Summary: The year 2022 saw democracy protected from tyrants in the US and abroad through the determined action of visionary leaders. That struggle continues. The struggle for health justice in the US is similar: facing growing threats and anti-democratic opposition, it requires persistent vision, strategy, and resolve.
‘Clowns And Thugs’: Jan 6th Evidence Broken Down, CNN, December 23, 2022
Ari Melber interview with David Remnick of The New Yorker (9 min).
The Brutal Alternate World in Which the U.S. Abandoned Ukraine, The Atlantic, December 2022, by Anne Applebaum
Ukrainian resistance and American support prevented a wide range of horrors.
[Had the Russian invasion proceeded as planned,] Russian soldiers, strengthened by their stunning victory, would already be on the borders of Poland … NATO would be in chaos; the entire alliance would be forced to spend billions to prepare for the inevitable invasion of Warsaw, Vilnius, or Berlin. …
This disaster would not have been confined to Europe. … Chinese plans to invade Taiwan would be well under way, because Beijing would assume that an America unwilling to defend a European ally, and now totally bogged down in a long-term battle against an emboldened Russia, would never go out of its way to help an island in the Pacific. The Iranian mullahs, equally cheered by Russia’s success and Ukraine’s defeat, would have boldly announced that they had finally acquired nuclear weapons. From Venezuela to Zimbabwe to Myanmar, dictatorships around the world would have tightened their regimes and stepped up the persecution of their opponents, now certain that the old rules—the conventions on human rights and genocide, the laws of war, the taboo against changing borders by force—no longer applied. …
But none of this happened. Because Zelensky stayed in Kyiv, declaring that he needed “ammunition, not a ride”; because Ukrainian soldiers repulsed the first Russian attack on their capital; because Ukrainian society pulled together to support its army; …
Comment:
By Jim Kahn, M.D., M.P.H.
Many of us entered 2022 with deep concerns about the future of US democracy, with Biden’s popularity low and the looming midterm election expected to yield big gains for the MAGA GOP. The Russian invasion of Ukraine in February stoked fear of the global weakening of democracy. In a remarkable moment, Ukrainian president Zelensky declined a US offer to be airlifted to safety, instead leading a stunningly effective resistance, buoyed by US and NATO military supplies and political support. The January 6 House Select Committee convened compelling hearings, offering powerful evidence of seditious conspiracy. President Biden gave two major speeches highlighting the current GOP’s threats to US democracy. A midterm thrashing was averted, though vote margins were often precariously slim. The year ends with the huge relief of disasters averted, and cautious optimism that the tide has persistently turned in favor of democracy.
The 2022 news about US health justice is less upbeat, mainly because negative prior trends continue. Tens of millions remain uninsured, under-insurance via huge deductibles and copays is widespread, nearly half experience financial barriers to care, and medical indebtedness burdens 40%. [In a few days: a full and cited review of HJM 2022 content.] Meanwhile, private insurer profits are at record highs, boosted mainly by public programs such as Medicare and Medicaid. An effort to privatize traditional Medicare is proceeding. Private equity is buying up providers. Longevity has dropped nearly three years in two years, in substantial part due to the lack of insurance amidst the COVID pandemic.
There is also good news. Public support for federal government responsibility for insurance remains above 60% (making it the democratic choice!). Various local (including California) commissions and votes have endorsed universal and unified insurance – aka, single payer. National Democrats finally coalesced on the Inflation Reduction Act, with symbolic if limited controls on drug pricing and out-of-pocket costs. The abuses of private insurers and negative consequences of for-profit providers are receiving critical scrutiny.
On balance, where are we? The for-profit healthcare system has never been more firmly entrenched. Associated problems – and the futility of following the for-profit free market model – have never been clearer.
Nor have the links with the fight for democracy ever been more evident. A government role for universal unified health insurance is the popular will. A single payer, improved Medicare-for-All would extend and improve life; foster liberty to choose providers and jobs; and support the pursuit of happiness through reduced worry and improved health care. It would brilliantly support our founding notion that all are created equal. Other values align too.
Let’s remember the three essential elements of eventually winning the fight for single payer:
Vision: As shown around the world, the best way to pay for health care is identical comprehensive coverage. It saves money & lives. That’s the vision. We will not accept minor and inadequate tweaks to our fundamentally dysfunctional fragmented approach.
Strategy: Marshall the growing consensus that our system is thoroughly broken, recruit disenchanted stakeholders (such as physicians), and build the irresistible majority. It’s a challenging social change movement, linked with other powerful social change movements.
Resolve: We are told, repeatedly, that it’s not politically practical to achieve single payer. But we will relentlessly pursue its unique and powerful benefits as the only path to health justice.
All the best for the New Year!
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