and affording health insurance for the 50 million Americans who have none."

It's "the only national physician organization in the United States dedicated exclusively to implementing a single-payer national health program."

It believes universal high-quality healthcare isn't a commodity. It's a fundamental human right.

According to Martin Luther King:

"Of all the forms of inequality, injustice in health care is the most shocking and inhumane."

Article 22 of the Universal Declaration of Human Rights says every "(e)everyone, as a member of society, has a right to social security…" Every nation is obligated to provide it.

Article 25 states "(e)everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control."

Article 30 says "(n)othing in this Declaration may be interpreted as implying for any State, group or person any right to engage in any activity or to perform any act aimed at the destruction of any of the rights and freedoms set forth herein."

Social justice is fundamental. It's on the chopping block for elimination. Neoliberal harshness demands it. Force-fed austerity is official policy.

It's neo-Malthusaianism writ large. Its holy trinity mandates no public sphere, unrestrained corporate empowerment, and repressive control for contrived national security reasons.

Inside the bubble, it's paradise. Outside is neoliberal hell. Ordinary people are increasingly on their own out of luck.

Even for vitally needed healthcare when most needed if they're coverage falls short of providing it.

Corporate empowerment matters more. Marketplace medicine reflects it. Bottom line priorities are the be-all-and-end-all.

Pillaging for profit is longstanding policy. Even for healthcare. Ordinary people suffer hugely.

They can have anything they're able to pay for. Otherwise they're deprived. Stuck. Often when most in need.

Healthcare reform efforts in America never succeeded. Lobbyists, politicians and medical professionals vie for their own agendas.

No single narrative exists. Future legislation may replace Obamacare. Or perhaps change its mandates.

For better or more likely worse. History is instructive. In 1798, US ships arriving from foreign ports had to pay 20 cents a month for healthcare covering each merchant seaman.

Legislation mandating it required establishing federally-funded hospitals. By 1802, they operated in Boston, Norfolk, VA, Newport, RI, and Charleston, SC. More were planned.

In 1916, Marine hospitals provided in-or-outpatient treatment for injured federal workers. Later they became part of America's Public Health Service (PHS).

During and post-WW I, new veterans' hospitals were established. In 1921, some became part of a new Veterans Bureau. Others remained in PHS.

Post-1950, phasing out PHS hospitals became official policy. In 1981, eight remained. Washington's model remained with little funding or means for enforcement.

In early 19th century America, state and local governments were involves. Mental hospitals were established for so-called "dangerous and unwanted individuals."

Isolated from urban areas. Including hospitals. Special ones for tuberculosis patients, Pennsylvania miners, and impoverished city dwellers.

At times, religious or nonsectarian NGOs ran them. In 1903, the first public hospital census showed public subsidies covered 10% or more of operating costs in 13 states.

With wide variations among them. Concern for government involvement was largely a 20th century phenomenon.

The phrase "socialized medicine" gained traction at the time. Not enough for legislation mandating it.

Powerful special interests opposed it. They still do. Bottom line priorities matter most.

As early as 1751, cooperative public/private ventures existed. Benjamin Franklin got a Pennsylvania state grant to establish the private nonprofit Pennsylvanian Hospital.

Around the same time, similar initiatives followed. Less public/private distinction existed.

In the late 1940s, federal Hill-Burton grants helped establish cooperative rural hospitals.

US health reform efforts began with 1913 - 1918 health insurance movement initiatives. The American Association for Labor Legislation spearheaded efforts to improve industrial workers' health and welfare.

At the time, the American Medical Association and other organizations supported initiatives.

In 1917, 15 states introduced healthcare coverage legislation. Eight others established commissions to consider doing so.

Nothing materialized. Efforts were weak-kneed. Lacking workable policies. Confusing even for supporters.

By the 1920, health reform advocacy was dead. Despite poor responses to 1918/1919 influenza epidemic crisis conditions.

Post-WW I, doctors focused on private practice. Medical specialties expanded. Community and university hospitals were established. Government supplemented other efforts.

In the 1930s and 1940s, government-sponsored health insurance again surfaced. Either through federally-subsidized state programs or Social Security.

At the time, doing so was contentious. Medical and political opposition surfaced. On issues of advantages or disadvantages for business and labor.

Private health insurance as an alternative. Concerns about too much government and states' rights.

By the 1950s, employer-provided healthcare coverage changed things. Complemented by newly established/expanding hospitals.

And a national commitment for federally-funded biomedical research in various areas.

After years of debate and strong Republican opposition, Medicare and Medicaid became law in 1965.

On July 30, 1965, Harry and Bess Truman became Medicare's first enrollees. Medicare.gov calls it "the nation's largest health insurance program." Millions of Americans are covered.

It's a "Health Insurance program for people age 65 or older, some disabled people under age 65, and people of all ages with End-Stage Renal Disease (permanent kidney failure treated with dialysis or a transplant)."

Medicare and Social Security aren't entitlements. They worker/employer funded insurance programs. They're contractual federal obligations. They for eligible recipients who qualify.

They're on the chopping block for elimination. Either by privatization or death by numerous cuts. So-called "creeping normalcy."

Destroying over time what's essential to preserve. Democrats are in league with Republicans. In a decade or less, these programs may no longer exist.

Decades of US healthcare reform efforts failed. In contrast, Medicare, Social Security and Medicaid succeeded.

They enormously benefit the lives, health and welfare of millions of Americans. Other public initiatives work as intended.

Including SCGIP (the State Children's Health Insurance Program), emergency room access, EMTALA (the Emergency Medical Treatment and Active Labor Act), government-supported clinics, and VA for veterans before bureaucracy and political indifference corrupted what once worked well.

By the 1980s, nonprofit hospitals were almost extinct. They competed unsuccessfully with private ones.

Healthcare is just another commodity. States reduced their mental care hospitals. Chronically ill patients ended up in nursing homes, on city streets or in prisons.

Uninsured or underinsured patients without families are especially vulnerable.

The 1973 HMO Act failed to deliver promises made. By the 1990s, federally funded health maintenance organizations became synonymous with managed care.

And the baggage they created. With gatekeeper bureaucrats making healthcare decisions, not doctors.

Obamacare is America's latest healthcare reform effort. It may end up in history's dustbin like earlier initiatives. The fullness of time will tell.

One system alone works as intended. Providing far more affordable high-quality healthcare than today.

Universal single-payer coverage is an idea whose time has come. What better time than now.

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Stephen Lendman lives in Chicago and can be reached at lendmanstephen@sbcglobal.net.

His new book as editor and contributor is titled "Flashpoint in Ukraine: How the US Drive for Hegemony Risks World War III".

http://www.claritypress.com/LendmanIII.html

Visit his blog site at sjlendman.blogspot.com.

Listen to cutting-edge discussions with distinguished guests on the Progressive Radio News Hour on the Progressive Radio Network.

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