Barack Obama aspires to be a “transformative” president, with his hopes particularly fixed on America’s finally achieving a universal health care system.
But would his health plan go far enough to transform a system that has been dominated and distorted by for-profit insurers who maximize profit by rationing care to patients, restricting doctors’ choice of treatments, and raising premiums? Of course, the outlines of Obama’s plan will be profoundly changed by the legislative process, and it may be virtually unrecognizable once a finished product reaches the presidential desk. But it is a valuable starting point for discussing what is likely to succeed, and what is likely to fail, in health care reform.
Obama has outlined a plan for universal coverage, cost restraints, and extensive choice for American health consumers, along with new regulations on for-profit insurers. However, the insurers will continue to claim a major role.
By avoiding the risks of a direct collision with the tremendous power of the health insurance industry, the Obama plan fails to address the problem of effective cost controls needed to sustain coverage for all Americans. Passage of his bill would set off a perpetual tug of war between insurers’ ever-rising premiums and the increasingly expensive goal of universal coverage. Further, leaving private insurers in place largely forfeits the massive savings in excess administrative costs that could help to fund universal health care and other priorities.
On the positive side, the Obama plan also offers a public, Medicare-style option that some advocates of his proposal view as the potential incubator of a single-payer system, if sufficient numbers of Americans gravitate away from private insurance. If this provision can pass both houses, it will set off a high-stakes struggle. The for-profit insurers will work to circumvent new regulations that could force them to provide treatment for all potential enrollees and limit their administrative overhead. Some experts expect that the insurers will attempt to turn the public program into a dumping ground for high-cost patients and will easily manipulate new regulations on other pernicious practices, triggering a new round of battles with health consumers and Congress. Eventually, these struggles could erode insurers’ legitimacy and exhaust all alternatives short of a single-payer system that dethrones the insurance industry.
Dimensions of the Health Care Crisis
To evaluate the Obama plan and the nature of the battles it will generate, we first need to grasp the scope of the health care crisis.
• Some forty-seven million Americans were already lacking health insurance before the economic meltdown. The sharp increa...
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Austin Frerick, who launched a bid for Iowa’s third congressional district on an antimonopoly platform, dropped out when party leaders made it clear that they preferred his better-funded opponents. Photo courtesy of Austin Frerick.
Early voting locations in the Indianapolis metro area in 2016, via IndyStar.
An Eritrean refugee in Khartoum. Photo by John Power.
Khartoum as seen from the river Nile. Photo by John Power.
Common migration routes from East Africa to Europe. Route information adapted from the International Organization for Migration, August 2015, by Colin Kinniburgh. Countries party to the Khartoum process are shaded in orange (note: not all shown on this map).
At the 1936 International Conference of Business Cycle Institutes, sponsored by the Austrian Institute for Business Cycle Research, Vienna. Ludwig von Mises is seated in the center with mustache and cigarette. Gottfried Haberler also pictured, at right. (Source)
In 1896, William Jennings Bryan, a Democrat from Nebraska, ran for president on a fusion ticket with the Populist Party. This cartoonist from a Republican magazine thought the “Popocratic” ticket was too ideologically mismatched to win. Bryan did lose, but his campaign, the first of three he waged for the White House, transformed the Democrats into an anti-corporate, pro-labor party. Cartoon from Judge (1896) via Library of Congress
Sketch for a 1976 poster by the New York Wages for Housework Committee (MayDay Rooms / Creative Commons)
Keith Vaughan, “Drawing of a seated male nude,” 1949. Courtesy the estate of Keith Vaughan / Creative Commons.
Political strategist Jessica Byrd. Courtesy of Three Points Strategies.
Stacey Abrams, Minority Leader of the Georgia House of Representatives and Democratic candidate for governor of Georgia. Photo courtesy of David Kidd/Governing.
A drawing made for the author by a five-year-old girl in detention at the South Texas Family Residential Center in Dilley, Texas (Courtesy of Nara Milanich)
A drawing made for the author by a five-year-old girl in detention at the South Texas Family Residential Center in Dilley, Texas (Courtesy of Nara Milanich)
A drawing made for the author by a five-year-old girl in detention at the South Texas Family Residential Center in Dilley, Texas (Courtesy of Nara Milanich)
Mayor Bill de Blasio inaugurates a new bus line in the Bronx, September 2017 (New York City Department of Transportation / Flickr)
Luxury condominium towers under construction in Williamsburg, Brooklyn, 2013 (Michael Tapp / Flickr)
The nightmare situations preppers imagine are already happening—to people whose wealth and status don’t protect them. Above, Hurricane Maria relief efforts in Puerto Rico, October 2017 (Agustín Montañez / National Guard)
From the music video for “Unforgettable,” by French Montana, featuring Swae Lee (FrenchMontanaVEVO / Youtube)
Wizkid performing at Royal Albert Hall, London, September 2017 (Michael Tubi / Alamy Live News)
The cover of L’antinorm, published by the Homosexual Front for Revolutionary Action (FHAR), February 1973. The subtitle reads “Workers of the world, stroke yourselves!”
Jair Bolsonaro, at a debate about violence against women in Brazil’s chamber of deputies, September 2016. Photo by Marcelo Camargo/Agência Brasil.
Jair Bolsonaro, at a debate about violence against women in Brazil’s chamber of deputies, September 2016. Photo by Marcelo Camargo/Agência Brasil.
The front page of the Canard, February 28, 2018. Courtesy of Le Canard enchaîné.
Selling drugs in the shadow of an abandoned factory, North Philadelphia. Photo by George Karandinos.
Bundle of $10 bags of heroin. Photo by Fernando Montero Castrillo.
On a dilapidated Havana street, an elderly man searches through the garbage. February 2018, Havana, Cuba. Photo by David Himbert / Hans Lucas Studio.
A state employee reads the newspaper at the reception of the Defense Committee of the Revolution (CDR). March 2016, Havana, Cuba. Photo by David Himbert / Hans Lucas Studio.
A street vendor selling tropical fruits in front of a Benetton shop in Old Havana. May 2017, Havana, Cuba. Photo by David Himbert / Hans Lucas Studio.
AMLO mural in Mexico City, 2007 (Randal Sheppard / Flickr)
MORENA supporters at a rally in Itzapalapa, Mexico City, April 2015 (Eneas De Troya / Flickr)
Audience members waiting for the program to begin at a MORENA rally, March 2016 (Eneas De Troya / Flickr)
MORENA supporter leafletting against energy reforms, 2013 (Eneas De Troya / Flickr)
Andrés Manuel López Obrador on the campaign trail during his previous presidential run, May 2012 (Arturo Alfaro Galán)
Courtesy of Robert Greene
At a protest against the alleged Pizzagate conspiracy, Washington, D.C., March 25, 2017 (Blink O’fanaye / Flickr)
The Kurds
[W]hen we refer to all Kurdish fighters synonymously, we simply blur the fact that they have very different politics. . . right now, yes, the people are facing the Islamic State threat, so it’s very important to have a unified focus. But the truth is, ideologically and politically these are very, very different systems. Actually almost opposite to each other. —Dilar Dirik, “Rojava vs. the World,” February 2015
The Kurds, who share ethnic and cultural similarities with Iranians and are mostly Muslim by religion (largely Sunni but with many minorities), have long struggled for self-determination. After World War I, their lands were divided up between Iraq, Iran, Syria, and Turkey. In Iran, though there have been small separatist movements, Kurds are mostly subjected to the same repressive treatment as everyone else (though they also face Persian and Shi’ite chauvinism, and a number of Kurdish political prisoners were recently executed). The situation is worse in Iraq, Syria, and Turkey, where the Kurds are a minority people subjected to ethnically targeted violations of human rights.
Iraq: In 1986–89, Saddam Hussein conducted a genocidal campaign in which tens of thousands were murdered and thousands of Kurdish villages destroyed, including by bombing and chemical warfare. After the first Gulf War, the UN sought to establish a safe haven in parts of Kurdistan, and the United States and UK set up a no-fly zone. In 2003, the Kurdish peshmerga sided with the U.S.-led coalition against Saddam Hussein. In 2005, after a long struggle with Baghdad, the Iraqi Kurds won constitutional recognition of their autonomous region, and the Kurdistan Regional Government has since signed oil contracts with a number of Western oil companies as well as with Turkey. Iraqi Kurdistan has two main political parties, the Kurdistan Democratic Party (KDP) and the Patriotic Union of Kurdistan (PUK), both clan-based and patriarchal.
Turkey: For much of its modern history, Turkey has pursued a policy of forced assimilation towards its minority peoples; this policy is particularly stringent in the case of the Kurds—until recently referred to as the “mountain Turks”—who make up 20 percent of the total population. The policy has included forced population transfers; a ban on use of the Kurdish language, costume, music, festivals, and names; and extreme repression of any attempt at resistance. Large revolts were suppressed in 1925, 1930, and 1938, and the repression escalated with the formation of the PKK as a national liberation party, resulting in civil war in the Kurdish region from 1984 to 1999.
Syria: Kurds make up perhaps 15 percent of the population and live mostly in the northeastern part of Syria. In 1962, after Syria was declared an Arab republic, a large number of Kurds were stripped of their citizenship and declared aliens, which made it impossible for them to get an education, jobs, or any public benefits. Their land was given to Arabs. The PYD was founded in 2003 and immediately banned; its members were jailed and murdered, and a Kurdish uprising in Qamishli was met with severe military violence by the regime. When the uprising against Bashar al Assad began as part of the Arab Spring, Kurds participated, but after 2012, when they captured Kobani from the Syrian army, they withdrew most of their energy from the war against Assad in order to set up a liberated area. For this reason, some other parts of the Syrian resistance consider them Assad’s allies. The Kurds in turn cite examples of discrimination against them within the opposition.
Proclamation of the reclaiming of Alcatraz by the Indians of All Tribes, November 1969 (National Parks Service)
Entrance to Alcatraz in 2008 (Babak Fakhamzadeh / Flickr)
Letter from the Indians of All Tribes to the National Council on Indian Opportunity, January 1970 (National Parks Service)
Sign on Alcatraz during occupation, 1969–60 (National Parks Service)
Members of the People’s Guard on motorcycles, 1920. Courtesy of Eric Lee.
Armed group of the Menshevik People’s Guard, 1920. Courtesy of Eric Lee.
Eleven-year-old Liza Greenberg, daughter of David and Suzanne Nossel. Photo by Todd Gitlin.
Protest against neoliberalism in Colombia, 2013
In a scene from HBO’s The Deuce, streetwalker Ruby presents an officer with a property voucher to avoid arrest. Courtesy of HBO.
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