Letter from Italy

James O'Brien

I got a lot of notes regarding my screed against the Democrats ("Spank the Donkey," November 27), but my favorite was this guileless, impassioned letter from a reader in Italy who wondered why this country has never developed a national healthcare system. It was too long for the Letters page, so I'm publishing the exchange here.


Subj: Recipe for sure victory for DEMS! A winning strategy in five easy points and a short necessary premise

Ciao Perry,

I am an Italian writing to you from Italy proper and I hope you can answer to this letter as I am hugely curious about it.

The basic difference between Europe (and Canada) and the States is, at a mass level, the lack of universal health care (at a moral level, capital punishment). Now my question is: Has America ever held a poll to check if every single American knows that every European/Canadian citizen has health care? How is it possible that a politician pushing for national health care on the Canadian model or the model of, say, France or Germany, doesn't win elections automatically? I mean any American politician might prove, with indisputable data in his own hands, that the Canadian/European models are the only ones truly providing health care for everybody (the Italian constitution itself says that every citizen has a right to health care), and that the only way to truly have universal health care is to have a strong government role and to mandate by law that every citizen must have health coverage.

So why is it that left-liberal politicians (however few they may be) don't bombard every American with the notion that in Europe and Canada, health care for everybody is just taken for granted? Why don't they bombard them with the fact that both the right and the left support it (Michael Moore did it in Bowling for Columbine, but it's such a rare voice), that it's a politically non-controversial point, just an obvious thing for civilized people! The only political differences may vary on how much citizens should receive from the health care system, but no one could dispute the fact that every single citizen should receive all basic medical needs and that such a fact must be recognized by law. Americans should be bombarded with facts like this: Even Margaret Thatcher (so close to Reagan) never dared touch the British national health service! Any European politician, even the conservative Berlusconi, would be politically dead if he pushed for the dreaded American profit-based system!

So the question to be put to voters should be: How is it possible that such an obvious goal becomes controversial and is said to be unaffordable, when America is obviously richer than say, Greece or Portugal or even France? More to the point, you say that Democrats know that but they don't want to lose the money of private financiers; that's right, but the first goal of a politician (particularly a candidate for president) should be to win. And I think every politician proposing universal health care on the basis of real experiences (Europe, Canada, and Australia for the past half century!) should be quite able to do that based on the following points:

1. What could a Republican say? Canada is a myth? France, Germany, Spain, all of Scandinavia, don't exist? Of course he could not deny that!

2. So what would a Republican say: Those other countries are richer? Of course they can't say that! Or: Yes, they are poorer but they spend less on defense? True, but false in its implication, as America is (on per capita income) much, much richer than many European countries, so that is not enough to justify its lack of universal health care! Furthermore, Americans already spend the same amount of money (or more) privately as Europeans and Canadians spend through health care taxes, so it's not a matter of money anyway!

3. How could a Republican say that every Greek resident can afford basic health care, but not every American citizen? I mean, any debate on these points should be immediately winnable, as Republicans could not deny facts!

4. A Republican might say: Yes, but the quality of health care in these countries is lower. Bull! First, quality in Canada and many European countries is good, and second, the main point is that the Canadian and European models bring patients out of the jungle by giving basic care to each and everyone as a citizen's birthright, as obvious as breathing. These systems save people from any chance of being bankrupted by health care costs, or suffering horrible things like having to sell their houses, etc. These things just never happen in the rest of the western world!

5. Finally, a (rare) Republican might say: Yes, we want universal health care, but just by tampering with the current model. Bull! Any adversary might easily reply that this system has always failed to give health care to all. You have to radically change it!

Again, based on real facts, on obvious facts, every American should be bombarded with the notion that health care need not be a problem. They should be told it's inconceivable in Europe that you could lose your job and then, double whammy, your health coverage too--that's akin to the law of the jungle! Politicians running on this platform should win at every level, both congressional and presidential.

Even you on the left, I think, fail to recognize (being born in the States) how uncivilized America, with its millions of citizens lacking health care, looks to other western people. I think by drilling the notion into American heads that much poorer capitalist nations give health care to everybody, you would get millions of votes (the same kind of popular mass vote as for FDR). Any politician should appreciate that. But in their dependence on corporate money, they still appreciate dollars more than votes.

Please, when you give this European letter to Democrats all over, remember that I helped give America finally that obvious goal of universal health care!


Paolo De Falco


Dear Paolo,

You have no idea how scandalous this letter of yours will sound to some American ears. First, everything you say is true. The popular appeal of political campaigns built on national health care would be enormous. Promoted the right way--in clear, unapologetic terms that portray private healthcare companies as the profiteers and empire builders they are--such a platform would sweep the country.

Why doesn't it happen? Lots of reasons. The whole political culture of America after World War II has conspired against popular impulses like universal health care. The commie witch hunts and ceaseless red-baiting of the cold war years kept lefties, liberals, and small-d democrats in America from pursuing the sorts of measures their counterparts in other Western countries were undertaking. While Europe and Canada were creating programs like national health, American politicians were busy scaring the public about creeping socialism in all its guises. Then, too, racism has always been a useful lever for dividing America's have-nots when they get unruly. And our education system has done its part. As the late, great political critic Walter Karp once wrote, "What the public schools practice with remorseless proficiency...is the prevention of citizenship and the stifling of self-government. When 58 percent of the thirteen-year-olds tested by the National Assessment for Educational Progress think it is against the law to start a third party in America, we are dealing not with a sad educational failure but with a remarkably subtle success."

Personally, I believe a great many Americans are ready to shed those old clothes and swim off into uncharted waters. They feel lost and betrayed and their allegiance is up for grabs. The main barrier to reaching them with a message like yours is money. Have you ever stopped to ask yourself why both of America's major parties vehemently oppose changing a system of campaign finance that costs them exorbitant and constantly escalating sums? This is an important question, so it needs defusing. The talking heads on TV flap their gums about it endlessly. It's always the same: "Politicians are greedy!" one will say. "No, no," his "opponent" then objects. "The real trouble is, the parties always get caught up in partisan bickering." And so on.

None of the commentators ever draws the obvious conclusion regarding money and politics: Democrats and Republicans don't want to change the present system precisely because it sets a high price for participating and thereby ensures that no idea distasteful to the parties' owners and managers will ever get a hearing in the court of public opinion. Careers in politics have to be prohibitively expensive, or the wrong sorts of people will get in the game. You can scoff at the perversity of this system all you like; the point is that it works very well for the people who control it.

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