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January 9, 2017



Today I responded to a blog seeking commentary on the upcoming ACA battle with the following, as slightly edited.

When the Social Security Act was passed in the middle 1930s, like all acts designed to serve a mass market in new legislative territory, it was imperfect in its application and was over the years thereafter amended to meet challenges to its purpose (aka congressional intent). It was and is the greatest piece of social legislation ever passed by an American Congress – so far. The ACA, like the Social Security Act, was imperfect in its original design, and like Social Security, needed time to see how it was working and in order to fix quirks and meet challenges to its intent based on what happens when the rubber meets the road, but unlike the middle Thirties, comes now the HMO-funded ideologues who rightly point out insufficiencies in the ACA but wrongly determine to throw the baby out with the bath water rather than try to fix things, and all without any discernible concern for the 20 million Americans to be adversely affected, their doctors, druggists and other such medical personnel.

If such thinking had been around in the middle Thirties and enough Republicans had been around to pull it off, we would have no Social Security but would rather be back to the old township trustee-poor house days, where the poor and aged are nothing more than social orphans, a holdover from the days of Charles Dickens’s stories of maltreated youth (see Oliver, David Copperfield) during the latter days of the Industrial Revolution.

Our overriding problem today can directly be traced (aside from ordinary greed) to delivery of an infamous memorandum written and delivered by Lewis Powell to the U.S. Chamber of Commerce in 1971. Powell was a Richmond, Virginia lawyer who represented Big Tobacco and was later appointed to the Supreme Court by Nixon. His memorandum outlined ways and means that Big Business could take over the American political process, and while this is not the first time Big Business has tried to own government, it is the first and most successful such attempt since the first Gilded Age of the Rockefellers, Vanderbilts and their ilk. It is an ideology based upon corporate greed harkening back to the days of Charles Dickens when orphaned children worked 14-hour days in British sweatshops for a pittance.

We know in gruesome detail what the problems are that the ACA is designed to fix, but time to fix it and HMO resources handed over to politicians stand between us and its solution fueled by an ideology that demands that all human activities public or private in this couuntry be privatized subject to the whim and caprice (and securitization) of the corporate moneychangers on Wall Street. (Read HMOs and the securitization of health as a commodity by Wall Street – people who make money off sick people).

There is an answer to all this, and it wouldn’t take years to perfect. It is single payer, a well- and long-tested plan that most civilized Western countries have had in effect for decades. It works. All premium dollars go to the provision of actual health care, including the otherwise 25-30 percent skimmed off the top for HMO corporate bonuses and other executive goodies such as capital gains and the like, all totally unnecessary as middlemen in the provision of medical care.

I therefore agree that the ACA needs amendment if we are to continue to play this game of giving the HMOs their pound of flesh, but perhaps surprisingly and like some ideologues on the right, I am in favor of repealing the ACA, BUT only if and when it is supplanted by a single payer system. To just repeal it without a replacement would bring on a catastrophic medical situation where people die, smaller hospitals would be almost quickly driven into bankruptcy (since they are required to give care to emergeny cases pro bono and would be inundated etc.).

Let’s quit messing around and solve this problem in one fell swoop (even though a single payer system may from time to time require find-tuning to meet new challenges to its intent as we go along). It’s time, and has been for a long time. Perhaps, in keeping with the idea of Social Security, we could name the legislation adopting single payer as the Medical Security Act.    GERALD      E


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