Health Care/Joan Retsinas

Hubris at the Feast

In this season of feasting and toasting, we give thanks – the affluent for their affluence, the middle class for Roosevelt’s “four” freedoms (speech, religion, want and fear – though the last has become problematic) and the poor for their comparative wellbeing. (They fare better than many counterparts in the countries that they fled.) So we thank our genes, our parents, our luck, and the gods of the marketplace that have smiled upon us.

Into this toasting, there is more than a whiff of hubris: we are fortunate because we are blessed. We who are neither poor nor crippled look upon Tiny Tim kindly. We have earned our just desserts.

Let’s get real: an avuncular Uncle Sam (and his state minions, little Uncle Sams) sit in the wings of our feasts.

Are you taking medicines to keep your blood pressure, your insulin, your heart, or you mind stable? Thank the pharmaceutical companies, but thank too the federal coffers that have poured money into basic research. Don’t forget the Food and Drug Administration: it oversees the safety, and more importantly the efficacy, of those medications. In a long ago past Americans took snake oil, goat serum, and feel-good elixirs; once upon a not-so-long ago time, pregnant women took thalidomide. Today’s safeguard: Uncle Sam. We still can buy non-regulated concoctions, with no overbearing Uncle Sam to certify them; but that is a caveat emptor arena. (If you wax nostalgic for laissez faire, remember the recent deaths from medications “compounded” by unregulated pharmacies.)

Are those medications – a lot of them – costly? Absolutely. Look to Europe, where the same brands cost less. The reason? Subsidies from those European governments. Some of our solons are proposing more aggressive governmental action to lower prices – a blatant invitation for Uncle Sam to step into this American marketplace.

Do you have health insurance? If you have Medicare, or Medicaid, thank John F. Kennedy, Lyndon Johnson, Wilbur Mills, Robert Kerr, and a host of others embedded in history tomes. If you have private insurance, do you have a subsidy for premiums, a policy that does not exempt “pre-existing conditions,” a cap on premiums, and a range of benefits? Thank President Obama’s Affordable Care Act. Even if you loathe anything related to President Obama, listen to the rhetoric of Republicans who promise to reinstate the past: a return to exclusions for pre-existing conditions, an elimination of caps on premiums, a surge in premiums, and re-introduction of “skinny” policies that don’t cover much.

Have you or anybody around your table gone to a hospital? More than 50 years ago, in a bipartisan era, Sen. Lister Hill (D-Ala.) and Sen. Harold Burton (R-Ohio) sponsored legislation that poured buckets of federal funds into hospital construction. Today Uncle Sam (physician training, insurance payments) continues to support many hospitals, long after the era of bipartisan cooperation evaporated.

Have you bought the food for your meal at a supermarket? Thank the United States Department of Agriculture, as well as the inspection minions in state health departments, for inspecting what you eat, and where you buy it. Did you drive to get anywhere this season? Do you take the safety of roads and bridges for granted? Don’t. Visit a country in the developing world where road-fatalities constitute a major cause of death. When you leave dinner to play football, or simply take a walk, do you cover your mouth with a mask, to avoid inhaling post-prandial pollutants? Visit a country without an Environmental Protection Agency to see masked pedestrians and gray skies.

The good news is that Uncle Sam sits unobtrusively at our gatherings. The troubling news is that we risk erasing him from our lives. The world of no-government laissez-faire stands in the wings, and it is a cruel one.

Back to Tiny Tim, the iconic belwether of the season, who sparked compassion in a miserly Scrooge. In reality, it isn’t the legion of reborn Scrooges, awakened to human misery, that have rescued all the Tiny Tims. It is the benevolence of government, backed up by taxpayers.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, December 15, 2018

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