Tuesday, January 17, 2017

If you doubt we need universal healthcare, let's talk about industrial pollution

Unless you've been hiding under a rock for the last few days, it's rather hard to miss the GOP's unrelenting efforts to repeal Obamacare, also known as, The Affordable Care Act (ACA). I've been perusing the news stories and see that people are holding rallies and sharing stories, daring the Republicans to listen to the stories and continue on their quest to repeal. All they need to do is look at the demographics to see that the vast majority of their constituents will lose coverage with repeal of Obamacare.

Trump isn't making matters any better for the GOP. He's insisting on fast and sure repeal of Obamacare with an immediate replacement that is just so, so good. According to Naked Capitalism, there is no replacement plan, well, at least there isn't a plan out there that meets Trump's requirements. It would seem, based on my reading so far, that Trump will not sign legislation to repeal Obamacare without a clear and present replacement that he likes. Yet, Republicans in Congress seem intent on sailing off the edge of the world and into the abyss.

Bernie Sanders ran for president on the campaign promise of Medicare For All. That is, expanding the program to anyone who wants it as a public option, with no restrictions. Opponents of his plan saw it as a clear challenge to the status quo, they saw it as the road to the single payer plan they believe has failed so miserably in places like the UK. Failed? I don't know. I remember the opening ceremony to the Summer Olympics a few years ago. During the opening ceremonies, they put on a giant show devoted to their beloved health care system, a single payer system, complete with choreographed hospital beds.

While Republicans would have us believe that a free market would serve all far better than any government plan, they seem to omit the salient point that their campaign finance friends have money and they want more of it. Democrats on the other hand, in their quest to keep the ACA intact, with some like Sanders seeking Medicare For All, are missing the point. Half measures avail us nothing. There is a case to be made for universal healthcare for everyone as a right.

Republicans (and neoliberal Democrats) seem loathe to discuss a few yawning holes in their arguments. First, they don't like to talk about the fact that there is an acute shortage of doctors and how that shortage drives up the cost of healthcare. They omit the fact that doctors who want to practice medicine here must complete a residency program here and that the availability of those programs is limited by law, by Congress. Fewer still want to discuss the very real option of opening up the floodgates to doctors worldwide by adopting an international standard for the practice of medicine, yet they are unabashed fans of globalization.

We have the internet, a network based on multiple international standards. We have cars that run based on widely adopted standards including fuel, parts and design. Cars have thousands of pieces that must work together and must comply with multiple standards and regulations across many jurisdictions - they're complex - so don't tell me the practice of medicine is more complex. 

There is no reason that doctors from other countries, willing to work for a fraction of the pay that our own medical divas receive, can't work here short of the political will to make it happen. Don't forget, doctors were perfectly willing to thrust American manufacturing workers into competition with third world countries while seeking and getting protection for their own incomes. They have the money to influence public policy. Manufacturing workers don't.

Republicans, acting as so-called conservatives, will jump headlong into debates about how free markets work so well while mercilessly refusing to discuss patents and their incipient transaction costs for drugs. Republicans and neoliberal Democrats alike seem perfectly happy with lousy trade deals like NAFTA and TRIPS,  both of which help to spike drug prices and protect doctors. Republicans and now some Democrats-in-name-only would prefer that we not permit programs like Medicare to negotiate drug prices. A free market means that all parties are free to negotiate. This prohibition doesn't sound like the free market at work. Those same people who don't want Medicare to negotiate drug prices also do not want to allow the re-importation of drugs at lower prices from other countries.

How many members of Congress have openly discussed the idea of paying for drug research up front instead of rewarding the researchers with patents? 0. We do this with neglected diseases and we do it with far greater efficiency than their beloved patent system. That could be a result of that wonderful spigot of campaign finance cash from the pharmaceutical industry. See? Money really does cloud judgment.

These are known issues and often turn up if you look for them. But there is one massive white elephant that no one in elected office seems to want to discuss when it comes to the topic of healthcare: industrial pollution. America has a well known history of pollution. Oil, coal and gas industries are the usual suspects. Not a week goes by without some sort of oil spill, coal ash spill or a gas leak that takes weeks if not months to cap off and fix. These examples should all make the case for universal healthcare, but there is one really big pollution story that I've never seen discussed in political debate: DuPont's C8, the sciency name is "perfluorooctanoic acid", and related chemicals. C8 is the chemical that gives non-stick coating its properties in cookware. Most of it is burned off during production, but some tiny fraction remains.

I spent an hour reading an article, which describes the sorry tale of a small town in West Virginia. That town is virtually owned by DuPont. There was a time when if you criticized DuPont in that town, your neighbors wouldn't talk to you anymore and they'd skip birthday parties for your kids. If you showed up in a restaurant, everyone would stop what they were doing and leave.

Welcome to Beautiful Parkersburg, West Virginia, is that story. It's a story about how cows got so sick from the chemical waste from DuPont that they bled to death through their mouths. It's a story about a company that lied through deceit and omission about just how toxic their C8 chemical was. It's a story about a company that took decades to even admit there was a problem and when brought to task in the courts, fought tooth and nail to escape liability and still works hard to flee, while raking billions in revenue.

Here are a few very interesting tidbits from that article to lend some context. Here's an account of a cow bleeding to death:
“One time this cow was coming down the road and it was just bellowing, the awfulest bellow you ever heard,” Della told me. “And every time it would bellow, blood would gush from its mouth and its nose. It just bellowed and bellowed and blood just kept flying, and then it would fall down, and it would try to get up … We didn’t have anything to shoot it with, so we just had to watch it until finally the cow bled to death.”
DuPont is the company that brought us to the Age of Plastic:
The rapid proliferation of plastics gave ordinary people access to conveniences and goods that had once been beyond their reach. It also brought tens of thousands of unregulated chemicals into American homes. In the early 1950s, a group of Columbia University scientists published several papers describing high rates of cancer in rats exposed to plastics such as vinyl, Saran wrap and Teflon. Some lawmakers began to worry about the lack of safety testing for chemicals in the food supply. (emphasis mine)
But because of the powerful influence DuPont had on Congress, not enough was done to investigate and regulate new chemicals released with new plastic products. "Tens of thousands of unregulated chemicals"? Who knew? What follows is decades of publication bias in the literature to protect the business and keep the general public in the dark about these new chemicals.

Legislation passed to regulate these industries allowed tens of thousands of chemicals to be "grandfathered in" as "safe", yet with one chemical alone, C8, babies were born with birth defects and numerous other diseases popped up. Here is a sample of symptoms of C8 exposure from the oldest surviving C8 tester:
Among the plaintiffs is Kenton Wamsley, the DuPont lab worker who was assigned to test C8 in the early 1980s. His complaint cites two C8-linked conditions: high cholesterol and ulcerative colitis. However, these diagnoses don’t begin to describe the extent of his suffering.
The crippling stomach cramps and anal bleeding that plagued him during his early days as a tester eventually grew so bad that he had to undergo surgery to remove intestinal blockages, a common complication of ulcerative colitis. After that, his stomach problems eased, but he developed severe asthma and was unable to work for long stretches of time. Other C8 testers also started falling ill: Wamsley recalls one coworker bleeding heavily from his tongue in the lab. By 2001, Wamsley's stomach cramps and rectal bleeding had returned, and he was diagnosed with intestinal cancer.
It's important to remember that this is just one company and just one chemical compound found in their products. C8 can now be found in small amounts all over the world. Who will pay for this? Who will clean it up?

From this perspective, universal healthcare makes total sense. Look how hard it is to make one company pay up for a small population of victims, let alone everyone who has been touched by C8 and the environmental damage done by it. Now multiply this by hundreds or thousands of companies, all with go for the jugular litigation lawyers who are willing to kill as many trees as it will take to win. Want to see what it means to stall in discovery in a hotly contested lawsuit? You'll find it here in litigation over pollution.

So what is the solution? Well, the solution is to encourage companies that pursue such enterprises to take responsibility for their work and the damage that is done. It is to encourage them to keep the environment safe and clean. But if they're willing to hide when the market is not free, God only knows what they will do if the market really were free. On the healthcare side, universal healthcare seems to be the best solution. Here is why.

It is already a given that a corporation that pollutes the environment will do everything in their power to externalize their costs of production. That means if there is a pollution issue, they will seek to externalize those costs or hide them. DuPont is a great example of how companies do that. When a manufacturer externalizes the pollution costs of their products, that also means those costs are not built into the products we buy in the stores. The costs of cleanup and healthcare are usually paid by the taxpayer. Wealthy corporations have a team of lawyers who know tax law and can use tax havens. Most ordinary people do not.

It is also worth noting again that wealthy elites and organized business interests have a far greater influence on Congress than ordinary people do. This has been amply demonstrated by this study, Testing Theories of American Politics: Elites, Interest Groups, and Average Citizens. In that study, polling was reviewed on more than 1700 political issues over 20 years and it was found that better than 60% of the time Congress voted against the polls. Yet, somehow, Congress now has a 96% re-election rate despite an 11% approval rating.

I really don't know how much universal healthcare would cost for America. Our taxes are pretty low now as it is and a large contingent pay zero federal taxes, with one estimate placing that contingent at 45% of Americans with income. But we're going to have to start somewhere because what we are doing now is unsustainable.

The point of taxation for universal healthcare is to ensure that the costs cannot be externalized and to ensure that everyone bears the costs of the pollution created by the products we make and buy. Note that much of what we import has pollution costs, too. The externalization of this pollution cost by setting up manufacturing overseas must be a highly attractive feature of offshore manufacturing.

No one that I've seen in the healthcare debate has discussed the need for universal healthcare in this context. No one has connected industrial pollution, which affects everyone without exception, and universal healthcare. Not Jill Stein or Bernie Sanders or even Hillary Clinton, once a staunch proponent of a single payer plan. The rest of the field is probably too timid to discuss it at all. Not like this.

I can't think of a better argument for universal healthcare. If American companies insist on making toxic products and lying about it, hiding it, or even moving it offshore (believe me, it comes back to us), then we need something that provides a catch-all solution, with no exceptions. In that context, a universal healthcare system with a tax that American industry cannot escape doesn't just make sense. Universal healthcare is now an urgent necessity. 
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