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Excerpt: "The U.S. healthcare system is an international scandal. It's roughly twice the per capita costs of comparable countries, and some of the worst outcomes, mainly because it's privatized, extremely inefficient, bureaucratized, lots of bill paying, lots of officials, tons of money wasted, healthcare in the hands of profit-seeking institutions, which are not health institutions, of course."

Noam Chomsky. (photo: Graeme Robertson)
Noam Chomsky. (photo: Graeme Robertson)

Noam Chomsky: Our Privatized US Healthcare Program Is an "International Scandal"

By Democracy Now!

05 April 17


resident Trump threw his weight behind the Republican plan to repeal and replace the Affordable Care Act. But he failed to muster enough support to pass the Republican plan, which would have stripped up to 24 million people of health insurance while giving the rich a massive tax break. For more, we speak with world-renowned political dissident, linguist and author Noam Chomsky. His new book, out today, is titled "Requiem for the American Dream: The 10 Principles of Concentration of Wealth & Power."


This is a rush transcript. Copy may not be in its final form.

JUAN GONZÁLEZ: And what do you make in terms of—when you’re talking about decimation, clearly, one of the big failures was their inability to end Obamacare. Could you talk about the—what you’re seeing now as the potential in terms of the healthcare system in the country, what they will try to do and what the potential is there?

NOAM CHOMSKY: Actually, there was a pretty interesting poll about it that came out a couple of days ago, simply asking people what they preferred. The Republican proposal was the lowest of the choices available. I think about 15 percent of the population were willing to accept it. Somewhat higher was the existing system, so-called Obamacare. And on that, it’s worth bearing in mind that a lot of people don’t know that Obamacare is the Affordable Care Act. So you have negative attitudes towards Obamacare, thanks to lots of propaganda, but more positive attitudes towards the Affordable Care Act, because of what people see.

Most popular of all—over half—was the so-called public option, a government-guaranteed healthcare program, which is pretty remarkable because no one publicly advocates that. But it’s been a consistent polling result for decades, that when people are asked what they want, they say that’s their choice. And, in fact, that’s about the only proposal that makes any sense. The U.S. healthcare system is an international scandal. It’s roughly twice the per capita costs of comparable countries, and some of the worst outcomes, mainly because it’s privatized, extremely inefficient, bureaucratized, lots of bill paying, lots of officials, tons of money wasted, healthcare in the hands of profit-seeking institutions, which are not health institutions, of course. And for decades people have preferred what every other country has, in some fashion: either straight national healthcare or heavily government-regulated healthcare like, say, Switzerland. Sometimes the support is astonishingly high. So, in the late Reagan years, for example, about 70 percent of the population thought that guaranteed healthcare should be a constitutional guarantee, because it’s such an obvious desideratum. And about 40 percent thought it already was in the Constitution. The Constitution is just this holy collection of anything reasonable, so it must be there.

But it just doesn’t matter what people think. When Obama put through his own program, I think support for the public option was almost two-thirds, but it was simply dismantled. When this is—occasionally, this is discussed in the press, New York Times, others. And they mention it. They say it’s a possibility, but it’s called politically impossible, which is correct, which means you can’t pass it through the pharmaceutical corporations and financial institutions. That’s politically possible in what’s called democracy. Sometimes they say "lacking political support," meaning from the institutions that really matter. There’s kind of this population on the side, but we can dismiss them, yeah.

AMY GOODMAN: Do you think there could be a kind of "Nixon in China" moment with Trump? He has, in the past, expressed support for single payer. He’s extremely angry right now at the Freedom Caucus. He can’t decide which more—which are the villains in this more, the Freedom Caucus or the Democrats. He goes back and forth. Do you think he could sort of throw it all out? Or is it going to just go as we’re seeing in these past few days, where it looks like they’re going to revive it to what the Freedom—so-called Freedom Caucus wants?

NOAM CHOMSKY: I think they’ll probably revise it. Trump is all over the place. You don’t know what he believes. He says almost anything that comes to his mind at 3:00 a.m. But the people who are really setting the policy in the background—essentially, the Ryan ultra-right Republicans—they understand what they’re doing. And they want to destroy the—any—the aspects of the healthcare system that are beneficial to the general public, that’s systematic policies. Probably what will happen is the kind of compromise that’s already being discussed, with states having the right to opt out of whatever the federal program is, which might satisfy the ultra-right Freedom Caucus, make it even worse than the current Republican proposal.

JUAN GONZÁLEZ: I wanted to turn to—

NOAM CHOMSKY: Just today, incidentally, one—I think Kansas—turned down expansion of Medicaid. I mean, anything that’s going to help people in need has got to be wiped out.

AMY GOODMAN: We’re going to break and then come back to this discussion with the world-renowned political dissident, linguist, author, Noam Chomsky. This is Democracy Now! We’ll be back with him in a minute. your social media marketing partner


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+10 # Wise woman 2017-04-05 10:40
Thanks Noah for finally making it clear why the US has consistently avoided this horrendous situation. What I have lived thru because of it nobody should have to. And I'm definitely not alone. It has destroyed my life as I knew it.
+18 # willsud24 2017-04-05 10:54
Why can't we get Democrats that speak like this and believe this? Why do we have to settle for posers like Obama? If something is wrong and scandalous, we need leaders on the left that say so and don't back down. The Obama/Clinton corporatist brand of Democrat needs to go away if we ever want any real change.
+14 # elkingo 2017-04-05 11:57
Right on Noam-o - as usual. Socialized medicine now! Trump et al are killing off the poor, the ill, the old: culling the herd so to speak, leaving only the rich, who God loves only, in conformance with early Protestant theology, notably Calvin.
0 # Skyelav 2017-04-07 13:27
Read the globalist plan for population control. It's lovely reading.
0 # sfreeman 2017-05-11 12:09
elkingo, I do not think you want socialized medicine. The U.S. military and Veterans Admin. are socialized medicine. My experiences with both are dismal at best. I'll spare you the detail.

I think a minimumly bureaucratized single payer (such as a less bureaucratic Medicare) would be very good. However, I think the best system probably would be Germany's--whic h had the world's 1st national health care system. It is based on private NON-PROFIT health insurance companies. Even though they are non-profit, in Germany and France, they are highly competitive in the "perks" offered to policy holders. By law, EVERYONE must have health insurance, primarily provided through employers who must include retired workers. The German government pays premiums for anyone incapable of working who otherwise does not have health insurance and for the unemployed until they gain a job and coverage through their employer. Health care costs are regulated by a board consisting of representatives of numerous different groups--governm ent, health care providers, insurance companies, unions.

From Germans I know, the system is not nearly as complicated as it may seem from the discussion above. The bureaucracy is not as heavy-handed as with Medicare in the U.S.
+17 # chrisconnolly 2017-04-05 12:34
"..anything that’s going to help people in need has got to be wiped out."

The republican mantra. Kill the people coddle the corporates.
+19 # reiverpacific 2017-04-05 15:02
In hard terms, with the US don't care system, between 30% to 40% of costs are administrative, whereas in other"civilized " nations, it's an average of 7%!
Also in the latter, doctors are paid well -on a parallel with other college-educate d professionals like Engineers and architects- but not the huge sums doled out to MD's here along with an almost God-like status.
Doesn't that just tickle y'all to death?
+4 # Blackjack 2017-04-06 12:41
"no one publicly advocates" the public option? Did Chomsky not hear a word that Bernie Sanders said for months about it?

and "support for the public option was. . .simply dismantled. . .when Obama put through his own program." It was "dismantled" because Obama shut out anyone from the discussion who was in favor of a public option and instead packed the committee with supporters of the pharmaceutical and insurance industries.

In short, Dems didn't opt for a public option from the very beginning because the pharmaceutical and insurance industries put many of them in office and were pulling their strings. Unfortunately, that is still the case.
0 # Skyelav 2017-04-07 08:27
Interesting POV only he fails to mention the Koch brothers and Mercer, whose daughter Rebekka and he have been fighting for a takeover. The ultra far right is not the "Ryan republicans" Chomsky speaks of. These are the freedom caucus people and as someone here says, they will do anything to remove all services (see comments on Kansas). Chomsky supported the Hillarites which made me feel sick because since when are her plutocrats (The Rockefeller/Mel lon gang) any more forgiving in all this? Mr. Chomsky seemed to dismiss Sanders throughout the primaries. Wondering why since their ideology is similar.

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