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This weekend I was reading an article in the New York Times about a nurse practitioner in West Virginia in a county which has the lowest life expectancy rate in the USA.   The nurse practitioner works in NorthFork in McDowell County, West Virginia.

The article stated that the poor, the sick living in McDowell County voted overwhelmingly for Donald Trump. This county is in the heart of Coal Mining country, devastated by a fast changing economy. Unemployment is high and the county has a very large proportion of poor people, people who cannot afford a Plan B, or private insurance coverage. It is the fear that as many as 24 million Americans will loose their health coverage in the USA if the GOP rolls back ACA also known as Obamacare. The people of that one county in West Virginia would be severely impacted by changes to the ACA or its roll back and the implementation of a Republican Health care bill.

It was a very difficult article to read, it is difficult to understand how Republican politicians elected by the people can believe in the idea that a free market health care system run by insurance companies is better than one where more and more people are covered without risking a personal bankruptcy.

If the Republicans are successful their system, as far as I can understand it, would basically force people to choose between death or bankruptcy. In the story the nurse practitioner spoke of her brother who 30 years ago at the age of 25 fell ill, he did not have health insurance and could not afford it. He was turned away because of his inability to pay and died from a disease which should have been easily treated if only he had the financial means. In this story this nurse practitioner goes through a normal day at the clinic, she sees people, all are poor and many are not well educated, they do not understand the system or have a wrong perception. Many suffer from diabetes, heart disease, are over weight, smoke, their medication now covered is expensive. It was sad to think that all those Americans without affordable health care would simply die. Dental coverage is another issue, many cannot afford the dentist, so they are exposed to a host of other diseases because of poor oral hygiene. One man who voted for Trump is an unemployed 54 year old, former coal miner. He explained that he wants to work and Trump’s promise to re-open the coal mines, this is what he was looking for, he reasoned that with a job he would have benefits and health care, so he voted for Trump. I have the sinking feeling that he will find out the hard way that Trump was nothing more than a snake oil salesman.

Many of the same poor people blame Obama for their Health care, not understanding that without ACA they would be worse off, but since they are also poorly educated they can be easily deceived by their Republican Congressman Evan Jenkins (R) and Senators Machin (D) and Capito (R) in West Virginia.

Living in Canada I cannot imagine any politician at any level talking of opening up our Canadian Health Care System which is a Provincial jurisdiction to free market insurance schemes, it would be suicide. I am also grateful to have been born in an era when our system was being implemented. Now retired I do not have to worry, I am fully covered and so is my spouse. I do have supplemental insurance but the monthly premium is so small as not to be a concern.

The article also mentioned that Medicaid and Medicare where in peril, seniors may find their benefits greatly reduced, mental health is not covered. At the end of this article I thought the Republican Congress is preparing a recipe for a terrible disaster.

A country cannot function if inequalities are stark, it only increases social tension to the cracking point.

Speaking of the cracking point, this afternoon on  CBC radio, I was listening to Ideas in the Afternoon with host Paul Kennedy. His guest was Wolfgang Streeck talking about Capitalism today. Here is the synopsis of this podcast.

The signs are troubling: the ever-widening chasm between the ultra-rich and everyone else. Mass protests. Political upheaval and social division. It looks as though the rocky marriage between capitalism and democracy is doomed, at least according to Wolfgang Streeck, who directs the Max Planck Institute for the Study of Societies in Cologne, Germany, where he is also a professor of sociology. In conversation with Paul Kennedy about his book How Will Capitalism End?, he makes the unnerving case that capitalism is now at a point where it cannot survive itself.

According to Streeck, capitalist societies are entering an interregnum — a pause or suspension of normal governance — as the system of capitalism collapses in on itself. In the absence of countervailing forces to keep it afloat, capitalism has essentially devoured itself. One consequence is a loss of state solidarity citizens in western countries have become used to. Streeck points to Italy, Greece and Spain, countries where young people can’t get find jobs; where fewer people can live on their own; and where marriage and birth rates are declining. People everywhere are now trying to protect what little they have left.

Wolfgang Streeck sees day-to-day life in the interregnum in stark terms: coping, hoping, doping, and shopping. He says that when it comes to the harsh realities of the interregnum, those who cope well will wear their stress as a kind of badge of honour. Those who cope poorly will mask their inability with drugs and mindless consumerism. We are having an opioid crisis in Canada and the USA right now. Here the Federal and Provincial governments have intervene, in the USA it is largely ignored.

Streeck then went on to speak about: “Democracy was always a problem in a capitalist society. There’s an enormous inherent tension between the two. Democracy is inherently egalitarian because every citizen has one vote. And the rich also have one vote but the rich are only five percent. Whereas in the market, every dollar has a vote. And the capitalist economy in particular functions according to — I think it’s [the Gospel of] Matthew — where it says he who has will be given [more]. And he who has [little] will have even what he has taken away…

And where you have capitalism and democracy at the same time, you have a contest between these two principles of distribution: egalitarian versus inegalitarian. This is why democratic politics have always tried to intervene in the markets and tried to contain the “Matthew effect”. You can also call it cumulative advantage if you want a more elevated term. So, where you have democracy in the form of trade unions, centre left political parties, sometimes centre right political parties, Catholic parties, and so on — they look at the market and what comes out of the market and then they become concerned both about their capacity to get re-elected and about principles of justice which, in a democracy, are principles of social justice, not market justice.”

This podcast on the CBC which last 53 minutes got me thinking of all those poor people in West Virginia who voted for Trump thinking they would be so much better off. I also think of people here in Canada who believe we in Canada would be better off with someone like Trump. They are usually members of the right wing neo-cons movement, business people etc, blue collar. Luckily they are a minority around 25% of the electorate. But in Canada we have to be careful, a fragile balance exist and desperate politicians will propose just about anything if they sense there is a vote in it.

Each decade is different, the 70’s were different from the 1960’s, today is vastly different from the era before 2000. It just feels sometimes as if the world is spinning out of control.