HONG KONG - This city, bastion of capitalism and perennial darling of
ultra-conservative think-tanks such as the Heritage Foundation, offers
affordable health care to every one of its seven million people. Massive
government subsidies make this possible.
Yet in the United States, my native country, where in some states as many as
25% of the people have zero health insurance, conservative critics threaten to
derail President Barack Obama's plan for guaranteed national health care as
some kind of socialist plot to undermine everything that is good and just about
American society. While an increasingly shrill and distorted debate rages
across the country, the health of nearly 50 million of America's 300 million
people remains at risk because they have no health insurance.
In the capitalist haven of Hong Kong, my adopted home, anybody
who can scrape together the equivalent of US$13 can receive generous, timely
and usually first-rate health care in an emergency ward. By contrast, US
hospitals are turning away the sick, the injured and the dying, even though
they might be carrying a lot more than $13 bucks in their pockets.
The US is the only advanced nation without some form of comprehensive health
care covering all of its citizens. So, as Americans continue their battle royal
over "Obamacare", which spilled over into unseemly heckling during the
president's address to a joint session of Congress earlier this month, the rest
of the civilized world can only look on in puzzlement and wonder.
When will this self-proclaimed global exemplar of democracy and humanity accept
the fundamental tenet that quality health care is every citizen's right? When
will America cross the medical threshold into the developed world not of the
21st century, but of the 20th?
Until that happens, I've always got at least $13 in my pocket, and I'll stay
right here in Hong Kong. While public hospitals here have recently been
embarrassed by a series of blunders - including two newborn babies taken home
by the wrong mothers and other infants injected with expired vaccine - in
general medical care is excellent. And, if you don't like the public option and
are sufficiently well off, superb private doctors and hospitals are also
available.
Why do so many in the US see such a public/private medical mix as a betrayal of
some perversely atavistic social contract and a point of no return toward a
socialist dystopia?
The Puritans who settled in New England nearly four centuries ago believed that
a person's inner godliness and prospects in the afterlife were reflected by his
or her prosperity on earth. In their view, the poor were probably damned and
the rich most likely blessed.
A similar attitude taints the health-care debate in the US today. An underlying
argument of many of those who oppose Obamacare - rudely represented by South
Carolina Representative Joe Wilson, who shouted "You lie!" at the president
during his address - is that those who don't have health care are unworthy and
that those who do should not have to pay for those who don't. To Wilson and
others on the far right, decent health care for all is a form of communism and
- or so their ugly rage suggests - unpatriotic, if not downright traitorous, to
American capitalism and perhaps to God himself.
This anger bubbled up again on the Saturday following Obama's speech, with tens
of thousands of protestors marching from the White House to Capitol Hill to
decry the Obama plan and similar, smaller "tea parties" taking place in other
parts of the country. Signs denouncing socialism and communism were commonplace
at these rallies. Some demonstrators carried posters of Obama wearing a
Hitleresque mustache - who knows why.
Presumably, these were some of the same people who kept their kids home from
school earlier in that week so that their minds would not be poisoned by a
presidential video message to the nation's school children that included such
radically socialist ideas as "work hard" and "stay in school".
Former president Jimmy Carter has condemned as "racist" Obama's angry
detractors on health care, but that oversimplifies the problem. Sure, many of
them might prefer a white president, but their reactionary responses go far
beyond race: they're afraid of change, even necessary change.
Let's not forget that the socialization of American health care began in 1965
with the creation of Medicare and Medicaid, two mammoth federal programs that
supply health insurance for the elderly and the indigent respectively.
Obamacare would simply complete - and hopefully greatly improve - the deal four
decades later.
But the task the president faces is daunting. Remember, the most effective US
senator in the past century - Edward Kennedy, who died last month at the age of
77 - spent most of his 46 years in the senate fighting for national health
insurance and failed to achieve his goal. Bill Clinton boldly took up Kennedy's
cause at the beginning of his first presidential term. Clinton backed away,
however, when he ran into stiff opposition in Congress, and health-care reform
died on the vine during his presidency.
Obama has made it clear that he will not back away.
"The time for games has passed," the president exhorted congress last week.
"Now is the season for action."
But the games will likely continue, and they are dirty games based on
fear-mongering and the politics of distortion and distraction. Millions of
Americans who listen to right-wing radio talk shows or watch cable TV's Fox
News, the unofficial mouthpiece and self-appointed hatchet man for the
Republican Party, are convinced that Obama is a communist whose vision of
national health care includes a free pass for illegal immigrants and the
establishment of "death panels" to determine who among the stricken elderly
will live or die.
Indeed, the president's address to a rare joint session of Congress was, in
part, an attempt to nip such misinformation in the bud, and polls taken after
his speech showed a rise in support for his handling of health-care reform.
"I will not waste time with those who have made the calculation that it's
better politics to kill this plan than improve it," Obama said. "I will not
stand by while the special interests use the same old tactics to keep things
exactly the way they are. If you misrepresent what's in the plan, we will call
you out."
Besides confronting his detractors, Obama showed a willingness to compromise.
While this may upset the liberal wing of his party, it will appeal to ordinary
Americans who have health care and worry that his plan will raise their costs
and sink the country into even greater debt. Reform will be financed by change
and savings within the system, the president pledged, adding: "I will not sign
a plan that adds one dime to our deficits - either now or in the future."
Most important - and most disturbing to liberals - Obama indicated he was ready
to compromise on the so-called "public option", a government-sponsored
insurance plan that would compete with the avaricious private sector, which has
shut its doors on 47 million Americans who do not have health insurance. The
president said he supports the option but will not insist on it, effectively
sounding its death knell as it already lacks adequate support in the Senate.
Ultimately, what all this means is that finally, with Ted Kennedy looking down
from above, America is probably going to wind up with comprehensive national
health care, flawed though it may be. Given the prolonged, torturous history of
the health-care debate in the US, even the passage of a flawed plan would
represent a significant victory if, in the end, anyone with at least $13 in his
or her pocket is guaranteed a competent doctor and humane care.
Kent Ewing is a Hong Kong-based teacher and writer. He can be reached at
kewing@hkis.edu.hk.
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