August Health Care Blues

I don't think it's an overstatement to say the health care debate is a debate more fundamental to who we are as a people than any we have had since perhaps the civil rights battles of the 1960's. It forces each of us to grapple with what we are willing to sacrifice to help our fellow citizens and whether we look at society as isolated individuals fighting over finite resources or a community of human beings who collectively work to secure dignity for every single person. This is what is at stake.

For the past few weeks we have had to endure a blizzard of lies from entrenched interests bent on stopping health care reform at all costs. We hear how old people will be left to die by government bureaucrats (people are being left to die today by health industry bureaucrats and there is nothing in any bill that would empower the govt to deny care to the elderly). I've even heard my liberal friends say that they support reform as long as they can keep their private insurance plans they are so afraid of a single payer system.

Let's be clear. Nothing on the table in congress right now goes far enough to really reform health care or guarantee every American equal access to health care. Eventually we will need to move to a single payer system. Honestly I hope the right wing nuts are right when they say the purpose of the public option is to destroy private insurance and I hope Obama is wrong when he says if you like the insurance you have you can keep it.

Here's why. As long as different classes of people do not have access to the same level of care, we are not a just society. Even under Obama's plan, a poor woman on medicaid who gets cancer is not going to get the same level of care as a rich woman. Effectively we are rationing care based on income. We are saying the lives of the wealthy are worth more than the lives of the poor. We are all participating in this and we are all responsible.

In Canada or the United Kingdom, the level of care is the same for everyone. There are not dozens of different programs like medicare, medicaid and private insurance (or even the "public option" which hopefully will become the basis of a single payer system here). Everyone in these other countries has a stake in making the health system the best it can be since they all depend on it. It's a much different mind set than in the US where we are conditioned to grab what little we can and hold onto it for dear life.

I know what many of you are thinking, "but their quality of care is horrible, they have to wait, rationing! etc." Bullshit. We have rationing in this country, it's based on income. We have higher infant mortality, lower life expectancy and they have better health outcomes in general. Single payer would reduce costs in a way that the public/private system being proposed cannot. Hospitals and doctors could be given global payments as opposed to being paid per test or visit they could be paid by each case or on salary.

Recently some right wing nut said that Steven Hawking wouldn't be alive if he were under the care of the British National Health Service. Well he actually is under the care of the NHS and says he owes his life to his NHS doctors. Here is a great article from The Guardian detailing how our health care debate is viewed in the UK.

My sincere hope is that somehow a strong public plan with rates tied to medicare rates that all doctors who accept medicare will be required to accept will survive in congress. If that happens this plan will eventually destroy private health insurance just as the industry fears. Once say 75% of the country is enrolled it will be politically feasible to pass a single payer plan. Imagine a day when every single person in this country knows he or she can receive the care needed if she gets sick, where the first thing one thinks of when diagnosed with a life threatening condition will no longer be money but how best to get well. This would fundamentally alter our feelings about ourselves and about our nation. The pervasive fear and insecurity that grips so many Americans would be no more and people would be free to pursue their life's dreams without having to beg corporations to promise to help if they get sick.

It's possible. A lot of money wants us to believe it isn't. Right now Democrats in the Senate are negotiating away the public option and Obama (who has already given away a sickening amount of leverage to drug an insurance companies) has signaled he is fine with this. Howard Dean has repeatedly said anything that is passed without a strong public option is not health care reform, but a huge giveaway to the insurance companies.

Yes, this is the transcendent issue of our time. This is why we elected a Democratic President. Unfortunately the administration has been acting more like Jimmy Carter on this than LBJ. As Roosevelt said to the left during the great depression when they wanted him to move faster "You have to make me do it". Obama is only hearing outrage on the right and he needs us to make him and the congress do the right thing.