Medically-Displaced Persons

[arendt]

History doesn't repeat itself, but it does rhyme. (Mark Twain?)

Medically-Displaced Persons
by arendt

.. "The problem of statelessness became prominent after World War 1.
.. During the war, the principal European states found it necessary to
.. amend their laws of nationality so as to take power to cancel
.. naturalization. The class of stateless persons created through
.. revocation of naturalization was very small; they established, however,
.. an easy precedent so that, in the interwar period, naturalized
.. citizens were, as a rule, the first section of a population that became
.. stateless. Mass cancellation of naturalizations...usually preceded
.. denationalization of citizens-by-birth in similar categories..."(e.g.,
.. Jews)

.. "No paradox of contemporary politics is filled with a more poignant
.. irony than the discrepancy between the efforts of well-meaning
.. idealists, who stubbornly insist on regarding as 'inalienable' those
.. human rights, which are enjoyed only by citizens of the most
.. prosperous and civilized countries, and the situation of the rightless
.. themselves. Their situation has deteriorated just as stubbornly,
.. until the internment camp...has become the routine solution for
.. the problem of domicile of the 'displaced persons'."

.... Hannah Arendt
.... "The Origins of Totalitarianism"
.... Chapter 9: The Decline of the Nation-State and The End of the Rights of Man


Living in occupied territory is so fundamentally alien to the American
experience that it has taken me almost ten years to figure out why
the HMO-run medical system we suffer under is such an affront to
our heritage. The rankling fact is that the medical infrastructure of
America, representing between 12% and 15% of our economy, is no
longer under democratic control; but, rather, it has become a medical
police state.

Just as in a police state, there is no freedom of movement. To enter and
leave certain areas and obtain certain rationed services you must present valid
documentation like a passport or, in our case, an insurance card. This card
is issued by some HMO or another, after you have proved to them that you
are employed and that you are not too big a health risk (i.e., loyal and fit).

And, just as in a police state, this vital identity document can be confiscated
or revoked at any time for any reason, and you will be forced to fight to get
it back.

Just as in a police state, you have no recourse to the law in case of criminal
or extortionate behavior by the police. (Remember, to this day, you are
not allowed to sue an HMO.)

Just as in a police state, your papers are constantly demanded by some
faceless, ignorant, just-following-orders, 18-year old draftee. Meanwhile,
you have about as much chance of talking to an HMO executive as a human
rights protester had to talk to General Rios Montt - the Guatamalan genocidist.

Just as in a police state, the (medical) facts, your life and limb, and the
well-being of the community take a back seat to the goals of the (corporate)
state. Any attempt to assert common sense, much less your so-called
rights will put you on their blacklist (enforced anonymously, since HMOs
have privacy rights while you have none when it comes to your medical
history).

----

What we are seeing here is a new form of creeping totalitarian takeover.
You don't take over the whole country all at once, you take it over one key
industry at a time. You extinguish peoples' rights by making whatever specious,
self-serving argument can be sold in a particular business area, all the time
saying with a straight face "but we still live in a democracy, this is just about
the efficiency of one business".

Today, between 30 and 40 million Americans have no health insurance.
These people are "beyond the law" when it comes to medical care. They
have no recourse except to turn to emergency rooms when minor problems
become acute due to lack of care. But, flooded with these "medically displaced
persons", the emergency room system has been overloaded and broken.
Ambulances drive from hospital to hospital, like modern day Ships of Fools,
trying to get these HMO-less people into care.


.. "This kind of factual propaganda worked...the incredible plight of an ever-
.. growing group of innocent people was like a practical demonstration of
.. the totalitarian movements' cynical claims that no such thing as inalienable
.. human rights existed and that the affirmations of the democracies to the
.. contrary were mere prejudice, hypocrisy, and cowardice in the face of the
.. cruel majesty of the new world. The very phrase "human rights" became...
.. the evidence of hopeless idealism or fumbling feeble-minded hypocrisy."

-Ibid

(I love how Ms. Arendt is still current - "the cruel majesty of the new world".)

The uninsured are increasingly unemployed and homeless. They wind up living
in dangerous neighborhoods, in automobiles or on the street. So, in one of the miracles of the marketplace, you have MDPs "voluntarily" checking themselves
into our state-of-the-art internment camps, a.k.a. ghettos.

The right wing fights hard to deny medical coverage to illegal immigrants and
other "undesirables", like women who want birth control. There is potent working-
class propaganda appeal in scapegoating aliens in our midst, not to mention
making sure their lives are even more miserable so as to conform to the
stereotype of desperate, unhealthy, but lazy people.

At the same time, the middle class must fear that the same upward ratchet
of "loss of medical citizenship" will be applied to them any day now. So,
as in the interwar years, fear of immanent ouster leads to intense loyalty to the
police state and to rabid demonization of those already designated as victims.

----

What is absolutely insane about upholding the HMO police state in America
is that it simply does not work. We spend twice as much of our GDP on
healthcare as those limp-wristed, pate-gobbling Europeans, but we get
worse health outcomes. As Al Sharpton points out, you could pay for immense
amounts of new healthcare if you simply eliminated the 25% overhead
of the HMO police state.

HMOs have already put charity-based healthcare out of business. Most of
those charity hospitals were run by religiously minded folks. Where are
the Christians-in-name-only (CHINOs) on this one?

HMOs have hammered doctors salaries so hard that medical school applications
have dropped, and experienced doctors are looking for the exits. Nursing is in
freefall. Psychological services have been reduced to six visits.

The HMOs have taken an industry of local, small providers (doctors, nurses,
laboratories, convalescent homes, etc.) and turned it into a soulless,
centrally-commanded, nationwide machine - a "care" machine that cynically
"nuisance shifts" patients and "accidentally" loses doctors' bills. They
are classic economic "middlemen". They add no value, but they take
almost all of the profits. While business gurus argue for "reducing hierarchies",
HMO paper-pushers proliferate. Where are all the entreprenuers-in-name-only
(EINOs) on this one? Probably counting their WalMart stock dividends.

Only delusional corporatchiks (corporate apparatchiks) could spout the
party line about the success of the HMOs. HMOs are the bureaucracy from
hell. They go out of their way not to deliver the service they are supposedly
providing. They antagonize and steal from both their customers (patients)
and their suppliers (doctors). They have gutted the infrastructure that
sustains them. But, somehow, all those wingnuts who want to dismantle
the government bureaucracy have no problem replacing it with this
unaccountable horror.

And waiting in the wings, they have the private pension police state. They
demand privatization, in spite of the 1% overhead of Social Security and
the Wall Street meltdown. They want to force people into the Wall Street
casino where "the house" rakes off 10% of their income. These people are
clinically insane; but since they control the healthcare system, that diagnosis
will never be certified.

I hope that whoever the Democratic nominee is, he beats the living hell
out of the GOP for their defense of the HMO Medical Police State and
offers "full citizenship" to our 30 million medically displaced persons.
Its time we joined the civilized world.