Over the past year, it has become evident that the U.S. bank and financial sector has a huge influence over both parties in Congress and the top financial advisers in the Obama Administration. The same has held true even longer for large manufacturers involved in weapons and defense spending. We will soon see the same heavy influence over Congress by the insurance companies, the AMA, pharmaceutical companies, and various healthcare providers.

For those who dream of comprehensive healthcare reform and some sort of universal coverage – you should live so long. 2009 Reality Check: “It’s not gonna happen.” The out-of-pocket costs for businesses and families have to be much higher, the number of uninsured and underinsured must be much larger, and the governmental deficits to maintain the current system must be simply untenable. Essentially things have to be much worse in order for Congress to pass any meaningful changes.

The wealthiest Americans and largest corporations control the business of this country. The U.S. has been, is, and will be an oligarchy or plutocracy (essentially the same), and our “meritocracy” simply exists to buttress this near complete control of the U.S. economic and political system. All members of Congress are so dependent upon campaign contributions for their continuing existences, that only those with enough money or the ability to raise significant amounts of money have access and effective control over the actions of Congress.

It is naive and simplistic for many advocates of various policies and programs to waste years, valuable time, too many brain cells, and far too much paper, internet storage space, and air time on the various Media, making laudable arguments that explain the “fairness, rationality, reasonableness, rightness, merits, efficiencies, ethics, cost-savings, and long-term benefits” for the majority of citizens of their proposals. These compelling arguments may be effective in some other country or political system but they have been completely useless and unpersuasive within our particular system of government.

No policy or program has been, or will be enacted or pursued if it does not benefit the wealthiest of Americans and large corporate interests that essentially control Congress and the U.S. political process. It would be better for advocates of any particular policy or program (regardless of the actual merits) to spend their time and efforts exclusively convincing this small group of people that it is in their best financial, economic, social and political interests to support a particular program or policy that happens to benefit the rest of the country. The simple reason why so many admirable programs and policies have languished in Congressional committees year after year has been that they do not resonate whatsoever with that elite group of people and their particular interests and needs.

Once 95% of Americans realize the fact that they exist principally to please and faun over that group of the wealthiest 5% of Americans (to which most members of Congress belong and upon whom they depend for re-election), then life will become much clearer and easier, and some of the things we secretly wish for might actually come true.

The American healthcare system does not exist to provide the best and most efficient healthcare to all Americans. It exists – as most everything else in the U.S. – to make money generally for the wealthiest of Americans and their controlled enterprises. The huge per capital costs of our healthcare system that far exceed the costs found in other developed countries are principally devoted to ensuring the system’s overall profitability to hospitals, physicians, healthcare providers, medical equipment manufacturers, medical technology providers, pharmaceutical companies, and health insurance companies. To ensure the maximum profitability for most of these participants, (1) we have to accept a large number of uninsured, (2) the reality that many claims and procedures are denied even if the sick people have insurance, and (3) higher infant mortality and lower life expectancies than all other advanced countries. Those other nations view healthcare as a right and a public good so profitability is not the central purpose of their national healthcare systems.

There are many other major wealthy players in the country that might be in favor of serious healthcare reform. They consist of many small, medium and large businesses not part of the financial services and banking sectors, and not part of the healthcare field. However, these stake-holders are historically not well financed, they are often inundated with many other pressing issues, and they are not well organized for effective Congressional lobbying. Therefore, healthcare reform advocates must look elsewhere for secondary support.

Advocates for serious and comprehensive healthcare reform designed to benefit the vast majority of Americans, must come up with arguments for their favorite policies and programs that will improve the wealth and influence of the richest Americans and those entities that control the healthcare industry. Of course, for the past 50 years, those winning arguments have not made and thus most healthcare reforms that have been suggested have been routinely killed Administration after Administration. Medicare/Medicaid and the recent Prescription Drug Program succeeded because they did not challenge the basic system – only provided another payer (the Government) for healthcare costs for those who were previously unable to pay directly and therefore ultimately enrich the many providers of healthcare services within the existing for-profit system.

Sadly, this author has no immediate ideas on how to convince those in power to give a damn about the other 95% of Americans on many areas of public policy, healthcare being just one of many issues. It may be likely that the current system will remain in place and our only hope is to increase the number of employers providing some sort of healthcare benefits to their employees, instead of hiring part-time independent contractors domestically or sending the work overseas. However, hope springs eternal. Now that everyone knows the real playing field, these winning arguments might be found and tailored to those who have the actual final say on any healthcare reforms.

One possible line of arguments should center on the benefits of greater investments in our transportation, energy and educational infrastructures. In fact, they now hold the most immediate and long-term promise for our country. It is very likely that most of the funds spend in these programs will ultimately trickle up to the wealthiest Americans and corporations, particularly those with heavy construction investments. It is well documented that most jobs in transportation, energy and education pay well and come with many extra benefits, including healthcare.

For example, new spending on Amtrak, rail mass transit, and high speed rail has garnered broad bi-partisan support in Congress, simply because the wealthiest Americans and many large corporations now see a direct future benefit to their own bank accounts by way of ostensibly doing something good for the American public. (It also helps that the housing bubble and other investment options are pretty well discredited.) If they did not see these public investments ultimately benefitting themselves, they would not now be playing such a large role in the current and future budget plans of this Congress and this Administration.

This post is meant to focus advocates of various meritorious ideas geared to help the majority of Americans to take the realistic view that for those proposals to ultimately become enacted, they must principally get the approval of the wealthiest Americans, investors and businesses. The author has focused other earlier postings on related topics: Americans must understand the real system of government we have and work within those overall parameters for reasonable change.

We have to make the best of an imperfect system. This is not advocating compromise since “something” is better than nothing. Instead, comprehensive policies and programs can be implemented if they are corrected argued and packaged to favor those who ultimately decide whether they are enacted or not. Comments from TMV Readers are always welcome.

5/24/09 by Marc Pascal in Phoenix, AZ