Toward a Fully Democratic Society or More Disasters?

It’s up to us — “We the People”

by Doug Dowd

Introduction

or almost all who read this, Obama’s victory in 2008 was something of a miracle, a lessening of racism, reversal of decades of raw conservatism at home and of arrogant militarism abroad. But it wasn’t a miracle at all. The two most important reasons he won were these:

(1) He had a large number of (mostly young) people knocking on doors, raising money for him.

(2) For well over a year the economy had been slipping into a serious recession. Many who had heretofore gone along no-matter-what realized golly, it’s time for a change — so they finally came around. But only when it sank in that the White House giving billions and billions to those who had created the problem. Unfortunately and worrisomely, Obama hasn’t managed to do much better. (But remember that during the campaign brand Obama received more Wall Street money than the loose-cannon Republican crew.)

I write in the summer of 2009. In many ways, it has been both a relief and a pleasure to have Obama in the White House. His decency and his intelligence are almost unique for politicians. However, as [Howard] Zinn points out:

Obama was and is a politician, so we must not be swept away into an unthinking and unquestioning acceptance of what [he] does. Our job is not to give him a blank check or simply to be cheerleaders. ...We want the country to go beyond where it has been, to make a clear break with the past. ...There is a common thread that has run through all American history and all of its presidents that has consisted of two elements: nationalism and capitalism. Obama is not yet free of that powerful double heritage. (Zinn, [2009])

Nor, Zinn adds, can Obama free himself from that burdensome twin heritage without pressure and strong support from us. The multiple troubles facing the USA today are both domestic and global, brought about by the interactions of that double heritage (as will be discussed below). There is little or no reason to expect that, left to themselves, either Obama or the current leaders of other nations will undertake what is required to reverse ongoing economic, military, or environmental troubles. They must be pushed from below. But will we have the gumption? Do we have he nerve?

For several decades “we the people” have been acquiescent participants in both the domestic and foreign follies of those in power. Beginning now, we must awaken and re-activate that kernel of what is best in ourselves. It’s a big step. It won’t be easy and we may fail. But to go down with the doomed and sinking ship of those who rule — without a struggle — would be a betrayal of our humanity. It’s also patently suicidal.

What we must struggle against are the two dominating social systems we have learned to view as both natural and desirable, as the best of all possible worlds, as the benign culmination of civilization. These twin enemies are capitalism and nationalism. Both must be challenged (as Zinn noted). In less than a century, these monsters have thrust us into two depressions and two world wars. We are unlikely to survive a third of either.

And even were we (barely) able to survive, our increasingly poisoned environment would soon finish us off. That said, and because both capitalism and nationalism are taken for granted, it is vital to make clear why they are neither natural nor desirable. The attempt to do so in what follows will begin with their intrinsic and dangerous natures, beginning capitalism’s political economy (the distribution of power) and its social economy (the [non]meeting of human needs). Then US nationalism and its wars will be analyzed. Indeed, as though that were not enough bad news, we will conclude with worries about our environmental recklessness.
 

Capitalism

The dark side of modern history has had several dimensions. As the medieval world faded away, the nature of societal institutions changed. The place of racism, colonialism, and militarism was taken by capitalism and nationalism. Both of these were greatly strengthened by accelerating developments in science and technology. Taken together, their always tighter interactions became the foundations for the modern world. The new world saw the transformation of not-exactly-tame colonialism into the more ravenously deadly imperialism. It saw worker exploitation explode into the socially comprehensive depredations of monopoly capitalism. And it witnessed raw imperialism put on the sheep’s clothing of the more sophisticated globalization. Waiting around the corner were two otherwise avoidable world wars and what have come to be giant steps toward environmental suicide, the slippery slope toward human extinction.

Some who read this essay will have studied economics — that is, taken “econ” courses; a few may even be teaching them. In either case, and particularly for those in the USA, your teachers are unlikely ever to have mentioned the word capitalism. Instead, econ discussions demurely focus the virtues of “free enterprise” or “the market system.” But, as is never pointed out, these exalted virtues can exist only in a vacuum — which, of course, nature abhors. In a word, it’s all fiction, mirage, fantasy, delusion.

The problem is this: Economic theory abstracts from reality. It either “takes as given” or “assumes away” any and all disturbing — and essential — aspects of capitalism’s reality. Thus, in the vacuous world of economic theory, there’s no exploitation, no concentrated economic power denying people the essentials of life, no political corruption, no waste, no institutionalized greed. You name it — if it’s real, in economic theory it’s gone missing. These doctrinally dismissed parts of economic theory and their ways and means will be examined in what follows. (For their birth and early history, see Tawney [1926]; G. N. Clark; Mantoux; Bowden.)
 

Basic Principles

Capitalism began to take hold in the 17^th century. As it spread and strengthened, it came to be touted as the basis for economic progress. That is to say, it was trumpeted as beneficial by the tiny minority who prospered because of it. Meanwhile, its essential worker exploitation was becoming increasingly disastrous for the majority upon which capitalism depends. Despite various flailing attempts to move along a different path, capitalism became an always more effective roadblock to what might have evolved into an always better economic and social world for all.

If there’s only one class of people — The People Class — there’s no capitalism. So sitting at the center of our roadblock to a better world has been the very definition of capitalism: two classes. One tiny class, the capitalist class, owns and controls the means of production; the much larger working class serves their masters in order to survive. It is taken for granted by capitalists that businesses can and should use the means of production — that is, the means of life — to make profits. For themselves alone.

Also taken for granted (if not in these words) is that profits require workers’ wages be less than the value of what they produce. (The capitalists, of course, keep the difference.) Workers are just another cost that needs to be minimized. To be kept as cheap as possible, they really shouldn’t be paid at all, but, sadly, slavery was not deemed appropriate. Besides, slaves had to be clothed and housed, however minimally. Workers could simply be shooed out the door at will. The best arrangement for owners was thus minimal payment to workers, whose utter dependency came to be known as wage slavery.

That bitter basic principle of capitalism finally came to be modified by workers’ organized union strength — as the wage slaves started fighting back. That’s the story of much of the 20^th century. The increasing disorganization of unions since from the 1970s on has brought that capitalist principle back to an always stronger life. Wages have stagnated. Benefits are “given back.” Class differences become ever greater. The 21^st century is a world of masters and servants.

For capitalism to flourish, economic, political, and social behavior have had to function in harmony with inequalities of income and wealth and, therefore, inequalities of power, their blood brother. The residual “power of the people” is found in our right to vote. Even that particular right was uncommon until late in the 19^th century (and then only for “white men”). The formal political power of the aggregation of people has always been tamed by corrupted governments and, more recently, by always more effective “mind management.” (See Schiller [1989]; Phillips [1994].) As will be seen below, power now sits in the hands of a tiny minority of capitalists, assisted by highly-paid lobbyists, and legislators bowing to campaign financiers. Before proceeding further, it is germane to look back at what opened the gates to the present era.
 

Capitalist Socialization

Since no later than the 19^th century, we have become accustomed to an always deeper and broader socialization process that inures us to the harm done by capitalist ways and means. Our critical skills are anesthetized until they wither. We internalize the values of the capitalist class. We don’t even think about questioning capitalism. It becomes as natural as the divine right of kings, as time-honored as slavery, as obvious as a pie-in-the-sky father-deity. We love Big Brother.

What has come to be our unconscious acceptance of this “education” was foreseen long ago by at least two critics of the capitalism of their time: Karl Marx (who gave capitalism its name) and R. H. Tawney. Although differing in many ways, both saw that capitalism’s very nature requires a dehumanizing and anti-democratic class society. Both sought to replace it with a social economy presided over by and for the people. Not a minuscule minority of rulers, but the people themselves! And both understood that capitalism’s intrinsic differences in income, wealth, and power will be sustained and increased by any means necessary. Marx (and Engels) saw that already in 1848, in The Communist Manifesto:

Constant revolutionizing of production, uninterrupted disturbance of all social conditions, ever-lasting uncertainty and agitation distinguish the bourgeois epoch from all earlier ones. All fixed, fast-frozen relations, with their train of ancient and venerable prejudices and opinions, are swept away, all new-formed ones become antiquated before they can ossify. All that is solid melts into air, all that is holy is profaned, and man is at last compelled to face with sober senses his real conditions of life and his relations with his kind.

Tawney was a socialist but not a Marxist. He strongly agreed with the above position in both his Acquisitive Society (1920) and again in Equality (1931, 1938). Until his death in 1962 Tawney was the most influential thinker of the British Left. As he wrote in the 1938 edition of his Equality:

Inequality is the critical basis of capitalism…. A tiny percentage of very wealthy people year by year take nearly one-quarter of Britain’s annual output of wealth….Far from being an economic asset, the wealthy are an economic liability of alarming dimensions. They involve:

(1) a perpetual misdirection of limited resources to the production of upkeep of costly futilities, when what the nation requires for its welfare is more and better food, more and better houses, more and better schools.

(2) They mean that, for the lack of these simple necessities, the human energies which are the source of all wealth are, in the case of the majority of the population, systematically underdeveloped from birth to maturity.

(3) They result in the creation of a jungle of special interests, which stubbornly resist all attempts to reconstruct the economy on a more just and rational line.

Tawney wrote these words over 75 years ago, focusing on his England. His indictment is far from outdated; it applies with a vengeance to today’s capitalism, especially U.S. capitalism. Not having the experience (and thus the memory and basis for comparison) of a non-capitalist history, the USA has been the most capitalist of all. In addition, from the outset US class inequality was much nourished by the racial discrimination and murder of native tribes and black slaves; lessened, but continuing with variations even down to the present.

Today social domination by capitalist goals has opened the door to crises well beyond those of Marx or Tawney. Our “jungle of special interests” makes Tawney’s seem not much worse than a neighbor’s smelly garden, except for this: He was writing in 1938, as what was creeping out of the jungle was World War II. That meant deep disasters for many years. Worrisomely, today’s realities and tendencies point to what could become worse — the all too real possibilities of life-on-earth ending calamities of nuclear war; or if we somehow avoid that, of environmental collapse.

In what follows we examine the grim realities and threatening problems of capitalist social economy. That done, nationalism and its wars will be studied, to be followed by the causes and consequences of our increasingly poisoned environment. (As we go along, there will be brief discussions of what needs doing by us if President Obama is to be able to reverse our present terminal lurching toward one of more looming disasters.)

A functioning economy has several dimensions: production, consumption, finance, investment, and trade. Herein the political economy will be concerned mostly with the power of capitalists, and the ways and means of corruption. The social economy examined here will focus upon the failure of history’s richest economy — ours — to meet people’s basic needs of nutrition, housing, education, and health care.
 

Big Business and its Financialization

From the late 19^th century on, capitalist economies came to be dominated by always more giant companies. As the 1920s ended, giant corporations were coming to dominate in steel, electric power and products, autos, and banks. (See Veblen [1923]; Soule.) That period was the mere infancy of Big Business. Today in the USA a few dozen of the Fortune 500 directly or indirectly dominate the whole society. A handful of giant corporations run the whole show. (This set-up also common elsewhere.)

US Steel (in whose Research Division I worked in the 1930s) was the first giant, but their parade came to be led by another colossus — General Electric. GE began with light bulbs, home appliances and radios. Nowadays...it still makes light bulbs and home appliances. But much, much more. Here is an official summary of its diverse corporate activities. GE is

•    One of the largest manufacturers of major appliances in the world

•    The world’s leading producer of jet engines

•    Provider of a wide assortment of integrated electrical power delivery equipment

•    Provider of energy products and services to more than 120 countries

•    Provider of medical imaging and information technologies

•    Provider of consumer, commercial, and industrial lighting products

•    Owner of NBC Universal, the prominent media and entertainment company

•    Provider of complete solutions for the oil and gas industry

•    The leading supplier to the world’s railroads

•    Provider in more than 30 countries of security, safety, and lifestyle enhancements

•    A leading global supplier of water and wastewater treatment systems
 

Plus, GE has been a powerhouse of finance. GE Capital (at least until recently) provided more than 40 percent of the profits of the entire corporation. This transformation from providing goods and services to finance was an early instance of what became today’s financialized economy.

From the 1970s on, the US financial system underwent three connected changes:

1.   It overtook the industrial sector in terms of income and profits.

2.   It was freed from the regulations meant to prevent a repetition of “the crash of 1929.”

3.   It changed its address, its way of doing business, its modus operandi from Wall Street — to Las Vegas.

Unfortunately, the economic story doesn’t end there. Not only did finance come to dominate production, but since the 1970s, a few giant companies have come to dominate a globalized economy — itself dominated by speculation. Among the latter’s many harmful effects — not least the ongoing financial crisis — have been the following:

1.   In the rich countries workers’ bargaining strength has been weakened and the jobs have been threatened, deskilled, cut back, or eliminated.

2.   The poor-but-dignified farmers in the weak countries lost their lands to such monster corporations as Archer Daniels Midland.

3.   The newly disenfranchised ex-farmers were forced to work for dirt wages in foreign-owned factories.

But what profits! So three cheers for globalization.

As these developments were unfolding, the basis for a global financial earthquake was taking hold. Its first tremors were felt in 2006 as the subprime housing crisis began. This was an early warning of what to fear from an increasingly berserk financial system — a system operating as if perpetrated by a weekend rampage of drunken frat rats.

Gaining speed during and after the 1980s, one or another of always riskier and interacting gambles came to dominate finance. Rather than traditional banking, money manipulation came to mean asset-backed securities — derivatives — such as structured investment vehicles (SIVs), colleteralized debt obligations (CDOs), funds of funds of hedge funds, credit default swaps (CDSs), and other arcana. These instruments were structurally complicated, almost completely unregulated, individually hard (or impossible) to unravel, and ultimately unsustainable. But what profits — for a while.

But how could all that happen? I mean, hadn’t the financial collapse of 1929 been followed by a series of congressional laws to prevent it from happening again? Indeed it had, but beginning in the 1980s, step by step those laws were being weakened. In the 1990s, with Clinton as President and Summers as Treasury Secretary, they were utterly demolished.

Not only in the Bush, but also in the Obama administration, the largest financial companies (together with their CEOs) have been “punished” with hundreds of billions of our dollars. (What’s the moral here?) Also unsurprisingly, what first took hold in the USA soon spread over the globe. Item: Iceland, long known for its austere landscape and rich fish-based economy, now struggles with a broken financial system in which, for example, credit cards no longer work. (It used to be joked that Icelanders would pay for a pack of chewing gum with a credit card.)

Meanwhile, the USA and the world economy limp along in ways pointing to a transformation from recession to depression. The “stimuli” of both Bush and Obama have been great for the financial big shots who created the problem. The stimuli will continue to be inadequate for the rest of us so long as Obama listens more to them than to us. We should speak up. In fact, we should shout!
 

Corruption

Another major part of the explanation as to why the USA is now experiencing something akin to 1929 is found in what we now examine — corruption. It has many homes; here the summary focus will be on lobbying and campaign finance. (A considerably fuller and readable treatment may to be found in several books of Phillips, beginning with Arrogant Capital.)

“There’s nothing new under the sun” applies all too much to corruption. That it has always been with us does not, however, mean that we can shrug it off with c’est la vie. As with out polluted air, unless we clean up our society, we will be done in by it. We have allowed getting ahead and getting rich to supercede, erode, or nullify our humanity and idealism. Especially in politics. Consider this excerpt from an editorial about the U.S. national election of 2008, “The Selling of America’s presidential candidates”.

The sticker price for U.S. presidential candidates and congressional elections is rocketing toward $5 billion, shocking even professionals who figure the ante in the opening Iowa round may cost $500 per voter….By next Election Day the two presidential candidates will be at the $1 billion mark in combined spending: a 50% rise over the outrageously high price of the 2004 campaign. (IHT, 2007-12-14)

Of course, corruption is not limited to politicians and politics. In fact, it is not limited at all. Corruption has been rampant in the scandals concerning the CEOs and their companies (Exxon, Tyco, Citigroup, et al.), to say nothing of our educational system, to say nothing of judges and police, to say nothing of sports...and to say nothing of another elephant in the room, our health care system (coming up later).

Hold your nose as we now we now take a closer look at the political corruption accomplished by its leading actors: lobbyists and campaign finance. Lobbying and campaign financing have been significant for only about a century. Limited though democracy is now, it was even more restricted before World War I — which is saying a lot.

Lobbying

“Lobbying” came to be called that because in its early days those who sought to create, eliminate, or modify governmental policies hung our in the lobbies of national and state legislatures, waiting to buttonhole those with open pockets and malleable principles. The country and its media were still young.

There is a difference between lobbying and campaign financing in the USA, but they have steadily become interdependent in influencing and controlling legislation, most especially for those businesses who know just what they want and how to get it: those in finance, health care, the military industries, and oil. (See Kaiser.)

Literally sitting in the lobby is now quaint in the USA. It continues mostly in doctors’ offices, although all too often drug reps simply barge into the back office and make their pitch. (Meanwhile in the waiting room, the sick patients stack up.) The lobbying business — and it is a big business — is more efficient than ever. No need to waste time hanging around — just dial a number. Already in 1991 there were 90,000 lobbyists in Washington, D.C., alone (then with mean annual incomes of $250,0000). (See Phillips [1994]; Kuttner [1996].)

Drug companies — Big Pharma — are not in the health business; their business is selling. Their corporate behavior, whether hard sell, soft sell, or soft soap, is rather to be expected. They have to move product. No sales, no profits. But given that life and death are so much involved in health care, perhaps the doctors, pharmacists, and hospitals are the most shameless of all. If there were a booby prize, though, we plain folks would win it — for having sat back and let the rich and powerful get away with murder all these years.

Campaign Finance

Like the CIA and NSA budgets, campaign finance amounts may be either stated or off the books. The amounts we know about are, of course, only those admitted to have been directly raised by candidates in all levels for all offices — including, mind you, judges. There are legal limits to any one person can contribute for a candidate and for the soft money raised by a political party for a particular candidate indirectly. Are the laws enforced? Make a guess.

Then there is this: Although illegal, it is common in many businesses to “ask” their employees to contribute to a given campaign. It doesn’t take much imagination to deduce that a high percentage of those “voluntary individual contributions” are either coerced or even reimbursed by the employee’s friendly boss.

There are two kinds of campaign contributions: hard and soft; one is legal. For an obvious reason we can’t know the quantities of illegal “softies”; this is the black budget of campaign financing. We do know already in the national campaigns of 2000 that more than $3 billion were “contributed,” and that more than ten times than that for lobbyists. (See Alan Krueger, “Lobbying by businesses overwhelm their campaign contributions,” NYT, 2002-09-19.)

So what’s wrong with a little or even a lot of corruption? Plenty, unless one sees the ongoing financial crisis and its associated economic collapse (among much else still to be discussed) as merely así es la vida. Those who have lost their homes and/or their jobs and/or much else can tell you it’s hell on wheels. (Soon we will turn to the social economy and our country’s disgraceful not meeting the basic needs of its own people.)

First, the connections between our economy’s ongoing deep troubles and its deep corruption. All too many of who read this will have been victims of the financial collapse whose first obvious steps occurred in 2006–7 as the housing bust rolled into view. That there was a “bust” is in itself demanding of an explanation. There would not have been a bust unless there had been an expansion that had little to do with housing and a great deal to do with gambling. That gambling was made possible by a corrupted Congress and a corrupted White House that had rid the nation of the laws specifically designed to prevent it.

As touched on earlier, that corruption process began its tight hold beginning in the Reagan years; it was then that the torpedoing began of the laws meant to keep speculation out of the housing market. One step led to the next up into the 1990s, when the Clinton-Summers crew put the axe to the last significant regulations, culminating with the repeal of the venerable Glass-Steagall Act. Now for the first time since 1933, bank holding companies could own other financial companies. The casino doors were wide open.

Thus, it was the 1920s all over again — but with a vengeance, with the past being a timid prologue. What was different this time around? Since 1929, the economy has changed in several ways that have brought all nations and their peoples into a tight dance, a dance swinging on to the tunes whistled by a Wall Street high on the heady economic drugs of derivatives. The philosophy guiding banks and insurance companies and builders — and Mr. and Ms. America — was simple (make that simple-minded): “What goes up no longer comes down.” It was the end of history, the final triumph of capitalist invention, the forever balloon of wealth creation. Soon the Dow (Jones Average) was sure to reach 30,000...

As also noted above, virtually all financial institutions joined the game, and all have hit the wall. But the ongoing financial collapse, though it could not help but bring 1929 to mind, was importantly different in both its causes and its effects: different in ways that may well take us to a crisis both deeper and broader than the earlier crash. Why? Here I give only a simple answer, in three steps:

1.   The imperialism preceding and following 1929 was neither so pervasive nor explosive as today’s globalization plus financialization.

2.   Today’s world economy has been critically dependent upon the USA as its all-important buyer.

3.   Up to 1929, the USA had been the world’s greatest lender; since 1980,the USA has been the world’s greatest borrower. There is no one to lift the USA, let alone the world, out of this crisis; nor, it needs adding, was the 1930s world lifted out its crisis, except by World War II. Some lift!

(Brushing modesty aside, I refer readers to Chapters 5–7 of Dowd [2009] for a more substantial analysis of the economy, and Chapters 9–10 for basic needs and the social economy.)
 

Health Care, a Prime Example of the
Social Economy of the USA

How is that the richest society in all history is also the one that, among all industrial nations, is the worst in the meeting of its people’s basic needs of nutrition, housing, education, and health care? As I now offer a least a partial answer to the conundrum of richest country-poorest services, the discussion will be concentrated on the US health care system. The criticisms also apply (with variations) to nutrition, housing, and education. All are disgracefully inadequate, all are subject to corruption.

I begin with the critique of Arnold S. Relman, M.D., professor emeritus of medicine and social medicine, Harvard University, and former editor in chief of the New England Journal of Medicine. First an excerpt from his recent article in the NYRB (2009-07-02), “The Health Reform We Need & Are Not Getting.” (And see his book, cited in References.)

Health care in the US is about twice expensive per capita as in other developed countries — nearly 17 percent of GDP in 2008 — and its costs are rising faster….[That fact] accounts for another problem: nearly 50 million people are uninsured and the number is rapidly rising, the main reason for which is the ever-expanding use of expensive kinds of diagnosis and treatment, such as new drugs, diagnostic tests, etc. Physicians in other advanced countries have access to the same resources but use them less. The difference is explained by a higher proportion of specialists in the US….one reason why primary care doctors are now in short supply.

And you thought that the Hippocratic Oath that doctors take had them promising to keep the good of the patient as the highest priority. Maybe it used to be. It still us for us. But now when docs graduate most sing, “Money makes the world go around, the world go around, the world go around,” and the oath floats like an autumn maple leaf into the wastebasket.

As Obama seeks to move the health care industry toward decency, it is unfortunately relevant to begin with what was done and undone in the Clinton presidency. In 1993, Bill and Hillary organized a conference of doctors, hospitals, health care insurance, and drug companies to discuss “The Clinton Health Care Plan.” Their stated intention was fine: to bring about a single-payer system of the sort common to Canada and all of Western Europe. But for reasons never explained by them to us, the conference began with the agreement that single-payer was not even to be discussed. In the years since the conference, health care costs (doctors, insurance, drugs, hospitals) have skyrocketed. But oh, the profits!

Poll after poll in the USA shows about two-thirds of the people in the country — when shown how the health care in the other rich countries works — favor that system for the USA. And by the way, how do they work? Here it seems appropriate to give some personal experience:

I have lived with the US healthcare system both as a citizen and as an assistant in surgery in San Francisco’s public hospital. I have experienced the system of Italy in my many years of teaching as a visitor and, in recent years, as an official resident. The two sets of experiences have been wildly diverse.

I worked as an assistant in surgery on the night shift at San Francisco Public Hospital (and going to school during the day). Our stations was just above the Emergency Room. For me, the routine was simple: When I heard the siren of the approaching ambulance, I would rush down below to the ER to pick up the patient.

One night I went down to bring up a man screaming in pain who, at the same time was being asked questions: “How much money do you have?” Scream! “How much?” Scream!

Finally the guy could speak: He managed to choke out that he had $300 in the bank. He was put back in the ambulance and taken to a private hospital. Three days later I saw him upstairs in Recovery — broke. That’s the USA.

Here’s Italy. In 1966 in my first week in Italy I was hit by a car, loaded into an ambulance, and hospitalized. At the hospital, they asked for was identification. I produced my California driver’s license. No demands of how much money can I pay or whether I can pay at all. For you see, there was no charge.

Several times since then I have been hospitalized in Italy. I have never had to pay a doctor, but I did have to pay for prescriptions. Now I am an official resident and I don’t have to pay for my medicines. I have my family doctor and specialist doctors, and every month — not unusual for someone my age — I have to get a bagful of prescriptions. My haul would cost several hundred dollars a month in the USA. In Italy: zero.

Why is such a system as Italy’s a four-letter word in the USA? Because only We The People want it. Robert Reich was Clinton’s Secretary of Labor, and he strongly supported the single player plan. This is his explanation of the US situation:

When you’ve got so many lobbyists and PR professionals and lawyers swarming over the Hill for [these] corporations they also can come together against the public; and the public’s voice can easily be downed out….Even Democrats are reluctant take on the big power players….The problem is not just the pharmaceuticals and the American Medical Association, Blue Cross/Blue Shield and so on; the whole system is now dominated by for-profit corporations. (See Moyers.)

So if single-payer was off the table, what was discussed at the infamous Clinton conference? In a nutshell, it was what the players wanted to talk about. It was what would suit their aims. That was profits. The cheerful result was to assure us that companies could be always more business-like. (See Gordon for the Clinton fiasco; Relman and/or Starr for an overall critique; and Moyers for much more regarding lobbyists.)Now some disgusting facts, taken from Drs. Himmelstein and Woolhandler (H&W), also of Harvard, unless otherwise indicated.

Government expenditures accounted for 59.8 percent of US health care costs in 1999. At $2,604 per capita, government health care spending was the highest of any nation; including those with national health insurance. (That figure includes expenditures of $65 billion to buy private insurance for government employees.) In that same year, a family of four spent $7,015 for their own health expense and $10,416 in health care taxes for government workers and government health programs like Medicare and Medicaid. (Today it’s worse.)

Well, so what, if our people are healthier than those of other countries? But they’re not. In fact, far from it.

“The US ranks high on the list of infant mortality, right up there with the poorest countries; the American health care system, despite the highest expenditures in the world, is badly in need of an overhaul.” (Editorial, IHT, 2008-10-22)

We pay the highest health care taxes, but much of that money is squandered. The wealthy get tax breaks, and the HMOs and drug companies pocket billions in profits at the taxpayers’ expense. Meanwhile, politicians claim we cannot afford universal coverage. Every other developed nation has national health insurance. We already pay for it: public money, private control. (H&W)

Although the US spends more per capita for health care nation, we also provide the least coverage to the average citizen. About 20 percent of us are completely without coverage; among the other rich countries, the worst rate is less than 1 percent while, those other countries also have higher longevities and lower infant morality rates. France is best, Italy next; the US, richest country, are worse off than impoverished Colombia. (Russell)

But do not Medicare and Medicaid and emergency rooms take care of those with too little (or no) coverage? No. First, Medicare: IF you can find a doctor, and IF there’s no serious problem, OK. However: it covers only 90 days of hospital care, and a “permanent supplement” is required to pay for doctors and drugs. It began as $3 a month; it is now close to $100 a month. Medicaid? It covers only half of the poor. Aren’t emergency rooms a a kind of socialized medicine for the poor? Not quite: after waiting in line for an hour or more, and then you will find that they are not free: the average cost of a visit is over $1,000. (Ehrenreich, 2001) That’s when you can find one; they are closing all over, disgracefully in the huge county hospital of Los Angeles.

Then there’s the matter of prescription drugs, which takes us to nine huge companies of Big Pharma. Read the annual Fortune 500. They are the most profitable, with profit margins four times the average of the others. (H&W.) What they are making profits on are the very high prices of their tightly patented products. (Multinational Monitor, September 2001, “Profits”) And the profits trickle up. The CEOs of Big Pharma have long averaged incomes of at least $20 million a year (not counting stock options, bonuses, and the like.)

To protect their interests, Big Pharma has thousands of lobbyists in Washington, D.C., and more in the states. From 1998 to 2006 the pharmaceutical industry spent close to $1 trillion on lobbying activities — more than any other industry.

Now why would they spend all that money? Because, thanks to their lobbyists, abetted by a complacent government and bribed doctors — and now facilitated by the once-forbidden right to advertise — they have succeeded in achieving their dream. They maintain high-priced monopolies on innumerable prescribed products. What profits! But these exorbitant prices mean, quite literally, premature deaths for who-knows-how many?

It is not pleasant to dwell on the large-scale cooperation of medical professionals, as the drug companies bribe them to recommend their products. Here’s a personal example. My pharmacist is a ski nut who also likes beaches. He gets to visit both regularly at “conferences,” paid for by guess-who. Then there is their tax-deductible spending on the promotion of their products: Ten years ago Big Pharma paid more than $13 billion for their doctor reps. Today it’s worse, with the benefits of direct-to-patient advertising, whereby patients come to the doctor’s office to ask for (or demand) a drug they’ve seen ads for. (H&W)

That’s more badly wrong with US health care. We have been effectively socialized to believe that our health care system is the best in the world. We might as well believe the world is flat. The fact is that among the rich countries, US health care is the worst — easily the worst — and it is also the most costly. For the richest nation in the history of the world, this state of affairs is a disgrace. We are deeply in need of substantial reforms. As of now, we won’t even get modest changes unless Obama has active and vocal support from a public demanding that decency and good sense get a chance.

Obama knows that and is seeking to gain our support to move in that direction. It is probably fair to say that he would be pleased if the US Congress were to pass legislation taking us toward the governmental health programs of Canada and Western Europe. But he is facing strong obstacles for any governmental program, unless it is approved by the rulers of the ongoing system: many doctors, all health insurance companies, hospitals, and Big Pharma. Presently, they are working together to ensure that the members of Congress they have bribed in one way or another will come through for them. Note these rat-a-tat stories from The New York Times, June 2009:

•   “New drive on health care planned by Obama” (2009-06-08)

•   “In poll, wide support for government-run health”(2009-06-21)

•   “Doctors’ Group [the American Medical Association]opposes public insurance plan. Health services should be provided in private markets.” (2009-06-11)

•   June 22: “Senate panel might revise health-care bill.”(2009-06-22)

In sum, by hook and their crooks the health care industry has through its lobbyists and its campaign financing hoodwinked the public into believing that our health care system is both the cheapest and the best in the industrialized world, when in reality is the most expensive and the worst. Obama wants to change all that for the better. He can’t do it without lots of push and support from us.
 

Nationalism, Wars, and the Environment

Dangerous and disgusting all of the foregoing is, what we have yet to discuss is even more threatening: our many wars and our struggling environment. If current tendencies in either (let alone both) are not transformed, total disaster awaits. Led by the USA, the entire world has been lurching toward both calamities for half a century.

First, let’s define our terms. It is important first to distinguish between patriotism and nationalism. Patriotism refers to the love of one’s country. It means — or should mean — that when the country is behaving badly or dangerously, its citizens will see it as their duty to work to make the beloved country lives up to its ideals. A patriot is the vigilant upholder of these ideals.

In the USA, nationalism has come to mean something entirely different. It’s mantra is “my country, right or wrong.” (“I will never apologize for the United State of America,” whined George H. W. Bush.) US history is stuffed with behavior betraying its ideals. Indeed, such nastiness even preceded our become a nation.

The new country began with the theft of the lands and extirpation of the lives of the continent’s native peoples. The country continued a tradition of centuries — murderous slavery. The country started well over a hundred large and small wars — for gain — north and south, east and west of “our” land. I am not alone in believing that, except for our Civil War, there has been only one other war that can be justified: World War II. (For a full listing, see W. A. Williams [1980].)

Disturbing though our many small and large wars of the past, those most disturbing have been the illegal wars after World War II: Korea, Vietnam, Iraq, and Afghanistan (with Iran all too possible). All were Officially Justified as Necessary and Unavoidable (during or after), but all have been shown to have been acts of naked aggression, which is to say they were all “wars of choice.” (For Korea, see Cumings; for Vietnam, see Young.)

Vietnam

For a quick look at the USA in Vietnam, we need only to focus on Robert McNamara, Secretary of Defense under LBJ. He proudly masterminded the Vietnam war. He cheerfully oversaw the murder of more than three million Vietnamese, Laotians, and Cambodians. He sanguinely plotted the distortion and destruction of the societies and ways of life of those countries and their ways of life. Then he had a change of heart. McNamara in 1968: “The goddamned bombing campaign has been worth nothing, done nothing: we’ve dropped more bombs than in all of World War II and it hasn’t done a f***ing [sic] thing; we made a mistake and should simply withdraw.” BG: “Nuclear Madness,” 2009-07-19).

We didn’t withdraw. Instead, LBJ fired McNamara, the war went on, and most of its dead and wounded occurred after 1968. (See also NYT, 1968-07-06–08 regarding McNamara’s role; see Young for the best analysis of the war.)

McNamara was wrong. The Vietnam war was not a “mistake.” It was a prolonged criminal act. Even the rationale for the war, the reason given as to why we were there in the first place, was a lie. The US government fabricated an instigation, an incident that never happened. We said the North Vietnamese had attacked one of our naval craft. (Years later, the captain of the US vessel finally admitted the tale had been made up.)

Tell it to the three million Southeast Asians dead. Tell it to their wounded. Tell it to the more than half a million casualties among the invaders. Tell it to the Vietnamese living today in misery today, with bodies devastated and minds mutilated by our Agent Orange. Tell it to the Southeast Asians who still lose limbs and lives to our land mines. But you can’t tell it to Robert McNamara. He died in his sleep recently at the age of 93.

Present Wars

Now to the present. The USA is already at war in Iraq and Afghanistan. As this is written in July 2009, war with Iran is all too possible. If and when such a war occurs, it is likely to be initiated by Israel, which has been itching to bomb Iran’s nuclear facilities (with all too much encouragement from some elements in the USA). After Iran’s (fixed) election of 2009, and quite apart from the position taken by Obama, congressional Republicans could scarcely hide their glee as they condemned the easily condemnable Ahmadinejad. It is to be hoped, but as of now unlikely, that ways will be found by the Iranians, the USA, and others) to find a peaceful and otherwise desirable means for avoiding what could and all too probably would pave the way for “the war to end all wars.” In short, we are presently stuck in three traps largely of our own doing (that of Iran assisted by Israel). What follows is a mere skimming of ongoing developments in Iraq, Afghanistan, and Iran. First, we examine the two ongoing wars.

Iraq  Critics of the Cold War (myself included) have argued that had Stalin not existed, the USA would have had to invent him. The same may be said of Saddam Hussein and Ahmadinejad. I agree that all three of them are (or were) dangerous brutes, harmful to their own countries and worrisome for neighbors. But the same can be said for many others the USA has assisted, cooperated with, or supported. Here’s a short list: Mobutu in the Congo; Pinochet in Chile, Franco in Spain. (See, in that order, Hochschild, Blum, Brenan.)

And here (without documentation) is a longer list:

 1.  Argentina: Videlia
 2.  Bolivia: Banzer
 3.  Cuba: Batista
 4.  Dominican Republic: Trujillo
 5.  Egypt: Mubarak
 6.  Guatemala: Montt
 7.  Haiti: Papa Doc (and Baby Doc)
 8.  Indonesia: Suharto
 9.  Iran: The Shah
10. Nicaragua: Somoza
11. Panama: Noriega
12. Paraguay: Stroessner

In addition, the USA posed as “neutral” as fascism won over in Italy, Germany, and France, and Spain, where neutrality meant assent. (When the supporters of democracy in Spain asked the USA for help during the Franco revolt, the reply was, “Golly, sorry, we’d like to help you, but we can’t — we’re neutral. Our hands are tied.”) After World War II, the USA cooperated all too nicely with the one remaining fascist dictator, Spain’s Franco — from 1937 until his death in 1975.

The role of oil  Oil hasn’t always been the main reason for the intervention of the USA in the Middle East and Central Asia, but more often than not it has played a crucial role. It needs adding that the decades-long US financial and political support of Israel (and its aggressiveness toward Iran) has been supported in part in the USA because of its politically strong Jewish population and because of Israel’s location in the Middle East. (Lest you see that as an anti-Semitic — that is, anti-Jewish — position, note 1.) that a substantial number of Israelis have agreed with this assessment; and 2.) because my mother was a Jew, had I been accessible to him, Hitler would have killed me along with the millions of others.)

The position taken here is a simple one; namely, were it not for Iraq’s oil deposits and its strategic location, the USA would have never have invaded it. That done, the USA is now stuck. If and as we depart, we will leave behind a thoroughly destroyed nation, 2–3 millions of whose people have fled, with many millions more left behind whose lives have been ruined, and a society in chaos. That is bad enough for the Iraqis. For the USA, the chaos left behind is a threat to long-emerging US strategic and economic interests. As matters now stand, it is all too likely that the USA — with or without Obama as President — will find reasons to maintain substantial military forces in Iraq for an indefinite but presumably long-term period.

The USA first became seriously involved in Iraq mostly to satisfy the desires of its giant oil companies. How and when it will ever get out is anybody’s guess. The dangers and costs of seeking to remain are unknowable at this time. They have already been great and are likely to become worse as we sink deeper and deeper into the quagmire of Afghanistan (with Iran bubbling next door).

Afghanistan  The interest of the USA in Afghanistan first took hold in the late 1960s, when oil giant UNOCAL anticipated that, given the never-ending turmoil of the Middle East, it would be wise — that is, profitable — to have an oil pipeline that could skirt conflict by going through Afghanistan. (See Everest; Klare.) As will now be seen, that interest was insanely warmed up thirty years ago, in 1979, during the Carter presidency. Then a very small group calling itself “the Taliban” (“the students” or “the students of Islamic knowledge”) was struggling into existence, while at the same time the USSR was beginning to make moves there. In July 1979, way before 9/11), Carter’s National Security Advisor Zbigniew Brezinski persuaded the president to sign the first of several directives allowing the CIA to provide weaponry to the infant Taliban. Why? The answer is found in what “Zbig” — he calls himself Zbig — gave in a boastful interview with Le Nouvel Observateur in January 1998, 20 years later. This was the aim:

To draw the Russians into the Afghan trap…We didn’t push the Russians to intervene, but we knowingly increased the probability that they would.

Three months later, on the very day the Soviet army entered Afghanistan, Zbig wrote to Carter, “Now we can give the USSR its Vietnam war.” He was right. After three years of fighting the US-armed Taliban, the USSR withdrew. The USSR got its Vietnam in Afghanistan, but got off easy. Now the US is on its way to its second Vietnam, not only in Afghanistan but also in Iraq and Iran. We are unlikely to get out easily. Our first Vietnam ended in disgrace... (See Everest; C. Johnson.)

The Taliban’s strength baffled the USSR in the early 1980s. That power dwindled after the USSR retreated. Then as the 21^st century progressed, the Taliban got the very smart idea of leading the impoverished peasantry to become what is now — the world’s leading source of opium. Oh, the profits! Now the Taliban are increasingly strong, powerful enough both to dominate Afghanistan and to make substantial headway in Pakistan (a nuclear power).

Note the title of a book review by William Dalrymple in the NYRB (2009-02-22): “Pakistan in Peril.” The book’s title is itself revealing: Descent into Chaos: The United States and the Failure of Nation Building in Pakistan, Afghanistan, and Central Asia, by Ahmed Rashid. Writing in 2008, Rashid had this to say:

American power lies shattered; USA credibility lies in shreds. The strategies of the Bush administration have created a far bigger crisis in South and Central Asia than existed before 9/11. [And, he concludes] South and Central Asia will not see peace and stability unless there is a new global contract among the leading players…to help the region solve its problems, which range from settling the Kashmir dispute between India and Pakistan to funding a massive education and job-creation program in the borderlands between Afghanistan and Pakistan and along their borders with Central Asia.

Since the arrogant adventure of Cold Warrier (self-styled) “Zbig,” the US policies in that region have plumbed depths beyond stupidity and toward insanity. There has been reason to hope that the Obama presidency would move in decent and more hopeful ways. But no — with Obama so far it appears that the US empire rolls on, at all costs: What he has done up to this writing (the summer of 2009) is to increase the presence of US troops by at least 20,000, even as our allies reduce theirs.

As matters now stand in Afghanistan, at noted above, the Taliban have increased their strength and aggressiveness well beyond anything even thinkable in 1979. They may be horrifying, but they are also hearts-and-minds smart: They have made it easier for the farmers of Afghanistan to live comfortably. The area is a cauldron...The US-created government of Afghanistan would be laughable were it not dangerously inadequate (and corrupted)...Pakistan, while instigating and supporting the Taliban in Afghanistan, is itself increasingly unstable...Kashmir smoulders like a house fire dancing inside a wall...

President Obama (for whom I did some campaigning) must stop, look, and listen. But listen to whom? A good start would be to consult Ahmed Rashid.