President Obama is a likeable man, a sophisticated thinker and smooth talker, an altogether charming and persuasive fellow, and he certainly knows how to compromise to get along with people, but we are not exceedingly satisfied with his performance, not only because Americans expect instant success but because he is changing the Change the voting majority expected.  But hope springs eternal. Once in a very long lifetime, a messianic president appears.

Many people suspected that President Obama’s ‘Change’ was just an empty catchword, in the first place, and that in this great nation of ours, where business continues as usual by virtue of the invisible hand regardless of what the so-called People say, his ‘Change’ was bound to amount to very little. Radical thinkers are none too pleased with his actions so far, which he says saved the nation from disaster, but to radicals they seem negligible, for who can say that what did not happen would have happened without him? We would have known that something had actually happened, for example, if Chairman Obama had directly hired a million people to do good works to begin with, including sending barefoot doctors into the hoods, paying us to improve our education and to write brilliant essays about the potentials of his presidency. Yes, President Obama is, thankfully, not a complete moron, quite to the contrary, and yes, yes, there is no doubt about it, we know he is a really good man, that we can say for sure, but what good has his good intentions actually done us? We like the nice speeches but we want the good deeds, and we want them now, before this great individualistic nation of ours goes belly up.

In crucial matters like our health care system we do not want change and reform, we want revolution. We ask not for the violent overthrow of the state, but for the nonviolent overthrow of the greedy corporatist government, the casting out of the forces of darkness of corporate board tribalism that has made the main business of government their business. There has been a real revolution smoldering within the so-called revolution since the birth of our American nation from its English mother, and right now we prefer a dose of harsh medicine to the pleasant patent palliatives: mere metaphors just will not do, for this great nation of ours is gravely ill. We do not want the engine tweaked; we could care less about the new technological bells and whistles: we want a brand new engine on a brand new superhighway. The long and short of it is that we want a single-payer health care system for our basic medical needs, such as enjoyed by other industrialized but more highly civilized nations.

President Obama does seem sincere about health care reform, and he would have radical reform like us, but his hands are tied. What can he do? He is just a humble preacher with a gift for gab, and that can move a few minds here and there, but he does not have a big enough bank to buy off the federal whorehouse lock, stock and barrel. He is only the President of the United States, and not the dictator of the working class. He knows that our present health care system is in a shambles, and that it is a disgrace despite the specious, self-serving claim of those who can afford the best health care, that it is the best system in the world. He knows that free-market rationing of scarce health care does not work fairly, that the insurance racket that helps make it so expensive has gladly left 65 million people uninsured and underinsured, but he has not come up with the cogent national plan he knows we want and should have, deferring to Congress to come up with some sort of patchwork the lobbyists like. Now we hear that the insurance industry, the hospital industry, the American Medical Association, and the drug lobby are behind a recently proposed plan: if there is a greater god than Mammon, may he or she or s/he or it forbid it!

At least the President has presumably stuck to his guns on the ‘Public Option’, the government health insurance option. We say presumably because he did not even mention it in the nationally televised speech he delivered before his July 23, 2009 press conference. He spoke instead of a “health insurance exchange” from which ordinary people could buy insurance, and said that such an exchange would reduce insurance premiums by fostering competition. A reporter brought up the Public Option, and the President said that the Public Option would keep insurance companies honest by virtue of competition. So we are led to hope that the Public Option is still on the table despite the bitter opposition in the past of the private insurance industry, which says it would drive them out of business.

We might be better off if the commercial health insurance companies who are reporting fat profits as we speak were driven out of the business of insuring our basic medical needs, for their own needs are superior to ours, as can be seen in high premiums and administrative inefficiencies. The goal of the capitalist system is not to foster competition but to reduce, incorporate or otherwise eliminate it. Whether or not there are two big companies to choose from, or an exchange or pool of several companies, we expect prices to be eventually fixed one way or another for the sake of profit.

Monthly insurance premiums create a huge fund for the health care industry to draw upon. Providing adequate insurance for another 65 million people will certainly boost the insurance industry, which will take a big cut out of the pie, and create more paying customers for health care providers. With this enormous boost to the supply of funds available and number of people insured, we expect higher demand and higher prices absent drastic cost containment measures. It has been well noted that, if the uninsured are insured and therefore go to the doctor more often, a great deal of money will be saved because emergency and catastrophic treatment will be diminished. That may be correct; in which case we should ask ourselves, who will get the savings? Since when are cost savings passed down to consumers, especially when demand is high? And demand for unlimited health care, including preventative health care, is certainly high.

The painful prescription for unlimited demand is rationing out the supply. That sort of rational thinking offends a lot of irrational people, so some sort of compromise between reason and unreason must be had, so that business may continue as usual for awhile longer, until the people get wise to the costs again. President Obama insists that two-thirds of the expected additional cost, whatever it amounts to, would be defrayed by improvements in efficiency. He does not blame us for having our doubts about that, for we have fallen before for the shtick that the efficiencies of big private corporations will save us money, only to be nickeled-and-dimed and have our pockets picked clean, and to see this great competitive nation of ours brought to the verge of utter collapse – the doomsayers still believe it will collapse or at least deserves to collapse as a result of the long Reign of Greed that prevailed.

On the other hand, big government is customarily accused of being more inefficient than big business. Government can be efficient and has been efficient on many occasions, but government is never given any credit for its efficiencies. Today our government is more or less the administrative cabinet of big business, but big business would like to be the sole shareholder of big government, and the power elite fears an uprising in the slave quarters. Verily, the only reason the anti-social people who fear socialism have for extending social benefits from the true socialism of the wealthy towards the base of the power pyramid, is to hold revolution at bay.  And they know from experience that lesser or common or vulgar folk will tolerate a great deal from their masters before bucking. They do not want change because they fear things might get worse.

However that may be, we give credit to President Obama for harping about the potential cost of the indefinite health care plan, and we might even thank him for his faith in the original goodness of doctors, hospitals, insurance companies, and drug companies, that they will voluntarily save us money although we are the ones who will ultimately pay for our health care system, in one way or another, whether we have insurance or not. The President has broken his campaign promise not to try to force uninsured people to pay insurance premiums. Who was going to pay for bringing the uninsured on board, everybody was asking, and asking because they certainly did not want to pay premiums for someone else.

But everybody who can pay does pay in a fair system, and in a fair system they are entitled to receive the same services as anyone else. Let us then have the Single Payer plan we need. Let the government pay with our tax revenues. If the paycheck worker must know how much s/he is paying net of payments collected elsewhere, let it be shown on his or her pay stub as a percentage of gross taxable pay. And why not also show how much is being withheld for defense expenditures on that pay stub as well?

No doubt the costs may rise somewhat under a Single Payer system, despite government reports to the contrary – both the U.S. General Accounting Office and the Congressional Budgeting Office have issued reports in the past to the effect that a single payer system such as that enjoyed in Canada would more than pay for itself because of reduced administrative costs and access of preventative medical care. In any case, we can deal with the factors behind high costs. We can deal with one of the worst, most expensive health care systems in the developed world. We can deal with the greed, with the obesity, the lack of exercise and nutritional deficits, with the exorbitant costs of drugs and with drug abuse including alcoholism. We can deal with the cost of administrative complexity. We can deal with the high cost of education and technological innovation, and with the licensing and accreditation devices that limit the supply of health care. But first of all we have to deal with the unfair distribution of the health care services we now have as a nation. If we act on this cry for social justice, we shall see that everyone shall benefit including the well-to-do the most of us work for.

Yes, indeed, President Obama is a likeable guy and an excellent salesman, but if he is to work wonders short of revolution we had better get behind him and quickly. If we want economic justice in a Single Payer system, and the polls say we do, there is no good reason why we should not have one in a true democracy. If this is not done now, the power-corrupted government of our federal state shall eventually be overthrown – we say nonviolently, of course, for we do not want to be falsely charged with treason.

 NOTE: In 2006, according to the World Health Organization, Canadians spent 10% of Canada’s gross national product on health care, or $2, 587 per person, and the government picked up the tab for 70.4% of that on behalf of the people out of tax revenues. The British paid out 8.2% of GNP, or $2,457 per person, and the government paid 87.3% of the total.  United States consumers spent 15.3% of GNP, or $3,076 per capital, of which the government paid 45.8%. By the way, 12 months divided into $3,076 is $256.33 monthly. If you are thinking of becoming a citizen of Luxembourg, keep in mind that its consumers spent 7.3% of the GNP on health care, or $4,992, with the government paying 90.9% of the total. There is room for private insurance companies for people who want the bells and whistles or want an alternative to the long waiting list for elective procedures – one can always go to an emergency room for emergencies. Premiums for private insurance are relatively low in Britain because many affluent people like to economize and get their major needs taken care of under the single payer system.