As US awaits "Obamacare" court ruling, some US-EU comparisons

This week the US Supreme Court will issue a landmark ruling on the constitutionality of “Obamacare”. It is still a mystery what the conservative-dominated court will decide.

There is speculation that the court may rule that just parts of the legislation are unconstitutional. The main provision everyone is watching is the requirement for all people to get health insurance or face fines. Republicans are arguing that it is illegal to force people to buy health insurance. But Democrats say that throwing out even just this one piece of the legislation will make the whole thing fall apart.

The healthcare reform changed the law to make it illegal for insurance companies to deny someone coverage because they are sick. Experience has shown that such a requirement has to be coupled with a requirement for everyone to have health insurance – otherwise healthy people would wait until they get sick to buy coverage. Eliminating the requirement to purchase insurance could send the whole system into the so-called “insurance death spiral” – where sick people suddenly flood the insurance market and send costs soaring.

America unhinged

Perhaps the only thing more depressing than this weekend's assassination shooting of US Congresswoman Gabrielle Giffords was the fact that it was so utterly unsurprising. The shooting, which for the moment remains an attempted assassination as its intended target fights for her life in hospital, so far has a death toll of six out of 20 people shot. For many observers in the US, the shooting is the culmination of two years of incendiary rhetoric from the right, an episode of far-right violence that people have been warning was coming soon. When you have mainstream American politicians telling people that the government is trying to establish "death panels" in its healthcare legislation and that there has been a "Socialist takeover" of the government that can only be brought to an end using "second amendment remedies", it was only a matter of time before some unhinged person on the far right acted out in violence.

The motives of the shooter, Jared Lee Loughner, are not yet clear. In fact authorities are looking into the possibility of a second shooter. It is not yet known whether Loughner had any specific ties to the Tea Party movement, whether he was an admirer of Sarah Palin, or whether he was a fan of incendiary Fox News hosts such as Glenn Beck and Bill O'Reilly. But from his online postings and notes, it already seems clear that Loughner subscribed to far right ideology. His online postings and YouTube videos rant against government tyranny, using language that is eerily reminiscent of the language the mainstream right has been increasingly using. In one of his postings, Loughner refers disparagingly to 'currency that's not backed by gold or silver' - an idea that is the subject of regular rants on Mr. Beck's show (right before his commercials for gold investment). This idea that a non-gold-backed currency is unconstitutional was also a main focus of the anti-government 'patriot movement' of the 1990's that was responsible for violence in the middle part of that decade. Loughner also went on long rants about immigration, particularly Hispanic immigrants in Arizona.

The real tea party

The other day I was at a conference here in Brussels and one of the speakers, who was German, made a joke about America's tea party movement. Making the case that European consumers would not like paying extra taxes in order to pay for recycling, he joked, 'but in the United States I understand they have the tea party to take care of this kind of thing'. The audience laughed, and I laughed as well, because I assumed it was said tongue in cheek. But then when I thought about it I realised, wait, maybe he's serious...

I wouldn't blame Europeans for thinking the American tea party movement is motivated solely by their opposition to taxes, after all this is how its portrayed in the European media - particularly by the British press. And they in turn are taking their cues from the American mainstream media, who have also been portraying it as a movement of libertarian fiscal conservatives concerned about deficit spending and taxes. But even as this narrative continues, there is clear and unavoidable evidence that this is not what the movement is mainly about at all. In fact the movement has no real focus, serving mostly as a confused jumble of rage. Its participants – who show up to street demonstrations and rallies wearing funny hats and revolutionary war costumes - appear to have various grievances, and some seem to have no specific grievances in particular. But one thing is clear – the leaders of the tea party movement, and the candidates they have elected to represent the Republican Party in November's midterm election, are the same old social conservative culture warriors that have been around for years. Only this time, they're wearing funny hats.

Be careful what you wish for, teabaggers

The Tea Party movement in the United States saw its most high-profile electoral success last Tuesday with the primary election of Rand Paul, son of the notorious Texas Libertarian Ron Paul, to be the Republican candidate for Senator in Kentucky. The pundits told us it was a “victory over the Washington establishment” delivered by voters seething with anger. Paul’s mainstream Republican challenger had received the endorsement of long-serving Republican senators, while Paul had been endorsed by the Tea Party and Sarah Palin. “This is a message to Washington from the Tea Party!” shouted an elated Paul at his victory speech.

But it wasn’t long before the reality began to sink in about exactly who the teabaggers were pushing into power. Like his father, Paul is an adherent to a uniquely American brand of ultra-orthodox Libertarianism. This strain of thought opposes almost all government interference in people’s lives. It is opposed to income tax, the environmental protection agency, the FBI, the Americans with Disabilities Act, government pensions, medicare, you name it. If the government does it, they want it killed.

Lately this kind of non-government ideology has been gaining popularity amongst an increasingly radicalized American public. The Tea Party movement, born out of citizen anger over Barack Obama’s efforts to give all Americans health insurance, has morphed into a snowballing anti-government crusade that seems like it won’t be content until Washington has been burned to the ground. Spurred on by Fox News, the most watched news network in the US, the Teabaggers believe that the US government is “out of control”, developing into an authoritarian super-state that seeks to regulate every area of their lives.

The US healthcare bill - what's in it?

Today Barack Obama signs the US healthcare reform bill into law. It's been a long, ugly and draining process, but in the end Obama and the Democratic congress have succeeded in doing what no US president before has been able to - reform the broken American healthcare system.

I thought I'd write a brief entry on what this bill actually entails because I've found a lot of Europeans (and Americans, for that matter) are confused about what it contains. Many of my friends on the left seem to be under the impression that the bill has been watered down so much that it is almost meaningless and will do no good for anybody. People on the right still seem to believe that this is a government takeover of the healthcare system that mandates rationing of care. Neither is true.

How individualism shapes the US healthcare debate

Of all the activities I expected to be engaged in Saturday night, finding myself at a bar in Switzerland vociferously defending the right to name a child Adolf Hitler was not one of them. But as it happens, this curious discussion about European naming regulations gave way to a very interesting conversation about the healthcare hullabaloo in the US – a debate that has perplexed Europeans over the past eight months.

The two very different attitudes in the conversation about whether the government should get involved in the naming of a baby was symptomatic of a larger divide between the Anglo-Saxon English-speaking world and continental Europe. Being reminded of this vast difference helped me to put into perspective Americans’ huge resistance to increasing healthcare coverage.

Talking about the US, a German friend of mine who lives in Zurich said he thinks it's strange how Americans give their children crazy names like Apple Blossom or Stapler, and such a thing would never happen in Germany. Of course the most extreme example of a bizarre name, widely reported in Germany, was the case of the neo-Nazi man in Pennsylvania who complained when a local supermarket refused to write his son’s legal name (Adolf Hitler) on a birthday cake. In Germany, where it is illegal to use any of the imagery of the Nazi party, people couldn’t believe that the government would allow someone to give their child such a name in the first place.

When 40 is more than 60: Why Republicans always win

In the wake of Tuesday’s game-changing Republican victory in Massachusetts I’ve been inundated by questions from perplexed Europeans. How is it, they ask incredulously, that one year after Barack Obama came into office on a wave of popular euphoria, he has somehow come to attract the rage of the very Americans he’s been trying to help?

The answer lies in this not-often-observed reality: despite the fact that voters banished Republicans from the leadership of every branch of government in the 2006 and 2008 elections, since Obama's inaugeration they have been able to wage one of the most effective oppositions in American history. Though the Grand Old Party is in the midst of a leadership vacuum and is no longer coming up with any actual policy ideas, they've somehow managed to stymie the Obama agenda to such a degree that in practice they are effectively a co-equal power in government. You’ve got to hand it to them, it’s truly a remarkable feat. They’ve managed to get the American public demanding a return to the party of George W. Bush.

Lobbyists 1, Obama 0

I’m here in the US for a white Christmas, it’s been lovely so far. The big news here, other than the terrorism attempt on a trans-Atlantic jet last night, was the historic passage of the healthcare reform bill in the US senate on Christmas Eve. But if some of you across the pond think this represents a fulfilment of the ‘hope and change’ promises in Barack Obama’s campaign, think again. The compromise legislation about to be enacted is being seen by liberals as a disappointing failure, and an indicator that the change the American president promised is not likely to materialise.

By definition, what was passed in the senate Thursday is not universal health care. It will bring the coverage level up to about 94%, meaning the US will remain the only developed nation without universal coverage. True, it will bring an additional 30 million people into the coverage umbrella. But it does so simply by legally requiring them to purchase insurance, without lowering the astronomical cost of insurance. It would force 30 million people to buy into the existing broken healthcare system. Rather than real reform, it’s a bit of a fudge.

Don't be so Shocked, Europe - US Healthfight similiar to EU Debate

You could call it a rude awakening. Over the past few weeks Europeans have reacted with shock and incredulity as they’ve watched the “debate” over US healthcare reform unfold across the pond. How could it be, they’ve asked me in tones of sheer exasperation, that even in the face of a healthcare crisis Americans could be so credulous as to believe the outlandish lies being spread about Obama’s healthcare reform effort. Death panels? Enemy lists? Nazi euthanasia? How, they’ve asked, could anyone be so stupid?

I haven’t had a good answer to give them, except that this is the cold hard reality of the place American politics has found itself in today. As I’ve written about before, many Europeans were lulled into a premature sense of relief when Barack Obama was elected in November. But while the head may have changed, the body remains the same – this is the same American public that elected George W. Bush twice. The combination of powerful vested interests in Washington, a strong right-wing media that dominates civic discourse, and a population that is, let’s face it, rather uninformed, mean that Barack Obama has his work cut out for him if he wants to effect real change. Getting elected was just the first step.

The mobs that have turned up to congressional town halls to shout down any discussion of healthcare reform, waving placards of Obama with a Hitler moustache and screaming about his “Nazi policies”, aren’t actually concerned about healthcare. This is about something much bigger, a general right-wing paranoia and militarism that tends to arise every time a progressive Democratic president is elected. It happened in the 1960’s culminating in a wave of political assassinations, it happened in the 1990’s culminating in the terrorist bombing in Oklahoma city by right-wing fanatic Timothy McVeigh, and it’s happening again now. Progressive Democratic presidents scare the bejesus out of the right-wing fringe inspiring hysteria and violence (although why this didn’t happen with Carter I don’t know, any ideas?).

What’s different this time around is that powerful Washington forces have decided to tap into this right-wing rage and use it to their own political advantage. Fox News has seen an opportunity to define themselves in the Obama era by stoking the flames of hysteria and paranoia, increasing their viewership handily over the past several months. The healthcare and energy lobbies have been able to tap into this paranoid rage by convincing people that attempts to reform their industries are actually part of a grand fascist scheme to enforce a dictatorship.

The most absurd example of this came yesterday when protesters congregated in Texas to rail against Obama’s “Nazi” climate change bill, which would finally sign the US up to international agreements to fight climate change. At first glance it might seem bizarre that ordinary citizens are turning up to yell and scream about a piece of legislation that doesn’t have much to do with them but rather affects the oil and gas industries, right? Well if you look at the bottom of their placards many read that they are concerned “Energy Citizens”, and if you look into the origin of this group you can see it’s actually sponsored by the oil and gas industry, whose trade organisation was recently revealed in a leaked memo to be suggesting that oil company employees be mobilized for these “grass roots protests” in order to “put a human face” on the resistance to the bill.

The same has been true of the healthcare protest and the “tea-bagging” protests, both organised by powerful Washington lobby groups working with the aid of Fox news, which gets people revved up telling them the healthcare reform bill will kill their grandma.

Is this in the bill? No. Is it rational to say Obama is a racist Nazi because he’s trying to reform the nation’s healthcare system? No. But these myths persist, with the majority of Americans now saying they’re concerned about Obama’s healthcare reform effort. It now looks like the administration is going to take the public option off the table or break up the legislation, which would effectively mean the myth-spreading tactics have worked. Meaningful healthcare reform could be dead.

Don’t Get too Smug, Europe

But before Europeans shake their heads and roll their eyes at the seemingly hopeless ignorance of the American public, might I remind them that they are not immune to these impulses either. In trying to explain to Europeans the raw emotion surrounding this debate, I’ve been struggling to think of an issue here that brings out the same level of irrationality. It wasn’t long before my mind settled on the EU. When it comes to ridiculous irrational myths, European knowledge of the EU - particularly in the UK - could give these American healthcare protesters a run for their money.

Take the debate over the Lisbon reform treaty. The accusations levelled against it in the UK and Irish media have been absurd almost to the point of self-parody. According to the British media the treaty is a “massive power grab” that will turn the EU into a “totalitarian super-state”. Sound familiar? In reality, the treaty simply makes tweaks to the EU’s governing structure, changes that have been made necessary by the recent EU enlargement. The main purpose of the treaty is to make the EU more efficient and cost-effective, not to give it more power. Its goal, much like the healthcare reform bill, is to help people – not to hurt them. But that doesn't stop the totalitariansism comparisons. Just take a look at this over-the-top video from YouTube.



Euromyths are rampant in the UK. Some examples of completely baseless euromyths spread by the British media: English fish and chips shops would be forced to use Latin names for the fish (The Sun, 5 September 2001), double-decker buses would be banned (The Times, 9 April 1998), British rhubarb must be straight and barmaids would have to cover up their cleavage. (Update April 2010: Here's a recent patently absurd - and easily disprovable - example from the Daily Mail about the EU supposedly changing the name of the British Channel to the "Anglo-French Pond". That story was picked up by numerous other media outlets including the BBC's 'Have I got News for You'.) All of these are widely believed in Britain yet are completely untrue. Many euromyths can be traced directly to deliberate attempts by lobbysists to influence policy in Brussels. And they’re frequently presented in the same kind of screaming-headline, hysterical tone that is now being employed in the US healthcare debate.

And of course, a recurring complaint about both the Healthcare reform bill and the Lisbon reform treaty is that they're too long and complicated for ordinary people to understand. And because they're so long, they must be trying to pull something over on everyone. Because naturally, incredibly complex pieces of legislation should be easily understandable by your local trash collector.

In the UK, the right-leaning media makes completely baseless and false accusations about the EU and about the Lisbon Treaty, saying it will do things that are not at all in the document such as ban abortion across the EU, mandate an EU army, establish an EU constitution or subjugate member state courts. The public comes to accept these myths as fact. Then when it comes time for a vote, as occurred with the Irish referendum on the Lisbon Treaty last June, the public bases their vote on the misinformation they’ve received about the EU and the treaty. Democracy at its finest.

Can you imagine if healthcare reform were being put to a referendum in the US? It would never have any hope of passing. In fact the only way that this legislation may actually come to pass now is if the US congress does the right thing and bypasses the will of the people, making the responsible informed decision that a vast swathe of the American public cannot make themselves because they are so misinformed. This is how representative democracy is supposed to work – citizens elect representatives and entrust them with the responsibility of becoming versed in issues that ordinary citizens are not equipped to make decisions on themselves. This is why it is irresponsible to put a complex legal document like the Lisbon Treaty or healthcare reform to a public referendum. It is the worst perversion of Democracy – mob rule.

People tend to be pretty gullible, and powerful interests will always be able to manipulate them. Now that the internet has brought us what sociologists have termed the "post-fact society", this misinformation is very easy to spread - be it in America or Europe.

No Appetite for Revolution

Now to be fair, the level of hyperbole used in mainstream media around the Lisbon Treaty hasn’t reached the alarming heights of the US healthcare debate. And the Lisbon Treaty hasn’t inspired gun-totting mobs to show up at politician’s doorsteps last time I checked. Comparisons to Nazis are rarely used in continental Europe, as the memory of what the Nazis really were is still too raw to throw around the comparisons as lightly as Americans and, to a lesser extent, Brits do. But the difficulties encountered in both efforts for reform show how difficult it can be to change societal systems at the dawn of the new millennium, as we prepare to enter the 7th decade of peacetime in the Western world. 

The fact is all of these big social programs, on either side of the Atlantic, were instituted in the years following World War II at a time when the public was still traumatised enough to have the appetite for real massive change. People are living in an era of unprecedented peace in the Western world, and even if there are major problems with system X, it’s working just fine for now thank you very much. Whether it be the EU project or healthcare reform, people in 2009 are just not mentally prepared for big change. Having lived their entire lives in peace, they just don’t have the appetite for risk. And powerful interests have grown up around the existing institutions that will resist change in order to safeguard their own interests.

Yet in both situations, the seeming comfort of the status quo is an illusion. Neither current situation is tenable in the long-term. In the US, while one out of every five Americans under 65 is uninsured, the majority do have insurance and, since they don’t know any better because they’ve never seen a European healthcare system, they think their coverage is the best in the world (Americans usually by default assume their anything is the best in the world). But the system of employer-funded healthcare is untenable. The US now spends around 15% of its GDP on healthcare, second only to East Timor among United Nations member states. Left unchanged, that number could rise to something like 30% in just a few decades. The current system is literally strangling small business. But all most Americans with insurance see is that they go to the doctor, he treats them, they get better. There is no crisis, they assume.

The same can be said of Europeans and their thoughts about the place in the world of their individual member state. The fact is that in a post Cold War world, with the rising power of India and China and the fact that the US no longer has a strategic long-term interest in safeguarding European defence, no individual European member state can hope to be a significant player on the world stage in the 21st century on its own. Yet your average British person hasn’t come to grips with this fact. As far as they can see, they appear to have a big influence on the world culturally (they often mistake American cultural imperialism and the widespread use of English as somehow attributable to themselves), they are nuclear armed, they have a seat on the UN security council and they are in the G8. But the fact is in 50 years they are unlikely to have any of these things (except perhaps an ageing fleet of dangerous and dilapidated Trident submarines) if they were to go it on their own. It’s a situation where the prospect of the UK separating from the EU could easily appear to be fine to the average British person, but where people with a real knowledge of world events and future projections know that is not a viable option.

In the meantime the media, big business and right-leaning politicians are all too willing to exploit the average person’s ignorance and lack of foresight in order to serve their own interests, convincing them that reform efforts that are meant to help the average person are actually an effort to impose a dictatorial superstate. It’s the situation we find ourselves in at the dawn of the 21st century on either side of the Atlantic.

We are, it would seem, a risk-averse species by nature. And a gullible one to boot.

UK Enraged by US Healthcare Portrayal

The US healthcare debate came to the UK in a very explosive way yesterday, when video of a British politician slagging off the NHS spread across the internets like wildfire. It was the twitterati who first started spreading the word, creating tags like #welovetheNHS to defend the NHS from this particular Tory politician, who happens to be a member of the European Parliament. My previous blog post on this subject has made the rounds pretty heavily on that tag actually.

The US media tour by Conservative MEP Dan Hannan has created a huge headache for Conservative leader David Cameron, who was scrambling yesterday to assert his love for the NHS and describe Dan Hannan as a fringe politician with "extreme views". The message is clear: the British National Health Service is a cherished institution in the UK, and politicians left or right criticise it at their peril. Whether this sort of "love it or leave it" mentality is helpful is debatable, but one thing is clear - any Briton can tell you that Dan Hannan's portrayal of the NHS doesn't bear the slightest resemblance to reality.



His description of the NHS, seen in this video above from Fox News, is so outrageously made-up that the Labour party - long trailing in the polls and virtually guaranteed to lose the next election - has pounced on it to show that the Conservative party can't be trusted with the NHS because they intend to make drastic cuts (Blair used the same argument in '97). The political headache for Cameron grew to such a fever pitch yesterday that some analysts were predicting that Cameron might sack Hannan from the partyand hence he would be out of the European Parliament). I know plenty in Brussels who would be relieved at this prospect, as Hannan has a long history of causing trouble in Strasbourg. But we'll see if the pressure remains through the weekend.

Of course as I pointed out in my previous healthcare blog post, the fact that the US media is focusing on the NHS at all doesn't make any sense. The healthcare plan being proposed by Obama and the US congress is not a single-payer system as exists in the UK Canada or France, but rather a hybrid multi-payer system as exists in Germany. Germany has a universal multi-payer system with two main types of health insurance: the public fund and private funds. Everyone is mandated to have healthcare, which is provided by the public fund to people below a set income level for a low rate. So, the wealthy can pay for exceptional private health coverage if they want to, or they can pay a small amount for the state insurance (many opt to do this). The end result is that everyone is covered and Germany spends 10% of GDP on health care, compared to 16% in the US. Obviously Germany would be the better example for the US media to use, yet the country, to my knowledge, has never been once by the US mainstream media.

This whole US "debate" (if you can call it that) has just been downright painful to watch, and has reminded me just how lucky I am to live in Europe. What's really unfortunate is that the hysteria and lies in the US are drowning out any actual debate on this bill - which will create one of two results. A bill will be passed without that perhaps lacks restraining measures that would have been helpful to it, or no bill will be passed which will represent the triumph of the mob, the victory of misinformation over reason. It's really a very sad thing to watch.

As for the British, perhaps watching the way this whole thing is unfolding in the US will make them feel a little more European. After all, this is one of those crucial ways in which the UK is much closer to the continent than to America. And the British should be grateful for it.

Germany, and Reason, Ignored in US Healthcare Hysteria

I’m sometimes accused by commenters on this blog of wishing to make Europe into the US, and while it is true that I often yearn for European politics to be a bit more self-assertive, ambitious or efficient, make no mistake - I would never wish for European politics to devolve into the kind of mob hysteria US political discourse has sadly become.

The current debate going on in America over Obama’s attempt to overhaul the broken US healthcare system has been particularly hard to watch in this regard, and makes me feel pretty fortunte that I live in Europe. The way this healthcare debate is unfolding in the US is not only shockingly unreasonable, it’s getting downright scary. And unfortunately, what’s been occurring around the heathcare debate isn’t an isolated incident - it’s reflective of the dangerous road the American right wing is heading down.

The worst part is that the illogical hysteria surrounding the debate is drowning out any kind of reasonable argument. The scare stories being floated in the US media about single-payer systems in the UK and France would be missing the point even if they were true – what’s being proposed by Obama isn’t a single-payer system but rather a multi-payer combination of public and private plans, much like exists in Germany. But astonishingly, Germany hasn’t been mentioned at all in the US debate, even though it currently has a system very similar to the one being proposed, while the British and French systems don’t even resemble the Obama plan.

A ‘Plot to Kill Old People’

The health insurance lobby in the US has launched a full-on campaign to sink Obama’s efforts at health care reform. The plan that is working its way through congress is to add a public option to the list of private insurance options available to the American public. Currently the US has a completely private system for those under 65, the only non-universal healthcare system in the developed world, in which nearly one in five Americans under 65 don’t have any healthcare at all.

Not having healthcare can bankrupt a person if they get sick or have an accident, and it happens often. In fact, medical debt is the principle cause of bankruptcy in the United States.

Healthcare in the US has developed in an uncoordinated fashion over the past half century after the US government was unable to come to an agreement over a national health plan (Medicare, in which the government insures all people over 65 through a single-payer system, was a compromise enacted in 1965).

People under 65 have traditionally been insured through their employer. This means if you lose your job, you lose your health insurance (so if you get hit by a bus two months after losing your job, you’re facing a $30,000 hospital bill and no income!). But as healthcare costs have risen many small businesses have been unable to offer their employees health insurance any longer, leading to a dramatic rise in the number of uninsured. Even people who are insured face ever-rising deductable costs every time they visit a doctor, and their insurance companies can deny them coverage at any time by claiming that they had a “pre-existing condition” before they enrolled in the plan.

So to put it mildly, the system is a mess. Yet what Obama and congress are proposing isn’t a complete overhaul - it’s more of a reform. The private insurance companies would continue to exist, and everyone who’s already insured could keep their existing plan if they so wish. But a new player would be introduced into the market, a government-funded public insurance plan that people can opt into. Additionally, everyone would be required to have insurance, and regulation of the insurance industry would be tightened to prevent insurance companies from denying people coverage because of pre-existing conditions or charging exorbitant deductable charges.

However the insurance industry fears that having the US government as a competitor will eventually drive them out of business. So they’ve mobilised their media outreach, finding people in countries with single-payer universal healthcare systems like the UK, France and Canada, and trotting them out to do interviews with US media outlets about their horrible experiences. These strange, wild-eyed European defectors tell stories of being denied treatment and having to go to the US in order to have desperately needed operations to save their lives.

Or, they tell tale of public hospitals with dead people lying on the floor all over the place. I wish I was making this up. To hear the stories that have been spread in the US media, the NHS in England is effectively a government euthanasia program that kills people once they reach old age Republicsn Congressman Louis Gohmert has said under the reform seniors "be put on lists and force them to die early.”

This group that’s spreading word that the healthcare reform bill will kill old people have even been given a nickname, the “deathers” – a reference to the mob of people claiming that Obama wasn’t really born in the US – the “birthers”.

Of course, all of these tales have been proven to be absolute lies by reputable organisations, yet these people keep appearing on US cable news.

Harnessing the Mob

Now the healthcare lobby and the Republicans have gone a step further, actually organising mobs of angry 'birthers', 'deathers', 'teabaggers' and other assorted crazies to show up at open town hall meetings that Democrats typically host during the August recess. These mobs have been instructed to scream down the representatives as they try to speak. It’s absolutely insane, and getting quite scary. Take a look at this clip from the Rachel Maddow show.


Right-wing lobby groups are organising these mobs, telling them where the town halls are, and instructing them to block all discussions. They refuse to allow anyone to speak. If actual townspeople at these town halls try to ask a question, the mob shouts them down with chants of "just say no". Congressman Boehner, the Republican House minority leader, has praised these mobs and encouraged them to continue.

The Republican party is now aggressively harnessing the energy of the “teabaggers” –a group of mostly lower middle class Americans who are angry at Barack Obama’s election and were organized into protests by GOP groups earlier this year under the mistaken belief that Barack Obama’s budget was making their taxes go up (Obama is actually lowering their taxes or keeping them the same). It’s also harnessing the energy of the “birther” movement, a group of angry white Americans so incensed that Barack Obama was elected that they have developed a conspiracy theory that he wasn’t actually born in the US and is therefore ineligible to be president.

Republican congressmen and talk show hosts have given credence to the conspiracy by saying Obama has never released his Hawaii birth certificate – even though he has and it’s been on his website since the campaign.

So it’s a two-pronged attack by the right: organising mobs of crazy people to disrupt town halls where Democrats are attempting to explain heath care reform to their constituents, and getting fake healthcare scare stories into the media

Better European Comparisons

But beyond the fact that these random Canadians, Brits and Frenchmen being trotted out are just flat-out lying and are actually being put out there by the health insurance industry, the reality that everyone in America seems to be missing is that even if these stories were true, they are completely irrelevent to the current US healthcare debate. Canada, France and the UK all have single-payer systems – where you walk into the doctor’s office and never see a bill. That system is not on the table in the current debate in the US. What is being proposed is a combined public/private universal health insurance program much like exists in other European countries, most notably Germany.

Germany’s system would be the more obvious comparison, yet it has not been mentioned at all by the US media, which continues to focus on single-payer systems that have no relevance to the current debate.

Germany has a universal multi-payer system with two main types of health insurance: the public fund and private funds. Everyone is mandated to have healthcare, which is provided by the public fund to people below a set income level for a low rate. So, the wealthy can pay for exceptional private health coverage if they want to, or they can pay a small amount for the state insurance (many opt to do this). The end result is that everyone is covered and Germany spends 10% of GDP on health care, compared to 16% in the US.

Alternatively, the US media could use the example of Switzerland, although I’m not sure I would use that as a glowing model considering it has the highest health care expenditure in Europe. But they also have universal healthcare in a combination of public, subsidized private and totally private healthcare providers, where the insured person has full freedom of choice among the providers in his region.

Unfortunately, using comparative examples that make sense have not been part of the debate around this issue, which has instead focused on the hysterical screaming of the right. US policy, much like hotdogs, is always something that can be a little stomach-churning to watch being made. But lately the level of vitriol being launched by an increasingly desperate Republican party has been downright disturbing. Outright lies? Fake experts? Organised mobs? Is this America or a banana republic?

The most troubling part is that these tactics are working. Recent polls have shown that 42% of Americans now think Obama’s healthcare plan is a bad idea, and 69% of Americans are concerned their care would suffer if they were on a government-run plan.

They say citizens get the government they deserve. Perhaps it can be said that they also get the healthcare they deserve. If the American public can be so easily manipulated by the powerful forces of the right, even when it jeopardises their own health, I don’t know if there’s much hope for real reform in that country. It's very sad to watch. One thing is for sure – the behaviour exhibited over the past several weeks has not been a proud moment for American political discourse. These are dangerous tactics the American right is using, and they can easily spiral out of control. In the mean time, they are blocking meaningful discussion over how to reform a healthcare system whose dysfunction has reached crisis proportions.

Pan-Europe healthcare plan delayed

Though proposals were expected today on the controversial new plan that would make it easier for patients in Europe to travel to other EU countries to receive healthcare, a European Commission spokesman said this morning the proposals have been put off, citing “agenda reasons.”

The idea behind the plan is that patients should essentially be able to “shop around” Europe for their healthcare, having operations done in countries where the wait time and expertise most suits their needs, and then having their home healthcare system foot the bill. So, for example, a UK resident who needs a surgery but is facing a 4 year wait to do it at an NHS hospital, could travel to France and have the operation done sooner (and maybe better), and then get the NHS to foot the bill.
But the plan has been enormously controversial, and the UK is particularly opposed to it because some fear it will spell the “end of the NHS” because the system would be forced to transition to a more insurance-based continental system.

For this reason the proposals have been hitting consistent delays, being drafted and redrafted, and the proposals today were expected to offer countries like the UK the option to pre-approve such out-of-country treatment and to opt-out. Of course, the proponents of the plan say this would negate the very purpose of it.

Mark Mardell had an interesting package on the BBC last night about a woman who faced a four year wait for gastric bypass surgery in the UK, so she opted to have the operation performed in Belgium where there was no wait for £5,000 (insert joke about the weight difference between continentals and Brits here). He's detailed more about this issue in his Euroblog today.