by Bruce Patterson, December 4, 2013
The notion that a business is clothed with a public interest and has been devoted to the public’s use is little more than a fiction intended to beautify what is disagreeable to the sufferers. — Oliver Wendell Holmes, Supreme Court Justice (1902-32)
After exiting her chair and opening the door of the examination room, the doctor pivoted around and glared at me. “Social Services?” She asked. “We don’t have any social services here.” With that, she disappeared down the hallway, kindly leaving the door open for me.
During our obligatory 90 seconds of chit-chat at the end of my appointment, the doc had asked what had brought me to Prineville. Among other things, I’d mentioned that my wife and I have an adult son on SSI who is mentally disabled, socially isolated and painfully obsessive/compulsive, and how we were hoping to maybe get him some, ah, social services. Thanks to the “budget hawks” on the County Board back home, I explained, it was something he’d never even gotten a taste of back in Ukiah. And now the doctor’s response had me wondering whether she was insulted by my naiveté or just plain proud to hip me regarding the local’s cultural values. Since, at least according to the town’s reigning Tea Party faction, this is God’s (read White Man’s) Country, I concluded it was probably both.
I’d gotten an appointment at Pioneer Memorial Hospital (once community-owned, now it’s a line item in some HMO’s portfolio) because, although I didn’t know it at the time, I’d pinched a nerve in my neck. I was in a world of hurt and, after four days of futilely waiting for the pain to subside, I was ready to reach down deep into my wallet to buy me some pain pills (by choice, I’m currently uninsured). So I paid $70 for the wear and tear I’d put on the HMO’s facilities, $210 for maybe eight minutes in the X-Ray room, $125 for ten minutes of face time with the doctor and $27 for 20 — just 20? — vicodin pills. While $432 amounts to chump change in today’s “healthcare market,” that’s like saying leeches are cool because they only suck a little blood at a time. Made me wish we could’ve hauled the AV Heath Center up here with us (minus their overlords).
While in this country every year thousands of mostly poor people die for lack of healthcare (and tens of thousands more either die or have their health permanently ruined by pollutants), most everybody with decent jobs gets shaken down by anonymous health insurance conglomerates selling policies that won’t even save you from bankruptcy should you get good and sick or maimed. If you’re old and used up, but not yet 65, and have managed during your working career to accumulate some life savings but are faced with a “medical emergency,” the first thing you do is kiss those savings goodbye. If they represent more than a decent down payment, you consider yourself fortunate. And, guess what? Once you’re returned to the ranks of the poor you realize you ain’t shit. No money, no play.
It ain’t for nothing that millions of America’s hallowed Senior Citizens (roughly 15%) experience hunger every month (the largest number are white women, too). Unfortunately for us and the rest of humanity — ruling classes play this card from cradle to grave — it’s in our nature to judge our own personal worth by looking down on those below us on the food chain. It’s an evolutionary thing: embracing the illusion of a just world makes life less painful. This “pro-life” and “Christian” country has one of the highest infant mortality rates in the industrial world? Well then it’s the mother’s fault. Millions of Americans work two or more part-time jobs and still can’t take a sick and miserable child to a doctor without getting their landlords pissed off? Well they’re obviously lazy, stupid with their money or “unskilled” and so it’s their own damned faults.
It’s small-minded, junkyard dog meanness that mistakes the so-called Global Free Market for the arbiter of the value of all things, and Adam Smith’s palsied Invisible Hand of Justice as synonymous with God’s Will (Jesus oh so wants you — yes, you, I’m talking to you — to be successful! Find God’s match for you!). This while about the only “free markets” left in this country deal in human flesh, weaponry, ammunition, street drugs and earth rape.
Since as American citizens we’re taught that voting our own pocketbooks counts as patriotism — it makes us about as predictable as laboratory rats in cages: rob Peter, pay me — I should admit that I’ve personally benefited from the Welfare State and that affects my views. My mom turned out to be a huge liability to the taxpayers, for one thing. During the last quarter century of her life (she died in 1985 at the age of 61) my mom got free stays in hospitals and mental hospitals, three hots and a cot in a downtown El Lay halfway house, free job training, Aid to the Totally Disabled, H.U.D apartments, surplus foods, food stamps, a heap of gold-plated prescription drugs and even a good amount of psychotherapy. For a couple of years while under her care I myself got money under Aid to Families with Dependent Children (I think my cut was $15 per month).
I can’t tell you how much, in real dollars, my mom cost the taxpayers. Yet, from their point of view, she produced zero assets and so counted as a total liability: a freeloading leech. Yet I do know this: if the taxpayers had seen fit to put into her palm even 10% of all of the money they’d spent on her, she’d of been “independent” and maybe even productive. Had the taxpayers seen fit to give her a job she was capable of doing that paid a living wage, she’d of been happy, I do believe. Certainly my disabled son would be ecstatic to land such a full-time job and say goodbye to SSI forever. Even “invalids” like making themselves useful and having a little pocket change.
When my step-mom died of emphysema in 1998, my dad showed me the books on her. My dad, who himself was falling apart and piling up medical bills, kept books on everything. As a corporate executive he’d gotten a golden parachute that included tippy-top health insurance. Yet, just because he paid so little out-of-pocket for their healthcare, that didn’t mean he was apathetic about the costs. “There’s no virtue in being generous with other people’s money,” he’d taught me when I was a little boy. The gist: in less than five years the company had spent far more money on their healthcare than he’d earned during his entire 40-year, highly productive and finally lucrative company career.
My dad had a stack of itemized hospital bills and he handed a sample. Running my eyes down the lines and seeing what these newfangled HMOs charged for an aspirin and a paper napkin, I was struck by their gall. What are we, rank suckers? I remember a couple of the adjectives my dad, a Reagan Democrat, used: “nuts” and “unsustainable.”
That was 15 years ago and since then, in real dollars, healthcare costs have more than doubled. Even ignoring the trails left by the dead, the human costs of this are incalculable. It’s like trying to measure the human costs of the roughly ten million American “homeowners” who have been thrown out of their houses by Wall Street swindlers and filthy-dirty banks these last nine years, or the 50,000 foreclosures that were “legally executed” last month. And how do you measure the human costs of ten million Americans who remain to this day unemployed through no fault of their own? Or, if you prefer, try to calculate the monetary damage done to the national economy by all of the above. Yet there are proven links between getting bled dry by outrageous medical bills and being foreclosed; between being foreclosed and forced into bankruptcy, bankruptcy and homelessness, homelessness and “permanent” unemployment, a swelling of the underclass and the spread of social malaise and predation.
About 150 years ago John Stuart Mills (hardly a flaming radical) wrote that “men may as well be imprisoned, as excluded from the means of earning their bread.” Substitute “people” for “men” and Mills got it right. A civilized society is one in which no one willing and able to work is denied work for long. Why? Because it’s labor that produces wealth and not the other way around. Prosperity isn’t a vast pool of dirt-cheap labor — prosperity is cheap Capital. Also — how we forget — constantly doing more with less leads straight to bankruptcy.
Look at us now. How many black, Latino and poor white boys are behind privatized bars (at a cost to the taxpayers of $40-$50 grand per head per year) because they got caught “holding” while hanging out on street corners? How many young “runaway” girls are behind bars for walking the midnight streets? How many Mexican farm workers are behind bars awaiting (and waiting and waiting) deportation because they drove their bald-tired, duct tape and baling wire jalopies into some lonesome irrigation ditch? All of these people had jobs, too; they were contributors and not freeloaders; givers as well as takers. But still that didn’t save them once The Law stepped in; the law now so corrupted by big-money and phoniness that it may as well be a frontier town marshal who is a pimp, bootlegger, bushwhacker and card cheat.
Long before the inventions of endless corporate propaganda TV and computerized walky-talkies flashing billboards, and back when the country’s rural communities were, if not exactly prospering, still viable, John Steinbeck wrote that Americans are a people trapped inside the capitalized “I” (English is the only written language that does that, i think). In other words, if the country has a motto, it’s: “I’ve got mine — fuck you.” While this mercenary attitude permeates our politics, thankfully it represents only our lowest common denominator: the basest among us and within our own selves. Not so fortunately, today it’s that base that rules. If by some wild leap of the collective imagination the current arrangement under their tender mercies can be called a “Nanny State,” then nanny’s got rabies.
It’s one thing to fail to see that universal and affordable healthcare should be a fundamental human right in this country. Chalk it up to bad upbringings resulting in a lack of economic sense and moral literacy. But when a corrupt and fanatical faction of an absolutely corrupt political party (follow the money) decrees that the Affordable Care Act, which is a first step in that direction, is an abomination against Jesus and a crime against liberty, National Security and the American (read strictly-for-profit) Way of Life, and when these same elected witchdoctors and money-grubbing demagogues are given, through blatantly anti-democratic means and aided by a collaborationist media, the power to obstruct and sabotage the smooth functioning of government while taking away women’s rights, voting rights, union rights, minority rights, etc, etc) it should be clear that the cannibals have charged out of the jungle and have overrun the fort. It should also be clear that if we wish to save your ass’s we’d best learn to watch out for each other. Evil is as evil does and the worst thing we can do in the face of it is to clamp shut our eyes, shelter our ears and seal our lips.
We the people are used to handing over blank checks to the rich, the multinationals and their government subsidiaries, and that needs to stop. But if we give blank checks to these Bible-thumping, gun-toting, God and Country, Gold and Glory, States Rights and “Privatize” crowd, I guarantee you they’ll cash them. They’ve already cashed the pocketful we’ve given them so far and they’re expecting us to hand over some more. Their hunger is voracious, their appetites insatiable.