Chomsky comentando la sanidad estadounidense

Un fragmento de una entrevista a Noam Chomsky en el que habla del sistema sanitario estadounidense. Puedes encontrar la entrevista completa aquí.



Well, healthcare is a dramatic case. I mean, for decades, the healthcare issue has been right at the top of domestic concerns, for very good reasons. The US has the most dysfunctional healthcare system in the industrial world, has about twice the per capita costs and some of the worst outcomes. It's also the only privatized system. And if you look closely, those two things are related. And the privatized system is highly inefficient: a huge amount of administration, bureaucracy, supervision, you know, all kinds of things. It's been studied pretty carefully.

Now, the public has had an opinion about this for decades. A considerable majority want a national healthcare system, like other industrial countries have. They usually say a Canadian-style system, not because Canada is the best, but at least you know that Canada exists. Nobody says an Australian-style system, which is much better, because who knows anything about that? But something like what's sometimes called Medicare Plus, like extend Medicare to the population.

Well, up until—it's interesting. Up until the year 2004, that idea was described, for example, by the New York Times as politically impossible and lacking political support. So, maybe the public wants it, but that's not what counts as political support. The financial institutions are opposed, the pharmaceutical institutions are opposed, so it's not—no political support. Well, in 2008, for the first time, the Democratic candidates—first Edwards, then the others—began to move in the direction of what the public has wanted, not there, but in that direction.

So what happened between 2004 and 2008? Well, public opinion didn't change. It's been this way for decades. What changed is that manufacturing industry, a big sector of the economy, has recognized that it's being severely harmed by the highly inefficient privatized health system. So, General Motors said that it costs them over a thousand dollars more to produce a car in Detroit than across the border in Windsor, Canada. And, you know, when manufacturing industry becomes concerned, then things become politically possible, and they begin to have political support. So, yes, in 2008, there's some discussion of it.

Now, you know, this is very revealing insight into how American democracy functions and what is meant by the term "political support" and "politically possible." Again, this should be headlines. Will a proposal come that approaches what the public wants? Well, we're already getting the backlash, strong backlash. And what private healthcare systems are claiming is that this is unfair. The government is so much more efficient that they'll be driven—there's no level playing field if the government gets into it, which is true.