Beyond Democracy, Or, Why Shooting The CEOs of Venal Healthcare Corporations Won’t Solve The Healthcare Hell Problem, #3.

(Marcetic, 2024)

TABLE OF CONTENTS

1. Introduction

2. The Core Argument for Dignitarian Anarchism

3. Anti-Oppression, Quasi-Federalism, and How to Construct “The World As It Could Be Made.”

4. Post-Democratic Social Dynamics: DDAO, Concordar, and Carnival

5. Healthcare Hell and Universal Free Healthcare

6. Conclusion

The essay that follows has been published in three installments; this, the third and final installment, contains sections 5 and 6.

But you can also download and read or share a .pdf of the complete text of the essay, including the REFERENCES, by scrolling down to the bottom of this post and clicking on the Download tab.

5. Healthcare Hell and Universal Free Healthcare

In a Wiki-nutshell, this is is what I call healthcare hell in the USA:

The US life expectancy in 2010 was 78.6 years at birth, up from 75.2 years in 1990; this ranks 42nd among 224 nations, and 22nd out of the 35 OECD countries, down from 20th in 1990. In 2021, US life expectancy fell to 76.4 years, the shortest in roughly two decades. Drivers for this drop in life expectancy include accidents, drug overdoses, heart and liver disease, suicides and the COVID-19 pandemic.

In 2019, the under-five child mortality rate was 6.5 deaths per 1000 live births, placing the US 33rd of 37 OECD countries.

While not as high in 2015 (14) as in 2013 (18.5), maternal deaths related to childbirth have shown recent increases; in 1987, the mortality ratio was 7.2 per 100,000. As of 2015, the US rate is double the maternal mortality rate in Belgium or Canada, and more than triple the rate in Finland as well as several other Western European countries. In 2019, Black maternal health advocate and Parents writer Christine Michel Carter interviewed Vice President Kamala Harris. As a senator, in 2019 Harris reintroduced the Maternal Care Access and Reducing Emergencies (CARE) Act which aimed to address the maternal mortality disparity faced by women of color by training providers on recognizing implicit racial bias and its impact on care. Harris stated:

We need to speak the uncomfortable truth that women—and especially Black women—are too often not listened to or taken seriously by the health care system, and therefore they are denied the dignity that they deserve. And we need to speak this truth because today, the United States is 1 of only 13 countries in the world where the rate of maternal mortality is worse than it was 25 years ago. That risk is even higher for Black women, who are three to four times more likely than white women to die from pregnancy-related causes. These numbers are simply outrageous.

Life expectancy at birth for a child born in the US in 2015 is 81.2 (females) or 76.3 (males) years. According to the WHO, life expectancy in the US is 31st in the world (out of 183 countries) as of 2015. The US’s average life expectancy (both sexes) is just over 79. Japan ranks first with an average life expectancy of nearly 84 years. The US ranks lower (36th) when considering health-adjusted life expectancy (HALE) at just over 69 years. Another source, the Central Intelligence Agency, indicates life expectancy at birth in the US is 79.8, ranking it 42nd in the world. Monaco is first on this list of 224, with an average life expectancy of 89.5.

A 2013 National Research Council study stated that, when considered as one of 17 high-income countries, the US was at or near the top in infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, homicides, and rates of disability. Together, such issues place the US at the bottom of the list for life expectancy in high-income countries. Females born in the US in 2015 have a life expectancy of 81.6 years, and males 76.9 years; more than three years less and as much as over five years less than people born in Switzerland (85.3 F, 81.3 M) or Japan (86.8 F, 80.5 M) in 2015. (Wikipedia, 2024b)

In view of the self-evidently obvious two-part fact that universal free healthcare, aka “single payer healthcare,” is not only the norm amongst industrialized countries, hence it could be easily afforded by the USA too, but is also infinitely superior to the healthcare hell that exists in the USA, then I ask you: how did this happen? Well, consider this:

In the United States, healthcare is largely provided by private sector healthcare facilities, and paid for by a combination of public programs, private insurance, and out-of-pocket payments. The U.S. is the only developed country without a system of universal healthcare, and a significant proportion of its population lacks health insurance. The United States spends more on healthcare than any other country, both in absolute terms and as a percentage of GDP; however, this expenditure does not necessarily translate into better overall health outcomes compared to other developed nations.[6] Coverage varies widely across the population, with certain groups, such as the elderly and low-income individuals, receiving more comprehensive care through government programs such as Medicaid and Medicare. (Wikipedia, 2024b)

So the self-evidently obvious answer to that question is this: healthcare hell in the USA is the direct result of corporate capitalism in the USA, in the form of privately-owned healthcare providers, privately owned healthcare insurance companies like UnitedHealthcare, and rich doctors.

What is to be done? Elsewhere I have argued that we should demand, wholeheartedly work towards, and ultimately implement, as the first three parts of a six-part realistic, collective altruist project in post-capitalist neo-utopian global ethics and politics, from dignitarian anarchist point of view (Hanna, 2018: part 3, 2023b), these three radical proposals—

1. Truly Generous Universal Basic Income (TGUBI):

Anyone 21 years of age or over and living permanently in the US, who has a personal yearly income of $80,000 USD or less, and who is mentally and physically capable of requesting their UBI, would receive $40,000 USD per year, with no strings attached.

2. A 15-Hour Workweek for Universal Basic Jobs (FHW-for-UBJs):

Anyone 18 years of age or older who is living permanently in the US, who has completed a high school education, and is mentally and physically capable of doing a job, would be offered an eco-job, paying a yearly wage of $40,000.00 USD, for no more than fifteen hours of work per week.

3. Universal Free Higher Education Without Commodification (HEWC):

Everyone would be offered, beyond their high-school education, a free, three-year minimum, optional (but also open-ended beyond those three years, as a further option), part-time or full-time universal public education program in the so-called “liberal arts,” and also in some of the so-called “STEM” fields, including the humanities, the fine arts, the social sciences, mathematics, and the natural sciences.

Now what about healthcare? According to my Universal Free Healthcare (UFH) proposal:

Every human person living permanently in the USA would receive free lifelong healthcare.

And here are two individually excellent and conjointly decisive reasons for implementing UFH, together with TGUBI, FHW-for-UBJs, and HEWC.

First, although it is true that, under the system of TGUBI together with FHW-for-UBJS and HEWC, not only would no one ever suffer from poverty or economic oppression again, forever; not only would no one who is mentally and physically capable of working ever have to be either unemployed or do a shit job instead of pursuing their lifework, forever; not only would no one who has completed a high school education ever be denied access to higher education again, forever; nevertheless, if UFH were not also simultaneously implemented, then most people living permanently in the USA would still suffer the slings and arrows of healthcare hell.

Second, therefore, under the collective system of TGUBI, FHW-for-UBJs, HEWC, and UFH, not only would no one ever suffer from poverty or economic oppression again, forever; not only would no one who is mentally and physically capable of working ever have to be either unemployed or do a shit job instead of pursuing their lifework, forever; not only would no one who has completed a high school education be denied access to higher education again, forever; but also healthcare hell in the USA would be ended, forever.

6. Conclusion

Therefore, for all these reasons, we must reject and exit democracy in general and liberal democracy in particular, especially neoliberal democracy, and create “the world as it could be made” for ourselves, by means of DDOA and dignitarian anarchism.[i]

NOTE

[i] I’m grateful to Elizabeth Hanna for encouraging me to write about the healthcare hell problem in the contemporary context of Trump’s recent re-election as President of the USA in early November together with the assassination of UnitedHealthcare’s CEO in early December.

REFERENCES

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