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Friday, March 18, 2022

HOW DO WE STAND BY UKRAINE?

 

                                                                     



The unfolding tragedy of the war in Ukraine has unleashed a torrent of anger among Americans. That's hardly surprising, given the images of dead and injured civilians, especially children, that are streaming into our homes 24 hours a day. The intense emotions aroused have led to a strong urge to act to stop the violence. Demonstrations of solidarity are inspiring, but they aren't going to affect Putin's plans for Ukraine. The question thus is, how do we most effectively stand with Ukraine?


Examples of what not to do abound. Consider:

Most people support the sanctions, despite abundant evidence showing that they typically don't work and at best achieve only limited success. The logic is to punish the citizens of the sanctioned country, in the hope they will rise up and topple their governments or at least submit to Western demands. It should come as no surprise that this is not a realistic objective in authoritarian societies. The main effect of sanctions is to increase the suffering of the citizens of the targeted country. Madelaine Albright famously admitted that US sanctions on Iraq after the first Gulf War cost the lives of 500,000 children, commenting that "We think it was worth it." This begs the question of who is this "we?" I certainly hope that it is not the opinion of the majority of Americans. In the present case, why would we want to punish the citizens of Russia for Putin's actions, especially when they are protesting by the tens of thousands on the streets of Russia, putting to shame the pitiful response of Americans to US-led wars.

Most people seem to support the arming of Ukraine, even though many analysts point out that there is ultimately little hope that they can hold up against a determined Russian military whose goal does not appear to be occupation. We're told daily about Putin's willingness to use brutal tactics to achieve his objectives, but we are being assured that the vastly inferior forces of Ukraine are really winning. As a result, people who want to support Ukraine are applauding the brave citizens who are taking up arms and putting their bodies on the line confronting trained soldiers, without apparently realizing that this will not likely change the outcome but will certainly lead to more Ukrainian deaths. There has even been serious consideration of the US providing incentives to NATO countries to send war planes to Ukraine, an act of war against Russia that could lead to the US being forced to directly confront the only other nuclear superpower. More and more, we are hearing arguments for why we can't rule out direct US involvement despite the fact that it could quickly lead to nuclear war.

Anyone who still thinks a no-fly zone is a reasonable option simply isn't listening to reason. As Biden and many others have pointed out, this requires being willing to shoot Russian planes down, which would likely lead to WWIII. Anyone who wants to disregard that risk does not deserve to be taken seriously.

There's a reason that "experts" continue to push policies that are at best futile and at worst, catastrophic. The only realistic alternatives would involve allowing Russia to achieve some of its stated goals. That would lead to the career-killing charge of "appeasement." Career politicians and professional pundits in the West cower at this thought, so much so that the idea would never occur to them. Fortunately, diplomats in both Ukraine and Russia are willing to consider what would be unthinkable for these cheerleaders of imperialism.

According to this article, progress is being made on a 15-point plan that would recognize legitimate Russian security interests the West ignored in the runup to the war, despite clear warnings from Russia. Among other provisions, Ukraine would alter its constitution to guarantee that it would never join NATO. Had the US simply declared that it would never allow Ukraine to join, the invasion might have been avoided. That the US refused speaks volumes about the intent of the US in its dealings with Russia with regard to Ukraine. Unfortunately, few are listening.

Russia is also insisting on an agreement that Ukraine will not host foreign military bases. Negotiations continue on what kind of security guarantees that Ukraine might get from NATO countries would be acceptable to Russia, while the article does not mention what kind of security guarantees Ukraine would offer the Republics of Donetsk and Luhansk, which have been subjected to continuous assault since the 2014 coup that put the current government in power. The article also does not mention the status of the Russian demand that Ukraine recognize Russia's sovereignty over Crimea, which it has asserted since the region voted overwhelmingly to rejoin Russia in 2014.

Meanwhile, the battles rage, with increasing loss of life on both sides. If you want to stand for Ukraine, stand for the interests of Ukrainians and common Russians alike and demand that your government stop inflaming the situation with weapons and sanctions and allow real diplomacy to end the killing.

Monday, March 14, 2022

DOCUMENTS INDICATE UKRAINE PLANNED DONBASS ATTACK WITHIN DAYS OF RUSSIAN INVASION

 

                                                                        
                                                                               
                                                                                                                         
Having written recently that it may be a bad idea at his time to keep trying to explain why invading Ukraine should be understood in context, it is with trepidation that I’m now going to do just that. The reason is that there are documents that just came to light which, if verified, prove that those who believed that Russia was trying to prevent a genocide were correct. Of course, if you are in the habit of assuming that any statements released by Russia are by definition false, don't bother reading further. 


Although you’ve probably never heard since it is never reported in American media, Russia reported that there were as many as 125,000 Ukrainian troops inside the ethnically Russian Donbass region of Ukraine by December of 2021, when the 8-year old conflict between Ukraine and the breakaway Republics was heating up again. These troops had been trained and heavily armed by the US, which had been encouraging Ukraine to forcibly take back. On February 24th, the day the invasion began, Ukraine was clearly poised to invade the self-declared independent Republics of Donetsk and Luhansk. The newly revealed records confirm what many of us suspected, that the Ukrainian invasion was scheduled to occur within days.

It is very likely that this was apparent to Russian military intelligence, which would provide a totally different explanation for why the invasion occurred even as Russia was negotiating with Ukraine than the idea that Putin was simply “mad” and “wanted to restore the long-lost Russian Empire.” The claim that Putin was lying about not wanting to invade was based on the fact that he was conducting a troop buildup while negotiating, and in the end he did invade. However, taking literally Putin’s statement that Russia had “no plans to invade” is disingenuous. Obviously, the Russian military buildup meant that they had a plan, but he said repeatedly that whether there would be war depended entirely on Ukraine’s actions. It is entirely possible that he would have preferred to not invade, as he repeatedly indicated. Unless, of course, you start with the assumption that he is mad.

Unlike those who believe the US wanted to avoid war, Zelensky understood what Putin was saying. He called for a halt to inflammatory rhetoric coming from the US and asked Biden to come to Ukraine underscore the fact that there need be no war. In the end, Zelensky was put in a position where he had no choice but to refuse to deescalate the situation by removing troops from Donbass. The video in this article shows why: When he had tried order troops out of Donbass in 2019, neo-Nazis with much greater power over the government and military than their numbers would indicate laughed in his face and sent him away. That’s how a Jewish president came to realize that he had better go along with what these US-backed fascists had in mind.

So go ahead and hate Putin if it makes you feel better. War is always a choice, and it is always brutal. Civilians are always killed, even though dead children make excellent propaganda for those who want to paint a war as one-sided. But if you want to prevent the next war, for God’s sake try to understand the logic of both sides of this conflict. More specifically, do whatever you can do to try and get your government to stop constantly provoking a nuclear power, while denying its legitimate security interests.

Below is a transcript of the official Russian Defense Ministry announcement. The cited documents can be seen here.
       -Translation supplied by Konstantin Scheglikov.

"During a special military operation, secret documents of the command of the National Guard of Ukraine came into the possession of Russian military personnel. These documents confirm the covert preparation by the Kiev regime of an offensive operation in the Donbass in March 2022.

The Russian Defense Ministry publishes the original secret order of the commander of the National Guard of Ukraine, Colonel General Nikolay Balan, dated January 22, 2022.

The order "On the organization of training of the battalion tactical group of the 4th Operational Brigade to perform combat (special) tasks in the operation of the united forces as part of the brigade of the Armed Forces of Ukraine".

The document is addressed to the heads of the northern Kiev, southern Odessa and western territorial administrations of the National Guard of Ukraine.

The order, brought to the command of the National Guard of Ukraine, details a plan for the preparation of one of the strike groups for offensive actions in the zone of the so-called "operation of the united forces" in the Donbass.

The document approves the organizational and staff structure of the battalion-tactical group of the 4th operational brigade of the National Guard, the organization of its comprehensive support and reassignment to the 80th separate airborne assault Brigade of Ukraine.

I would like to emphasize that this brigade from the airborne assault forces of Ukraine has been trained by American and British instructors in training programs of the "NATO standard" in Lviv since 2016.

In accordance with the order, the Deputy Commander of the National Guard was tasked with organizing combat coordination of the battalion tactical group of the National Guard as part of the 80th separate airborne assault brigade of the Armed Forces of Ukraine from February 7 to February 28, 2022.

I draw your attention - as many as five paragraphs of paragraph 4 are devoted to the issues of careful selection of personnel, examination of all psychologists and ensuring their high motivation.

To do this, the National Guard is ordered to provide "visual agitation, information and propaganda materials, flags, and printing products."

The Deputy commander of the National Guard for Personnel was ordered to organize "an effective system of informational, moral and psychological support for the battalion-tactical group of the 4th brigade of operational purpose, internal communication of commanders with subordinates."

At the same time, it is important to provide "an explanation to the personnel of management decisions and the importance of performing upcoming tasks."

I draw special attention to the fact that paragraph 12 of the order prohibits sending to the area of combat coordination and to the place of execution of "combat special tasks" of the National guardsmen who showed "unsatisfactory" results of psychological testing according to the criterion of "readiness for risk".

All measures of the nationalists' combat coordination are ordered to be completed by February 28 in order to further ensure the fulfillment of combat tasks as part of the Ukrainian "joint forces operation" in the Donbass.

The document contains the original signatures of the officials responsible for the tasks of the command of the National Guard of Ukraine.

We well remember the statements of the leadership of the Kiev regime, replicated in February by the Western media, about the alleged absence of any plans for the armed seizure of the Lugansk and Donetsk People's Republics. Their desire to solve all issues allegedly "by political and diplomatic means".

However, the originals of the secret combat documents of the National Guard of Ukraine unequivocally prove the falsity of these statements.

A special military operation conducted by the Russian Armed Forces since February 24 has forestalled and thwarted a large-scale offensive by shock groups of Ukrainian troops on,uncontrolled to Kiev, the Lugansk and Donetsk People's Republic in March of this year.

Thus, only one question remains unclear so far: how deeply the leadership of the United States and its NATO allies were involved in the planning and preparation of the operation to storm the Donbass by the Ukrainian interspecific group of troops in early March. All those who care so much about peace in Ukraine today."

The Russian Defense Ministry publishes the originals of the National Guard's combat order proving that Ukraine is preparing an offensive on Donbass in March this year."

Source https://www.youtube.com/watch?v=HRNaoDh__L0

https://vk.com/public207684894?w=wall-207684894_53

Monday, February 21, 2022

UNDERSTANDING UKRAINE





                                                                             
                                                                 
On Wednesday, Ukrainian forces intensified ongoing shelling of Donbass, lending apparent credibility to Biden's repeated claims over recent weeks that an invasion is "imminent." However, the news raises a number of questions about what we have been told by politicians and the mainstream western media since the beginning of the crisis. We need to take these claims into account in order to understand the significance of current events.


Let's break down the propaganda to figure out how this increase in violence fits into the NATO narrative:

First, the US has given several reasons for why they expect Russia to invade over the last few weeks. That alone should give us pause, given the certainty with which the US has been making these claims. Since they have cited no evidence for most of them, you have to wonder why the secret "evidence" keeps changing. If you've been keeping track, they are, in order:

- "Putin wants to restore the Empire." This has been repeated ad nauseum since the outbreak of the crisis, most recently by Blinken on Wednesday.

- Unsourced "evidence" indicated Russia will stage a false flag attack on Donbass as a pretext for invasion

- Unsourced evidence indicated Russia will fake a false flag in Donbass, using staged video.

- Officials stated that Russia will use its promise to protect Russian citizens and ethnic Russians in Donbass as a "pretext" for crossing the border.

Of these, only the last is a plausible reason that Russia would trigger massive sanctions by invading. If there is any validity to the US doctrine of Responsibility to Protect. That's the pseudo-legal argument that was cited as the reason for violent US interventions in Libya and Syria in contravention of international law. If there is a time when it was justified, this would be it. More properly, it would be an example of using force to prevent genocide (see below for more on this).

As the situation evolves, the propaganda gets more convoluted:

- Thursday, it was reported that Russia was going to invade in respond to a Ukrainian attack on Donbass. By Friday, media were reporting it was unclear who attacked first, even though it makes no sense to imagine that the residents of Donbass were trying to goad the Ukrainian military into attacking, as it was clearly prepared to do (again, more on this below).
- In responding to reports of the increased shelling, Biden stated that the attack on Donbass was a "false flag" operation by Russia, claiming that Russia had fired the first shots in order to provoke a Ukrainian response that would create a "pretext" for an invasion. Interestingly, a reporter on the scene in the same televised report categorically stated that Russia had not fired the first shots.
- A day later, explosions rocked downtown Donetsk and Luhansk, the two principal cities of the breakaway Donbass region. At the time of this writing, I am awaiting the announcement that this was the long-awaited Russian false flag.

It's worth noting that over time, more responsible news sources have begun explaining the Russian security concerns detailed in their response to US demands to withdraw from their own border. At the same time, western media continued to describe these red lines only as "demands," as if Russia explaining its red lines in the face of US threats is unreasonable. Not surprisingly, US officials simply dismissed the most important of these arguments without acknowledging that they had any validity, while claiming to want to negotiate peace (on US terms, of course).

If one accepts that the only plausible reason for a Russian incursion was to protect Russian citizens and ethnic Russians in Ukraine, and that the US must have known, why did Biden suddenly predict before the shelling that it was going to happen within 24-48 hours, again with no evidence? It's reasonable to suspect that the US knew Ukraine was going to attack because it was behind it.

The US government had been trying to talk Ukraine's President Zelensky into escalating the conflict since last spring. Zelensky responded to Washington's lead with threats to residents of the breakaway Republics, but by January he lost his nerve and began to openly dispute US claims of "imminent" war that would serve no one's interest but that of the US weapons industry.

The increase in shelling thus raises a very important point: Since Zelesnky had repeatedly denied that he believed Russia had any intent to invade, why would he suddenly provide a pretext? It's reasonable to suspect that he didn't. The more likely culprits are embedded pro-US fascists in the army acting on their own. If that's the case, Zelensky can't deny ordering the attack if he values his life. We all saw how violent the US-backed Right Sector fascists were willing to get in over to overthrow the elected government and seize power in 2014. There is no reason to think that they would not do the same to Zelensky if he stood in the way of the plan.

The brownshirts of Right Sector are now dispersed throughout the military, including their Azov battalion. Tens of thousands of Ukrainian troops have been massed on the borders of Donbass since before the Russian buildup (which might reasonably be assumed to be the original reason for Russia's massing its own troops on the border last spring). Since some of these neo-Nazis have openly called for genocide of ethnic Russians, it seems likely that they would be perfectly willing to provoke a conflict that will result in horrendous bloodshed, regardless of who "wins" the war in Donbass. Of course, if Russia doesn't take the bait, the US can still score propaganda points by saying that it prevented the invasion that would have otherwise occurred.

In view of Friday's bombing, it appears that the US may have gotten tired of waiting for Russia to respond to the escalation in violence by the Ukrainian neo-Nazis and taken matters into their own hands, using CIA-trained Ukrainian special forces in place in Donbass.

It will be interesting to see how Putin takes advantage of a situation which he surely anticipated, given the lack of imagination of the neocons who have clearly engineered the crisis.

 

Monday, September 14, 2020

IT COULD HAPPEN TO YOU




                                                                                  





As I've said many times, the easiest way to get through the corporate media blockade on a lot of issues is to write letters to the editor and guest columns for your local paper. Their editors are not as invested in denying a voice to those who would chip away at corporate control of government.

The following is an editorial I wrote for the Eugene Register-Guard a few years ago making the case for universal health care using an emotional hook. Research has shown this to be most likely to make people think about the issue who would ordinarily be predisposed to dismiss the idea out of hand as "socialist." I was recently reinded of the importance of this idea in a presentation on how to advocate for single payer. I reprint it here as an example of how to hook such people so that they will pay attention long enough to learn how such a system would benefit them, which is ususally the first thing most people think of when they consider public policy.


We’ve all seen it: You walk into a convenience store and there on the counter, taped to a jar, is the photo of a child. Scrawled on the picture is an appeal to leave your change to finance a bone marrow transplant or some other treatment the child’s family cannot afford. Or maybe you can help the victim of a fire or accident by buying a pizza on the night that one dollar per sale goes to her medical expenses.
  Do you feel good about being able to help, or are you outraged that these families have to beg for desperately needed assistance?


If you don’t feel guilty passing up such chances to help, perhaps it is because you realize the ultimate futility of such appeals. But if you don’t support doing something about it, you should feel guilty. These are neighbors in need. We can turn away from them now, but what happens when we need medical care we cannot afford?

Chances are, you don’t have enough insurance to keep from going bankrupt if you get an illness or injury requiring expensive treatment. 60% of bankruptcies are due to medical bills, and 75% of those undergoing medical bankruptcy are insured.  In other words, simply having insurance isn’t enough if you can’t afford to use it, or if you use it and go broke anyway.  Medical bankruptcies are unheard of in other developed countries. There, risk sharing through universal health care prevents the unlucky families who most need help from having financial ruin added to their burden. Everyone contributes to the system so that none need go without care when it is needed.

Aside from the humanitarian issue of having nearly 30 million Americans uninsured, most of whom are the working poor, there are many practical advantages to universal health care. When access to care is not tied to employment, it is much easier to change jobs. People are free to work where they want instead of keeping a job with medical benefits that doesn’t otherwise fit their needs. If they want to start their own business, they don’t have to worry about losing it due to unexpected illness or injury. Businesses are more competitive with overseas competitors when they do not have to pay extortionate rates for insurance and instead, have predictable costs.  These costs are significantly less in countries with universal health care than they are in the American system of access through for-profit medical insurance.

The financial benefits of universal health care are well known, but since some continue to claim that we cannot afford it in the US, it bears repeating: Other countries provide universal, comprehensive care for as little as half the amount per person that we pay in the US for care that is full of gaps even for the insured.  While it’s not estimated that we will save that much under the plan recently introduced in Congress by Bernie Sanders, his proposal for an improved system of Medicare for All would provide comprehensive care to every American at less cost than the current system.

Such as system would have built-in cost controls lacking in the Affordable Care Act. Without such constraints, the system will ultimately become unsustainable due to the familiar “death spiral” of medical insurance:  As costs rise, fewer can afford it, leading to premium increases to maintain profits, which leads to fewer being able to afford it, thus causing a new cycle of price increases. Ultimately, most of us will not be able to afford insurance without the subsidies offered under Obamacare. These subsidies amount to a bailout of Wall Street investors in the insurance industry for the sole purpose of maintaining their profits. They add nothing of value to the system to justify their siphoning 30 cents out of every health care dollar, when Medicare overhead is less than a tenth of that.

When you understand the economics of universal health care, it is hard to argue that we cannot afford it. The question then becomes, do we really want to pay more for less care for ourselves and our loved ones, just to deny it to those we think may not be worthy?

Thursday, August 6, 2020

FIGHTING TRUTH DECAY IN THE NAME OF PEACE

                    

                                                                  

                                    “Truth is the first casualty of war.”
                                   -Aeschylus

                                   “After that, it’s mostly civilians.”

                                  -Source unknown.

As Chomsky and Herman wrote, starting a war depends on manufacturing the consent of the public. Fortunately, though opposition to war has diminished to a barely audible voice in the last 50 years amidst the clamor of warmongers’ alarms about imagined threats to the Empire, it persists. There is an urgent need to use the limited strength of the peace movement to rally public support to the cause of ending war. Whatever tactics we might use, our first goal must be to awaken Americans to the fact that nearly everything they are told by the mainstream media about US foreign policy is false.  

Only when Americans recognize that the corporate media is captive to war profiteers will they understand that war is not inevitable, that it threatens human survival because it enslaves us to fossil fuels, that silence is consent to continue on the path to self-destruction and that without that consent, the Empire cannot continue to wage endless war against the mass of humanity.

Awakening the public to these truths requires a strategy to enable them to see beyond the blinders of their belief in American exceptionalism. This idea is so deeply engrained that even many antiwar activists do not recognize it in themselves. It is the belief that the United States is essentially good and that our tendency to war is due to our desire to do the right thing regardless of how consistently we do not accomplish our stated objectives. The idea that the Vietnam War was a mistake, that the lies that led us into invading Iraq were an aberration, or that humanitarian intervention is a noble endeavor are all examples of how the insidious belief in American Exceptionalism can blind us to the fact that excuses for war are always (or almost always) based on propaganda.

I don’t know what students are learning in high school these days, but when I was a sophomore I learned how the Hearst newspaper chain created support for war with Spain by calling for a “humanitarian intervention” to help Cuba liberate itself from imperial rule. The result of course was that Cuba, the Philippines, Puerto Rico and Guam, Puerto Rico essentially became colonies of the US. In more recent times, the Vietnam was justified as “self-defense” based on lies about the Gulf of Tonkin incident, Iraq was invaded for a second time on manufactured evidence for the false claim that it was building WMDs and Libya was destroyed based on an unverified claim that Gaddafi was preparing to massacre US-backed “rebels” in Benghazi. There are similar stories to tell about essentially every American intervention since WWII (not to mention WWI itself), for those who want to take the time to explore the history of modern wars.

Given these well-known examples of the US government lying to its people, you might think it would be easy to make the case that they are being lied to about Syria, Ukraine, Iran, Venezuela, Nicaragua, Russia and other nations whose governments have been targeted for imperial expansion. If so, you do not appreciate the degree to which Americans have been induced to unconsciously accept the premises of American Exceptionalism through education, media, and politicians. The only way to break through this wall of denial is to educate the public about exactly how this is accomplished. How else will they learn to critically examine the lies they are being told by virtually everyone in the Western media, politicians, and the Wall Street war profiteers whose interests they serve?

It is hard for most people to accept the idea that the corporate media lies about nearly every aspect of foreign policy. It sounds to the uninitiated like a conspiracy theory, which they have been taught to disregard (unless it comes from the government). In order to understand how it is possible to get all of the mainstream media to repeat the same false story, you have to understand the ways in which it can be manipulated through both economic pressure (as detailed in the introduction to Manufacturing Consent) and the influence of propagandists in the CIA, their assets in the media and private think tanks. It is the extensive influence of the CIA on corporate media that is the hardest to accept for people who have not done the research, but for those willing to read a little further, I wrote this short essay to make it easy to understand the main points.

Since 1983, the CIA’s propaganda function has been largely replaced by corporate think tanks, the US Agency for International Development (USAID) and its spinoff, the self-proclaimed “private nonprofit” National Endowment for Democracy (NED), which is in fact almost entirely funded by Congress. They use the same techniques of using government funding to influence both US and foreign media to tell the same stories whose scripts the US foreign policy establishment has written. Their function is to weaken governments targeted for regime change, whether through war, insurrection, US-backed terrorist invasions or crippling sanctions.

This is of course only a bare-bones summary of the way that the media is manipulated and why it is important to challenge the official narrative. I hope that I have made the case that it is critical to get people to understand the extent to which they are deceived by their government. Interested readers are encouraged to read the linked articles and to do their own research. The importance to the peace movement of freeing Americans trapped in the prison of their false belief systems cannot be overemphasized. Please join the effort by learning more and joining the fight to free America from the Matrix of lies in which most of us exist.

Tuesday, February 11, 2020

WILL DEMOCRATS FALL FOR THE PUBLIC OPTION SCAM AGAIN?




                                                                               




When all the Establishment-backed contenders for the Democratic presidential nomination support some version of a public option, it’s a safe bet that corporate interests that finance the DNC are the ones that are being served. As corporatist candidates like Harris and Biden fail to resonate, new champions of “pragmatic” approaches to reform rise to take their places. Even progressive darling Elizabeth Warren favors an incremental approach that she thinks will lead to single payer, starting with a public option. Only Sanders has consistently indicated his willingness to take the lead in a fight for a Medicare for All now.

The arguments made by the corporatists in the party are having an effect. A substantial proportion of Democrats are buying the false claim that a public option is the only viable way to establish universal access to health care. That’s shown in their growing support for a public option and decreasing support for a single payer system like Medicare for All.  It’s disheartening that so many supporters of a single payer system of health care are falling for the same nonsensical arguments that were used to undermine support for it during the “health care reform” debate in 2009.

Those of us who understood then that the call for a public option was a bait-and-switch strategy to defuse the growing movement for a single payer system must start all over again educating progressives about why it will not lead to single payer. Instead, it will just add one more plan to a multipayer system of access to health care that is inherently inefficient. This inefficiency is the main reason that health care costs per capita in the US are about twice the average in countries with universal health care. Americans will not accept another expensive half-measure that won’t address the root problem or assure access to all.

The reason a public option won’t lead to single payer is that a Congress saturated by lobbyist cash will never create a plan that would compete with private plans. Democrats who are ready to embrace Biden, Buttigieg or any other proponent of a public option have apparently forgotten that Senator Schumer explicitly stated in 2009 that Democrats had no intention of creating such a plan. They also fail to recall that the corporate Democrats who kept single payer off the negotiating table continued to claim that people would like the plan so much that Americans would eventually all want to join it, creating a single payer plan by default. Nothing has changed since then.

To be fair, it’s theoretically possible that a public option could at least provide universal coverage. However, that’s not the same as universal access to health care. Anyone who has studied the issue understands that premiums, copays and deductibles remain a significant barrier to access to care for the insured. Financial barriers to access have dramatically increased since 1998, according to a recent Harvard study published in the Journal of the AMA. That study also showed that even the much-touted Obamacare expansion, expensive as it was, has not appreciably decreased the proportion of people who experience problems with access to affordable care. That’s why one in four Americans report that they or a family member have put off needed care for a serious condition because of cost. In families earning less than $40,000 per year, that figure rises to one in three.

Insurance is not the same as access to care when financial barriers to using it persist. That even applies to patients on Medicare, who also often have serious difficulty paying for their medications. That’s why single payer advocates generally prefer the term  “Improved Medicare for All” when referring to the plans advocated by most advocacy groups and members of Congress who actually understand these issues and support a single payer solution to the continuing crisis in health care access and affordability.

Improved Medicare for All refers to a system that is more comprehensive than Medicare, with coverage for vision, dental and hearing and medications, no or minimal premiums or copays and no deductibles. Some versions include long term care, as is provided in several European countries such as France and the Netherlands.  It is also a feature of one of the bills currently in Congress. All such bills introduced in the last few Congresses are variations on Improved Medicare for All because that is the type of single payer system that is widely acknowledged to be the most politically palatable in the US due to the generally positive views of Medicare.

I won’t go into the explanations of why single payer systems are less expensive than publicly funded and administered (single payer) systems (the basic reasons are summarized in this bullet-point document, which also points out other economic advantages). There are endless articles written on the subject for the interested reader, but the simple response to those who say we can’t afford such a system is this: countries that provide universal health care to all their residents using a publicly funded and administered system provide care as good or better than the US at the least cost.

If other countries can do it, the only thing stopping the US from doing the same is the lack of political will due to Americans dithering about whether it is politically possible. It will be possible only when we demand it. A single payer plan like Medicare for All is the only affordable way to end the crisis of health care access and affordability in the US. Accept no substitute

Monday, November 20, 2017

MEDICARE FOR ALL-HARD HEADED ECONOMICS, SOFT HEARTED POLICY



                                       


We’ve all seen it: You walk into a convenience store and there on the counter, taped to a jar, is the photo of a child. Scrawled on the picture is an appeal to leave your change to finance a bone marrow transplant or some other treatment the child’s family cannot afford. Or maybe you can help the victim of a fire or accident by buying a pizza on the night that one dollar per sale goes to her medical expenses.  Do you feel good about being able to help, or are you outraged that these families have to beg for desperately needed assistance?

If you don’t feel guilty passing up such chances to help, perhaps it is because you realize the ultimate futility of such appeals. But if you don’t support doing something about it, you should feel guilty. These are neighbors in need. We can turn away from them now, but what happens when we need medical care we cannot afford?

Chances are, you don’t have enough insurance to keep from going bankrupt if you get an illness or injury requiring expensive treatment. 60% of bankruptcies are due to medical bills, and 75% of those undergoing medical bankruptcy are insured.  In other words, simply having insurance isn’t enough if you can’t afford to use it, or if you use it and go broke anyway.  Medical bankruptcies are unheard of in other developed countries. There, risk sharing through universal health care prevents the unlucky families who most need help from having financial ruin added to their burden. Everyone contributes to the system so that none need go without care when it is needed.

Aside from the humanitarian issue of having nearly 30 million Americans uninsured, most of whom are the working poor, there are many practical advantages to universal health care. When access to care is not tied to employment, it is much easier to change jobs. People are free to work where they want instead of keeping a job with medical benefits that doesn’t otherwise fit their needs. If they want to start their own business, they don’t have to worry about losing it due to unexpected illness or injury. Businesses are more competitive with overseas competitors when they do not have to pay extortionate rates for insurance and instead, have predictable costs.  These costs are significantly less in countries with universal health care than they are in the American system of access through for-profit medical insurance.

The financial benefits of universal health care are well known, but since some continue to claim that we cannot afford it in the US, it bears repeating: Other countries provide universal, comprehensive care for as little as half the amount per person that we pay in the US for care that is full of gaps even for the insured.  While it’s not estimated that we will save that much under the plan recently introduced in Congress by Bernie Sanders, his proposal for an improved system of Medicare for All would provide comprehensive care to every American at less cost than the current system.

Such as system would have built-in cost controls lacking in the Affordable Care Act. Without such constraints, the system will ultimately become unsustainable due to the familiar “death spiral” of medical insurance:  As costs rise, fewer can afford it, leading to premium increases to maintain profits, which leads to fewer being able to afford it, thus causing a new cycle of price increases. Ultimately, most of us will not be able to afford insurance without the subsidies offered under Obamacare. These subsidies amount to a bailout of Wall Street investors in the insurance industry for the sole purpose of maintaining their profits. They add nothing of value to the system to justify their siphoning 30 cents out of every health care dollar, when Medicare overhead is less than a tenth of that.

When you understand the economics of universal health care, it is hard to argue that we cannot afford it. The question then becomes, do we really want to pay more for less care for ourselves and our loved ones, just to deny it to those we think may not be worthy?



This article first appeared in the News-Review (Roseburg, OR) on November 17, 2017.