Italians Care
At the last Democratic debate Joe Biden held up the ongoing pandemic tragedy in Italy as poster child for the interests of the American private for profit health insurance industry (HCI) and proof that a National Health Service (NHS) is a bad thing. Biden stared into space and barked, “you have a single-payer system in Italy — it doesn’t work there,” with the conviction of a man who knows the score and knows what his handlers want him to say.
It was not the most egregious lie of an evening filled with Joe’s blunt mendacity and the complicit silence of CNN’s panel of journalists, but it was the most vile and vicious, sleazily complicit in the ongoing health care homicide in America that leaves forty five thousand people a year dead. A dirty malignant worm of a lie, for a nation that has little knowledge and less interest in politics of life or death of our neighbors, and what those neighbors might teach us about our own political life, and death.
As the dead pile up around the world in nations with National Health Services, Joe Biden without context or grace sought to de-legitimize Sander’s signature policy call for Medicare for All, confirm the superiority of our for profit HCI system, and denigrate healthcare systems that produce better health outcomes than the soulless anxiety of for profit U.S. HCI. At half the cost! In the process, wittingly or not, Joe was also deflecting attention from the monumental tragedy that 40 years of neoliberal corporatism has unleashed on the world.
No Italian (or German, or French or British) person I know, including myself (I have worked in the EU since it was the EEC), would ever trade our system of guaranteed healthcare for the physical, economic, and logistical nightmare of the U.S. HCI, and its unrelenting dehumanization of health to consumer choice for paying customers. However overcome the system in Italy is by the number of Covid-19 cases, every Italian (and EU citizen) knows they will receive care if they need it. They know that the cost will be zero, and that any necessary drugs will be available at minimal cost.
With over 16k deaths and millions out of work, the Italian Constitutional affirmation of the right of every citizen to health care is exactly what has created the solidarity and faith necessary to keep the country from falling into chaos. The country is holding together nicely, tapping deep humanistic roots with great stoicism, real food, good humor, much fear, some crime, and a firm belief that this will pass and we will be okay (even if no one knows what ‘okay’ will look like). In contrast, while the bailout bonanza delivers brown bags full of taxpayer cash to prime corporate members across the country, it is an easy bet, as people lose their jobs, their homes, their health insurance (if they had any) the U.S. will move to martial law in some states as the reality of poverty, desperation, fear, and NoCare meet the reality of the pandemic. Turn on the radio everyone is holding their breath, gun sales are through the roof.
Since the 2008 financial meltdown Italy has faced 12yrs of “austerity” measures imposed by the European Union that have effectly frozen funding for the NHS at same level as 2005. Notwithstanding unquestioned support by every major political party across the spectrum, the ongoing neoliberal assault on the Italian National Health Service has caused inexorable limitations as tax revenues stagnate, and the Italian population continues to age.
Over those 15 years the percentage of the Italian population over 65 has gone from 20% to 23%, and increase of over 2 million people. In that same period average life expectancy has increased from 81 to 84 years (of course in the U.S. life expectancy is 5 years less and stagnant). Italy has done more with less over the past 15years, with better outcomes, than the U.S has done with more and more and still more (3 times what Italy spends). There is none of the daily healthcare anxiety, no gold, silver, bronze and tin plans. Insulin costs about $10 a month unless you can’t pay, then it is free. There is no one who is not covered. With over 25% of the population uninsured or under-insured the United States spends more on Healthcare administration than Italy spends for their entire NHS.
Are there problems, yes, there are 60 million people in Italy, public debt is high, growth is low, EU neoliberal policies bite hard, corporate globalization toward low wage production has destroyed jobs in Italy as it has in the U.S., and income flows up and away from public coffers. But the debate about the NHS is in the public sphere, and it is lively: how to fund, resource allocation, hospitals to open or close, services to provide, etc.
There is no such debate in the United States, the market is master of our health, and the welfare of the entire nation. So long as HCI surrogates like Joe Biden drive the wheelchair, we navigate a savage hierarchy of the smugly secure vs those locked in a Rube Goldberg maze of the “healthcare market,” networks, pre-existing conditions, premiums, copays, deductibles, employer provided, medicare, medicaid, public option, Catastrophic Care and NoCare. Industry financed pundits, researchers, and candidates offer a torrent of nonsense that renders much of the public unable or unwilling to make a simple calculation: while a NHS (Medicare for All) would require a tax based on income it would eliminate the rest of the payments with a net reduction in the cost of healthcare, and a huge reduction in gibberish.
Like in Italy, a U.S. NHS would fit seamlessly into your life, your needs covered wherever you are, regardless of employment, or income. That Biden, with callous indifference to the magnitude of the suffering and the effort to protect every citizen, pronounces Italy’s NHS a failure is not just ignorant and self-serving. As we witness the complete lack of preparation, coordination, brutal lack of care, the calls for working people to “work through it,” and the bald face of dehumanizing profit, as America sinks deeper into crisis and the body count mounts, Biden’s comment is a willful disservice to the American people, it is a lie that excuses responsibility and an accounting for what will be the death of thousands as it hides the solution that is right before our eyes, being tested and succeeding where we are failing.
