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THE UNFULFILLED PROMISE
Posted by Time for change in General Discussion (1/22-2007 thru 12/14/2010)
Wed Oct 08th 2008, 10:31 PM
Under the Obama plan, health care in our country will become substantially more affordable, health insurance coverage will substantially increase, and discrimination against the unhealthy or the genetically unfit is likely to disappear.
The use of private health insurance, though better than no health insurance at all, has long posed serious problems for the American people. Given that the primary purpose of these corporations is to accumulate profits, they frequently resort to such tactics as denial of coverage to those whom they consider to be at high risk of disease or fraudulent denial of claims. That, combined with the rapidly rising cost of health care, has resulted in a rising wave of health care related bankruptcies.

The rapid rise in scientific knowledge in the field of genetics, with the consequent proliferation of genetic testing procedures, though producing many benefits, also poses new dangers to the American public. One of the most serious dangers posed by the rapid rise of genetic testing is the potential for abuse by the health insurance industry.


Genetic discrimination by the health insurance industry

The Medical Information Bureau (MIB) is a massive databank, comprising information on millions of U.S. citizens, used by America’s health insurance industry to check out medical information on its insured clients. The availability of genetic testing data has added tremendously to the amount of data contained by the MIB. What are their plans for the use of this information?

Denial of health care coverage to those considered to be at “high risk”
Edwin Black, in his book “War against the Weak: Eugenics and America’s Campaign to Create a Master Race”, explains that one use of genetic information by the insurance industry will be to use it to exclude additional people from coverage – those who are said to have “pre-existing conditions”:

Insurers increasingly consider genetic traits “pre-existing conditions” that should either be excluded or factored into premiums. A healthy individual may be without symptoms, or asymptomatic, but descend from a family with a history of a disease… Many in the insurance world argue that their industry cannot survive without such information, and the resulting coverage restrictions, exclusions and denials that would protect company liquidity.

The health insurance industry has been discussing these issues for some time now. In 2002 the American Academy of Actuaries released a paper titled “The Use of Genetic Information In Disability Income And Long-Term Care Institutions”. In that paper, the health insurance industry puts forth an argument for why it needs access to genetic data:

Insurers are concerned that if they were prohibited from obtaining genetic information from the medical records of applicants, then those applicants would know more about their genetic predisposition than the insurance company, and more substandard and uninsurable individuals would qualify for insurance. Premiums could not be adjusted adequately to cover the deterioration of the insured population because the higher prices would drive out the healthy…. The increase in premiums would further reduce the number of health policy holders and could eventually cause the insurers to become insolvent.

This process is already occurring. An article in Risk Management, titled “Genetic Discrimination: A New Frontier”, found that 22% of families participating in genetic disorder support groups had been denied health insurance and 13% had been fired from their jobs because of their genetic status.

Denial of claims based on accusation of fraud
More ominous than refusing coverage is the denial of health care claims based on the presumption that the insured individual knew or should have known about the genetic status of his/her ancestors or family members. Edwin Black explains:

Some insurers may also want genetic data so they can use the information to rescind insurance, claiming that an individual fraudulently or even inadvertently omitted ancestral information from an application – even if the insurance claim is unrelated to the medical condition.

Black goes on to describe the case of a Quebec man who was killed in a car crash. The man carried a gene for the disease myotonic dystrophy and knew that his father had that disease, but he omitted that information from his life insurance application. The man’s widow was denied her life insurance payment based on the genetic information.

Black notes that the Quebec precedent is spreading to other countries and also expanding to include cases even where the insurance applicant was unaware of the genetic information, on the basis that he should have known about it.


My commentary on insurance industry use of genetic testing to deny coverage or claims

The insurance industry claims that they need genetic information on insurance applicants to prevent raising insurance premiums on healthy individuals. But think about it. They have expressed the intention of using the information to exclude from coverage people who are at “high risk”, based on genetic testing. Even if the excess risk is very small they can use the information to raise premiums on individuals found to be at “high risk”. This will undoubtedly increase their profits. Does anyone believe that they will balance these actions by decreasing health insurance premiums on individuals found to have a stellar genetic record? That seems highly doubtful. The end result will be more Americans with either no health care coverage or more expensive health care coverage. The health insurance industry will profit, and large segments of the American public will suffer for that.

The ability to deny claims for individuals who have paid insurance premiums for years holds even more potential for abuse. The propensity of health insurance companies to deny coverage for any questionable reason they can find is well known. With the availability of genetic test results they will be able to expand their excuses for denial of coverage. Those denials may often involve cases where the insured individual had no knowledge of the test results when s/he applied for insurance. No matter. How many people have the money or the time to fight insurance companies?

The health insurance companies argue and whine that their inability to use genetic information for these purposes may cause them to become insolvent. Well, I have an answer to that argument: Go ahead and become insolvent. WE DON’T NEED YOU.


How Obama’s health insurance plan will prevent genetic discrimination

The Obama health care plan addresses the problem of genetic discrimination in two ways.

First, it prohibits private insurance companies from excluding individuals from coverage based on pre-existing health conditions. If insurance companies can’t exclude individuals based on pre-existing conditions, then it’s difficult to see how they could deny claim payments based on pre-existing conditions. But let’s suppose that they somehow manage, based on their disproportionate wealth and power, to get away with those things from time to time.

The more important way in which Obama’s health care plan prevents genetic discrimination is that it directly offers its own health insurance to any American to who wants it. This plan is similar to Medicare, except that it applies to the whole U.S. population, not just the elderly and the disabled. To make sure that all Americans can easily afford this public health insurance plan, individuals, families, and small businesses will be offered tax credits on a sliding scale.


How McCain’s health insurance plan will prevent genetic discrimination

McCain’s health plan will absolutely NOT prevent genetic discrimination. John McCain is an anti-regulatory ideologue. Consequently, he is opposed to the idea of requiring private insurance companies to abide by regulations that prohibit discrimination against individuals with pre-existing illnesses. Just three weeks ago McCain bragged about this when he said in an article titled “McCain: We Should Deregulate Health Insurance Like we Deregulated Wall Street”:

Opening up the health insurance market to more vigorous nationwide competition, as we have done over the last decade in banking, would provide more choices of innovative products less burdened by the worst excesses of state-based regulation.

Nor does McCain provide an alternative to private health insurance, as Obama’s plan does.


Comparison of coverage: The Obama vs. the McCain plan

Of course, one of major reasons why a good quality national health insurance plan is needed in the United States is to reduce the number of Americans who are not covered by health insurance, which currently stands at about 46 million.

McCain offers a $2,500 tax credit to individuals and a $5,000 tax credit to families to help them cover the cost of health insurance. However, at the same time his plan will eliminate the tax break for employer provided health insurance, which of course will cause many employers to drop their employee health care coverage. An article by Paul Krugman estimates that this will result in about 20 million Americans losing their health care coverage. And McCain’s $5,000 tax credit for families will hardly enable them to purchase health care insurance, since the average family plan is currently about $12,000 annually. The end result, according to virtually all analyses of McCain’s health care plan, is that any increase it produces in health care coverage will be marginal if not zero. Furthermore, as Krugman explains:

The total number of uninsured Americans might decline marginally under the McCain plan – although many more Americans would be without insurance than under the Obama plan.

But the people gaining insurance would be those who need it least: relatively healthy Americans with high incomes. Why? Because insurance companies want to cover only healthy people, and even among the healthy only those able to pay a lot in addition to their tax credit would be able to afford coverage.


The increase in coverage resulting from Obama’s plan is debatable, but universally recognized to be substantially greater than with McCain’s plan. Some people will undoubtedly choose not to purchase health insurance despite the tax credits they receive for doing so. I’ve found estimates that his plan will result in 47% to 98% coverage of the currently uninsured, including all children. Krugman doesn’t provide a precise number, but summarizes the Obama plan thusly:

Barack Obama offers incremental reform: regulation of insurers to prevent discrimination against the less healthy, subsidies to help lower-income families buy insurance, and public insurance plans that compete with the private sector. His plan falls short of universal coverage, but it would sharply reduce the number of uninsured.


Summary

John McCain’s health care plan fails abysmally to produce any substantial benefits to the American people. It could even result in a net increase in the percent of uninsured Americans because of its taxing of employer-provided health care benefits, which will undoubtedly cause many employers to drop their employee health care plans.

Furthermore, McCain’s plan does nothing to discourage discrimination against the unhealthy or people who have or whose ancestors or family members have various genetic risks. Indeed, McCain’s plan probably will encourage such discrimination, by deregulating health insurance beyond its current lack of regulation.

And yet the cost of the McCain health care plan is only marginally less expensive than the Obama plan.

Krugman summarizes McCain’s plan by saying, “In short, the McCain plan makes no sense at all, unless you have faith that the magic of the marketplace can solve all problems. And Mr. McCain does”

Under the Obama plan, health care in our country will become substantially more affordable, health insurance coverage will substantially increase, and discrimination against the unhealthy or the genetically unfit is likely to disappear. With time, the private health insurance industry very well may disappear, as the American people come to recognize that government-sponsored, Medicare-like health insurance is far superior to private for-profit insurance.

Some may object to my cavalier attitude towards the fate of our health insurance industry, especially my saying that it doesn’t matter if they become insolvent, and saying WE DON”T NEED YOU. What about the people who lose their jobs if the private health insurance industry disappears? Well, their experience in the health insurance industry should qualify them for jobs with the government health insurance program. Why should the American people be held hostage to a for-profit industry that has so frequently defrauded them with respect to the health care that they so desperately need. They can either shape-up and offer a product comparable to Medicare, or they can disappear. As Barack Obama said in his second debate with John McCain, “Health care is a right”, not a privilege or a responsibility, as John McCain said.


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The Unfulfilled Promise
The Unfulfilled Promise of the American Dream: The Widening Gap between the Reality of the United States and its Highest Ideals




Time for change


Notwithstanding the lofty sentiments and purpose of the U.S. Declaration of Independence, the reality of the United States of America did not then – and never has – lived up to its ideal. Our nation remains today a long way from fulfilling the promise implied by those ideals. Yet, our Declaration was a great start, and it has long shone as a beacon of hope for people all over the world.

Throughout our history, while many have striven to close the gap between our highest ideals and the reality of our nation, others have focused on the accumulation of private wealth and power, at the expense of everyone else. In recent decades the latter have gained much ground, leading to increasing imperialism abroad and deteriorating democracy at home, characterized by routine (and legal) bribery of our public officials, the fusion of government and private corporate interests (corporatocracy), a corrupt election system largely in the hands of private corporations, a corporate controlled communications media, and the widespread acceptance of Executive Branch secrecy, routinely justified with little if any questioning, by the magic words “national security”. All of this is rapidly turning our country from the democracy proclaimed at our founding into a plutocracy (government by the wealthy and for the wealthy). The result is the most obscene wealth gap our country has ever known, the highest imprisonment rate in the world, rampant militarism, routine flaunting of international law, the least efficient health care system in the developed world, a pending environmental catastrophe that threatens to destroy the life sustaining forces of our planet, and myriad other problems that threaten to destroy our nation and tyrannize our people.

My new book, The Unfulfilled Promise of the American Dream – The Widening Gap between the Reality of the United States and its Highest Ideals, explores the roots and consequences of the demise of our democracy, and why most Americans have been unable to understand this process or even become aware of it. A good understanding of why and how we have deviated so greatly from the ideals of our nation is the first and necessary step towards getting back on the right track and revitalizing our society.

The book is currently being sold in electronic PDF format and can be purchased at http://www.unfulfilledpromise.com/Buy-the-... for $3.99. It will also soon be available in Amazon Kindle format. DU members who cannot afford to buy the book but would like to read it can pm me with your e-mail address, and I will send you a free PDF copy.

I’ve previously posted on DU a slightly earlier version of the introduction to the book, which is also posted at my site. Here is the Table of Contents, followed by a brief description of the three parts of the book:


TABLE OF CONTENTS

Introduction
Acknowledgements
Prologue – What is Wrong with the United States of America?

Part I – Root Causes of the Impending Demise of American Democracy
Chapter 1 – Legalized Bribery
Chapter 2 – Human Psychological Factors
Chapter 3 – Corporatocracy
Chapter 4 – Corporate Control of Media
Chapter 5 – Corrupt Election System
Chapter 6 – Government Secrecy
Chapter 7 – American Exceptionalism

Part II – A Sampling of Imperialist Actions
Chapter 8 – Slavery and its Legacy
Chapter 9 – Early U.S. Imperialism
Chapter 10 – U.S. Imperialism in Cold War
Chapter 11 – Iraq War and Occupation
Chapter 12 – Afghanistan War

Part III – Consequences
Chapter 13 – Election of George W. Bush
Chapter 14 – War and Imperialism
Chapter 15 – Class Warfare
Chapter 16 – Predator Financial Class
Chapter 17 – Shock Therapy
Chapter 18 – Contempt for Int. Law
Chapter 19 – The “War on Drugs”
Chapter 20 – Climate Change
Chapter 21 – “War on Terror”
Chapter 22 – Health Care
Chapter 23 – Unaccountable government
Chapter 24 – Response to 9/11 Attacks
Epilogue


PART I – Root Causes of the Impending Demise of American Democracy

It is somewhat difficult to separate the causes of our problems from their consequences, since they combine to form a long chain of cause leading to consequence, leading to more consequences, etcetera. Nevertheless, it seems worth while to identify the root causes of our problems, those that occur early in the chain and lead to so many of the tragic consequences we see today. The only chance we have of reversing the demise of our democracy is through addressing and attacking its root causes.

At the top of the list is the systematic bribery of public officials by the powerful corporations (Chapter 1) whom our government is charged with regulating in the public interest. Instead of calling it bribery, we call it “campaign contributions”, but what we call it isn’t as important as what it is. It is hard to fathom how democracy can survive when such a practice is legal and condoned.

Working in tandem with our system of legalized bribery is the nature of the people who inhabit our country. That is not to say that Americans are inherently substantially different than any other people. Human beings are imperfect, and that is probably a major reason why in a world where civilization began more than five millennia ago, the oldest written national framework of government in the world today – the Constitution of the United States of America – is only a little more than two and a quarter centuries old. Chapter 2 explores the roles of basic human needs, authoritarianism, psychological defense mechanisms used to prevent us from perceiving reality as it is rather than as we’d like it to be, and corrupted ideologies in causing us to passively accept the accumulation of power in the hands of ambitious and ruthless individuals who care about little else than expanding their own wealth and power.

When bribery of public officials is tolerated as an inevitable aspect of public life, government inevitably grows close to the wealthy interests that shower it with money in return for legislative and other favors. A malevolent symbiosis grows between the state and corporate power, resulting in rule by an oligarchy that is highly detrimental to the lives of ordinary people (Chapter 3). Using their accumulated wealth and power to manipulate our legislative process, the oligarchy grabs for more and more control of the communications media (Chapter 4) that are used to control the information available to and shape the attitudes of our nation’s people, in pursuit of their own narrow interests.

Since the 1980s an orchestrated campaign has been underway to demonize “big government”, thereby paving the way for private corporate control over more and more functions that were previously deemed intrinsic functions of government. Among those functions is the running of public elections (Chapter 5) – the function that symbolizes democracy perhaps more than any other single function. Consequently, the purging of selected registered voters from our computerized voter rolls has become a routine recurring event throughout much of our country, and without a doubt determined the results of the 2000 – and probably 2004 as well – presidential election. Just as bad, more and more of the counting of votes in our public elections have been turned over to private corporations, which count our votes using electronic machines using secret software to produce vote counts that cannot be verified by anyone.

Bribery, the fusion of government and private interest, fake and biased news, and corrupt elections are not things that government and its corporate allies want us to know about. Consequently, they construct walls of secrecy (Chapter 6) to keep us from obtaining information that sheds light on their activities. The perfect phrase for facilitating this is “national security”. When our government tells us that the “national security” requires that certain things be kept secret from us, the understanding is that to question such a pronouncement is unpatriotic, and to actually attempt to obtain the “secret” information may be treasonous.

But indefinitely maintaining secrets from the American people can be very difficult, because at least some people want to know what their government is up to. So in addition to the formal mechanisms of secrecy, informal mechanisms are constructed (Chapter 7) to keep vital information away from us. One of the primary methods for doing this is to make certain sensitive subjects taboo – that is, to create the widespread belief that discussion of these topics is so outside the bounds of acceptable human discourse that anyone who discusses them should be shunned by society, or worse. The most common issue that falls into this category is any discussion that sheds light on the disparity between American ideals and the reality of life in our country today.


PART II – A Sampling of Imperialist Actions in U.S. History

Notwithstanding the fact that our founding document says that “all men are created equal” and speaks of the inalienable rights of humankind, the United States has throughout its history partaken of massive exploitation of other peoples.

It is estimated that at the time of our birth, 18% of our population was black slaves. In our expansion westwards during the late 18th and 19th centuries, we decimated the original inhabitants of our continent, and often treated them with great cruelty. In 1846 we manufactured an excuse for war with our neighbor Mexico, in which we continued to expand our country westwards and southwards. In 1893 we began our overseas imperialism with the conquest of Hawaii. Our overseas expansion was greatly accelerated in 1898 with our participation in the Spanish-American War, which led to our conquest of Cuba, Puerto Rico, and the Philippines. With our arrival at world superpower status at the end of World War II, we began the Cold War, which led to and served as a rationalization for covert and/or direct military actions against myriad foreign nations over the next 46 years. With the September 11, 2001 attacks on our country, we declared a perpetual “War on Terror”, which served and continues to serve as an excuse to invade and occupy Iraq and Afghanistan, nations that posed no threat to us. We do not know when or if this perpetual war will ever end. We don’t know how many additional imperial conquests it will lead to.

Most Americans don’t think much about all this. Many of these actions are done in secrecy, and the American people don’t find out about them until many years later – or we never find out about them at all. Those that we do know about are spun into the most favorable light, to make them seem benign or even noble.

But these actions come at great costs: in the lives of our soldiers; in the ruined lives of the peoples of the victim countries; in trillions of dollars cost to our people and their future generations; in our international reputation; in anti-American hatred leading to terrorism; and, to our democracy itself. For how can a nation claim to believe in the inalienable rights of humankind specified in its founding document, while making a mockery of that belief in the way it treats other peoples? For that reason alone it is worth while to take a brief look at our long history of imperialist actions.


PART III – Consequences

In the Prologue I give a brief account of what I see as some of the worst and tragic consequences of the root causes that I discuss in Part I – to enable the reader to see where this book is heading. When elections of our public officials are for sale to the highest bidder… when our public officials are so addicted to the “campaign contributions” of their wealthiest constituents that they develop a symbiotic relationship with them… when our communications media are owned and controlled by an oligarchy of wealthy elites… when our citizenry lack the ability to differentiate propaganda from reality… when we allow machines provided by private corporations to count our votes using secret electronic software… then we should expect that the consequences will not be pretty or comfortable for the vast majority of our citizens.

In Part III, I explore those consequences in much greater detail, in the hope that the reader will agree with me that these are very serious problems, and that they must be successfully addressed if our country is ever to fulfill the promise of its ideals, or even make progress in that direction. When enough Americans recognize our problems as problems, stripped of the gloss and spin put on them by our oligarchy, they will rise up and do something about them. Until then there will be no progress, and we are very likely to head in the direction of all the former empires of our planet, ending in chaos, widespread catastrophe, suffering, and ignominy.

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