Monday, March 22, 2010

malaysiakini-Azly Rahman: Class divisions in access to healthcare

Class divisions in access to healthcare
Azly Rahman
malaysiakini, Mar 22, 10
1:56pm
'Why can't all Americans have the same access to healthcare to those enjoyed by members of Congress?' is a popular question on the ObamaCare debate.

At the time of writing I am following the debate over universal healthcare for all Americans. If the US$1 trillion Bill passes, it will help insure 32 million Americans that do not have access to healthcare.

This is another controversial issue in the tradition of Democrats and Republicans. This is a good case study of one of the enduring issues of an advanced capitalist state.

I know friends who do not have health insurance and who question the human rights dimension of it - right to life, liberty, and the pursuit of happiness, endowed by the Creator who insist that 'all men are created equal' and cautioned by the Enlightenment thinker Jean Jacques Rousseau that “… everything is good in the hands of the Author of Things and everything degenerates in the hands of Man”.


barack obama president of the united states of americaFrom the point of view of the Democrats, the health insurance system is broken and in deep crisis. Millions cannot get proper medical health. The insurance system is predatory. Expanding health coverage and lowering prescription drug prices, and giving rebates to insurance companies are the main features of this proposal.


From the Republicans' point of view, Americans need health reform but not to the point of bankrupting the country. A Bill which covers the cost of abortion is the controversial part of it; that Americans must not pay for those who do not have the respect for life. The Bill is said to be a wrong approach that will make winners and losers in the system. Essentially it will open up other complications in virtually all aspects of the system.


Whatever the outcome of it, Americans will still be divided ideologically on this issue. The argument is emblematic of the American political philosophy: what is the role of the government vis-a-viz the social contract between the 'ruler and the ruled'?


It is a classic Jeffersonian-Franklinian debate. America has evolved into a country envisioned by Benjamin Franklin - America which is more of the big business and less on the man on the street.


Americans are taught to not trust governments; its history is that of a revolt against British colonialism famed by the slogan 'taxation without representation' and therefore 'give me liberty … or give me death', as the revolutionary leader Patrick Henry said.


Americans went to war and bankrupted the nation. It was a Republican war. That drained trillions of dollars, perhaps contribution to the near-collapse of the American Empire, as many a Complexity theorist would propose. The Butterfly that flapped its wings in Baghdad, near Saddam Hussein's mansion has contributed to the turmoil in the Obama Office.

Rights of all Malaysians



But what is the situation in Malaysia, as we have evolved as a modern state enculturalised by happenings in other advanced countries such as the US?


How do we care for the sick? Essentially is there also a class system in our healthcare system? Do the poor get the same treatment as the wealthy members of parliament or those in the list of billionaires?


With the proliferation of private hospitals, are we creating the foundations of a class system that will inherit the problems the Americans are trying to resolve?
Or is this merely a natural progression of an economic system that is also predatory in culture - that the rich will be richer and the poor growing in numbers?


With the urge for Malaysian private hospitals to venture into 'medical tourism', will our good doctors abandon their Hippocratic Oath in favour of professional hypocrisy?


Marx would say that we are defined by the economic condition we are in - we are homo economicus. I suppose how we live and how we die and how we are taken care of in-between this period of 'borrowed time', depends on how the state defines what human rights mean vis-a-viz our ability to pay for healthcare and how we lived our lives as a economic beings.


We must consider that each human being is a cog in the wheel of Capital. Those who own the machines of production oftentimes influence policies through political-economic arrangements.


A wealthy country such as Malaysia that prides itself on tall buildings and a growing number of billionaires ought to start reflecting on the need to ensure that each citizen will have affordable healthcare.


One wonders what the limit of wealth creation is and where the moral dimension is in capitalism, when the rich control the lives of the poor.


By shaping ideology and creating installations to change the social relations of production - and by doing this through the control of mind, media, machinery, and materials - we expect that wealth is to be shared. Socialism for the rich must be replaced with capitalism for the poor.


It's 11pm here in New York. The historic Bill has just been passed, 219 to 212 in the House. God bless the life of 32 million more Americans. Let Malaysia learn from this victory!



DR AZLY RAHMAN, who was born in Singapore and grew up in Johor Bahru, holds a Columbia University (New York) doctoral degree in International Education Development and Masters degrees in the fields of Education, International Affairs, Peace Studies, and Communication. He has taught more than 40 courses in six different departments and have written more than 300 analyses on Malaysia. His teaching experience spans both in Malaysia and in the United States and in a wide range of teaching context; from elementary to graduate education. He currently resides in the United States.