“The orchestration of press, radio and television to create a continuous, lasting and total environment, renders the influence of propaganda virtually unnoticed precisely because it creates a constant environment.”—Jacques Ellul, 1965
When the mainstream corporate media raise alarms over the rising costs of health insurance and major problems involving the misnamed Affordable Care Act (a.k.a. Obamacare), you can be sure corporate interests are threatened. Since the open enrollment period for 2016 ACA policies began on November 1, National Public Radio, the New York Times, CNN, etc., all supporters of Obamacare, have issued warnings couched in typical reassuring double-talk about developing problems.
While the alarms seem to be directed at the general public, it’s safe to say that they are actually directed toward the federal government on behalf of the insurance industry. The message: This isn’t working out as we planned when we wrote the bill together; we want greater profits and so the program needs to be altered.
The New York Times has written about the shock consumers will experience when they log on to HealthCare.gov to renew their policies and see the large premium jumps and higher deductibles that will greet them. Thus their policies will be all but useless. This is couched in reassuring language; the shock will be eased if consumers “are willing to shop around,” or, as the Times quotes the advice of Dave Chandra from the liberal-leaning Center on Budget and Policy Priorities, “Everyone should come back to the marketplace and shop. You may get a better deal.”
For NPR, it’s about how steep price increases attached to large deductibles have already forced many to drop their insurance, and how health insurance co-ops are folding, leaving tens of thousands of people in the lurch.
CNN warns of a single-payer system, not run by the federal government, but by a corporate Ma Bell of healthcare as a result of a massive wave of mergers among health insurers, pharmaceutical companies, hospital corporations, and drug store chains. While this will result in far fewer health care options for consumers than a few years ago, such mergers shouldn’t be blocked since “this is capitalism at work.”
The Hill reports that the giant insurer United Healthcare is threatening to bail out of the ACA and The Week writes of “the quiet unraveling of Obamacare.”
Where were these warnings years ago when all this was predicted by prescient alternative voices (The Polemicist and Paul Craig Roberts)?
And by alternate voices I surely don’t mean Republican and far right political operatives with their phony, opportunistic objections to all things Obama. Nor do I mean their Democratic and liberal partners who dare not criticize Obamacare. These two groups are partners in a dance of dissimulation, aided and abetted by the mainstream media.
It was only from the alternative Internet media that one could have learned the truth.
Not that it took much prescience since it was obvious from the start that the game was rigged. It was a propaganda coup to convince the public that the ACA was a program to help them, when it was a government assistance program for the health insurance industry. It was meant to ensure continuing and increased profits for the private health insurance, pharmaceutical, and hospital industries, and it had very little to do with health care. It will never lead to a single-payer, government-run, and universal coverage program such as Medicare for all since its basic premise is that health care is a commercial commodity and not a human right.
But it was sold as a gift to the American people with the slogan of “affordable, quality health care.” In November 2009, as he was pushing his product, President Obama said, “The challenges facing our health care system aren’t new—but if we fail to act they’ll surely get even worse, meaning higher premiums, skyrocketing costs, and deeper instability for those with coverage.” Then in 2010, when signing the bill into law, he said the law would guarantee “the core principal that everybody should have basic security when it comes to their health care.”
None of this was true.
But the propaganda game is a refined art. One of its key methods is to set up false dichotomies between so-called liberals and conservatives. In this case the right-wingers cried out that the ACA was socialism; the liberals argued that it was a significant step forward toward universal, one-payer coverage. This framed the ensuing debate, which was no debate at all. It was nonsensical rhetoric that they are still repeating today, knowing it to be untrue. Unless, that is, they are simply ignorant, which is not far-fetched. It is hard to know which side dissembles more.
Obama never was a socialist or a liberal. He has always been a free-market, neo-liberal corporatist, as the recent Trans-Pacific Partnership agreement makes clear. He was not voted Advertising Age’s marketer of the year in 2008 for selling his brand to the American voters for no reason. The selling of a presidential candidate as a man of peace was followed by the selling of Obamacare as affordable health care.
Politics in the United States is show business. The opposing sides—liberal/conservative, Democratic/Republican—each play their scripted parts as they wink at each other backstage, while up front the media do their emcee routines. It’s sort of like Jon Stewart joshing with Bill O’Reilly to the great amusement of the audience.
To the crisis of uninsurance—still a major problem that will get worse under the ACA—has been added the problem of underinsurance. Many of those who, under threat of penalty, still maintain their insurance will be unable to use it. Their deductibles are much too high and going higher.
Let me give a typical example from an average state. A 30-year-old single female with an income of $48,000 can get a policy for a premium of approximately $230 per month. If that policy allows her to see a primary care physician three times (usually the maximum) a year with a co-pay of $40 per visit, her total cost for the year is $2880 if she visits the doctor three times. Since her deductible will generally be over $6,000, that means each of her doctor’s visits would cost her $960—now that is an affordable deal. And this generally excludes specialist, drugs, lab tests, etc. She must pay for those out of her pocket up to the deductible of $6,000.
And if those who have insurance through their employers think they are escaping unscathed, they should think again. As with those insured through the ACA, insurers are shifting costs to consumers. This means more expensive health care across the board: higher premiums, co-pays, co-insurance, and deductibles, as well as more limited provider networks. As insurers gradually shift costs to consumers, employers costs decrease, and the insured will be progressively squeezed in the coming years as the economy contracts. No one is safe from this process, retirees included.
A bit of history is instructive in this regard. In the late 1940s when a government-sponsored national health insurance program was a real possibility, it was sabotaged by the American Medical Association through a massive public relations media blitz. To make sure that no federally administered one-payer system for all ever developed, the AMA forged an alliance with big business and organized labor to offer workers private health insurance as part of their “fringe benefits.” This became the template for many fully employed people for decades. It worked when there was a robust economy, especially from the late forties until the late sixties, but its future is seriously in doubt as the American economy is being hollowed out.
As the screws are being tightened on the poor, the less poor, and the middle class, it is worth concluding with a final thought on the mainstream media’s recent warnings. Have they suddenly become the friends of average people? Only the most gullible would believe that.
I suspect the message from the health insurance industry to the Obama administration concerning the ACA is something like the following: Unless we jack up the rates on older, sicker people and lower the rates on the younger, healthier people to get them to sign up more (which they are not doing because they know that they are being ripped off, which was how it was intended), we are leaving the system. We insist on larger profits.
We are not in the health care business.
We are casino operators in a casino capitalist system.
And the house must win big.
Got it?
Edward Curtin is a sociologist and writer who teaches at Massachusetts College of Liberal Arts and has published widely.
