My advice to Obama - throw away the kid gloves by Mark Steel

One result of the American system is that a third of health employees are in marketing.

Mark Steel

When you watch Barack Obama make these speeches to try and introduce healthcare to America, you have to wonder whether he might improve his ratings if he lost his temper and chucked things. Because the opponents of health reform are getting away with whatever they want, such as Sarah Palin’s claim that “My parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’.”

And somehow she and the Republicans have convinced millions of Americans that if everyone has healthcare, a panel looks at each patient and decides whether or not to kill them.

Next she’ll say, “Under Obama’s plan, patients on life support will be forced to race each other for their lives down a bobsleigh course. They’ll be pushed by a relative and the one who finishes in the slowest time will have their machine turned off by a socialist, like what happens in Britain.”

It seems extraordinary that so many people can be opposed to universal healthcare that would clearly benefit them, because it contradicts their attitude to the free market.

If a health service was established there, you’d get farmers from Tennessee complaining, “I was out in the back yard, felt kinda peculiar an’knew I was havin’myself a heart attack. Well I’ve laid down by my pigs a-gaspin’ an’ the next thing I’ve got paramedics a-pumpin’ away on ma chest savin’ ma life. Now I ask yer what right did they have interferin’ with ma business like that? Them state-run sons o’bitches made me fit as a fiddle without even askin’, what happened to my freedom o’choice?”

The objections have been organised by a “grassroots” campaign, called the Tea Party, that’s so grassroots it had a convention at which Sarah Palin spoke that cost $549 a ticket. And it’s backed by businessman Steve Forbes, who once boasted that his father spent $5 million on a birthday party. But this is a movement of grassroots millionaires, who are sick of being pushed around by the posh ones.

In their defence, it’s not easy to stick up for the US health system without making up stories. One result of their private system is that one third of employees in US health are in marketing. It’s as if the NHS shut down one third of its hospitals and turned them into advertising agencies.

Because when you’re rushed to Aand E in agony you don’t need a surgeon, you need an actor in soft focus saying, “Nobody wants pancreatitis, but when you’ve got it you want to be in a place where you can relax. Unlike in other health outlets, here your drip is installed by professionals, and you get a free top-up of coffee whenever you want. Hmm, that smells good. Because at DCK Healthcare we make a breeze out of liver disease.”

Millions of Americans have no healthcare at all, while US health companies spend $189 million a year lobbying politicians, and billions of dollars a year on administering the insurance. So almost anyone with experience of the British system wants Obama’s plan to get through.

The trouble is, the scheme has been diluted so much it’s now little more than a device to enforce everyone to take out private insurance. And so many concessions have been made to the health companies they’re likely to charge 50 per cent more for insurance to anyone with a record of illness. What sort of a system is that, which tells people “We’d be more than happy to give you healthcare, but the only thing is you seem to be occasionally ill.”

It’s like a baker who tells you his prices, then says, “But obviously it’s a good deal more if you ever want to take any bread.”

To be fair, some people have already benefited before the bill is passed. For example Ron Williams, CEO at healthcare company Aetna, trousered $2.4 million in a year, and he didn’t even have anything wrong with him. Still, there are bound to be winners and losers in any scheme I suppose.

Shares in the health insurance companies are going up in anticipation of the bill, so the mania raised against it has probably not really been about health, but part of the drive to undermine Obama.

But instead of confronting those health companies, he’s tried to win them over, just as he tries to do with the Republicans in general. And that’s where he’s coming unstuck.

So I’d be tempted to make a speech that starts, “Sarah Palin has accused me of wishing to implement death panels. Well Sarah, you’re right, and we’re starting with you. The moment you get a runny nose you’ll be dunked in a flotation tank full of morphine, then used as a drill bit in a search for oil in Alaska.” But that’s probably why I’m not a politician.

First published in The Independent on 10th March 2010