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Health Care Reform: A story of intrigue and power with a do it yourself ending…

Post by Karen Irwin on July 27, 2009 at 8:39 am with 5 Comments »
July 27, 2009 8:39 am

They are going to write about us you know.

Someday, in the distant future, books will be written and movies will be made about we the people who lived in the time of the Great Recession. I’m talking "Grapes of Wrath" like stories only instead of traveling across country looking for work in a run down double decker go cart, the people of our time will be symbolized by a picture of a single mother sitting in an emergency room with a crying three year old on her lap and a bored six year old at her side.

Cinematically speaking, a "Grapes of Wrath" sojourn from Oklahoma to California has a far more dramatic effect than a woman in an Emergency Room leafing through a year old edition of People Magazine, but that is our current cross to bear in the year 2009, a health care system that is really no system at all, a lopsided wasteful land where some people gorge and others starve.

I can almost hear the future movie pitches now, and yes there are two rolling around in my skull because as of yet we don’t know which one will win out. We don’t know which version will be part of the great American narrative. Will it be the struggle conservatives have to keep health care embedded in a free market system, a fight to keep an encroaching government out of a business in which they don’t belong, or will it be the liberal struggle, a story of a one hundred year old uphill climb that began with Teddy Roosevelt’s presidential platform and finally succeeded with President Barack Obama?

Here’s the fun part:

we get to decide. In August our representatives are going to come home and in between golf and sailing they are going to be listening very hard to their constituents. They will be asking us how we want them to tackle this crisis, or if we want them to tackle it at all.

When we answer we must remember to speak up very loud so as to be heard over the various self interest groups who also have their ear. These self interest groups, mainly profitable insurance companies, are producing commercials right now, commercials that will attempt to scare most of us away from trying to solve this problem.

The scare tactic was effective in 1992 and 1993 when the Clinton Administration tried to get universal coverage, but those were different times. In 1993 sixty-one percent of small businesses were providing some kind of medical coverage for their employees. Today, only thirty-eight percent of small businesses are able to provide some kind of coverage, and increasing costs are causing more businesses to drop out. And it’s not just small businesses collapsing under the weight of health care. GM spent more on health care for its employees than it did on steel. Starbucks spends more on health care than it does on coffee.

The truth is that our government already pays almost half of today’s health care expenditure, so it is fair to say the government has a vested interest in improving that system. It is also fair to say that in these troubled economic times, made worse by health care costs, that we are in the midst of a defining moment because before we can get into the particulars of solving the problems of health care, and the particulars are a tangled mess by all accounts, our elected officials will look to us for generalities to get their cue on how to proceed, specifically they will ask questions like: Do we want to fix health care? Who should get access, only those who can afford the rising costs?

It’s a difficult question to answer because keeping health care in the private sector incentivises innovation and it is why every bit of the one thousand page outline President Obama recently handed Congress deserves vigorous debate, but one thing the president is right about is that doing nothing will result in financial peril. Today, eighteen percent of our GDP is spent on health care, and if costs follow this current trajectory in 2050 it is estimated we could be paying forty-four percent of our GDP. Clearly, things have to change.

Conservatives fear a universal health care plan is "an assault on the concept of citizenship," and they warn of a collective mindset, a mindset that will lead to a socialist or communist state. "Reject Socialism" is a repeated mantra. As they see it: Today affordable mammograms. Tomorrow matching pajamas. For many, dealing with the health care crisis is a zero sum game.

A conservative pastor who is against health care reform recently summed up a dominant sentiment among conservative Americans when he wrote on a political blog: "we must recognize there is always going to be the haves and the have nots." He believes that medicine is not a right but rather, "an entitlement." But I wonder, looking into the eyes of an uninsured single mother, a "have not" if you will, a woman who recently found a lump in her breast and has no insurance, would that same pastor have the courage to tell her that she is not "entitled" to a biopsy?

Thomas Jefferson wrote that our constitution was merely an extension of "the natural rights of humanity." I wonder what Mr. Jefferson would say if we asked him if health care could be considered a natural right, or is it just a natural extension of capitalism, a game of survival of the fittest, just an entitlement afforded by a diminishing few?

History shows that when trouble bubbles in the national cauldron, and it’s at a steady simmer now, that is the time when we the people get to probe the character of our American vision, a vision that was supposed to be indivisible but unfortunately rarely is. How we handle this crisis, this opportunity before us, will be the story that ultimately gets told.

It is my hope that we can have just enough of a "collective mindset" to get this right, that we don’t politicize the fight too much, that we listen to the legitimate concerns of the Right and we honor the intention and impetus of the Left. To be sure, a Right meets Left ideological fight is a potent lure, but if we stand up together and say that we are the people who want to fix this, even if it means a robust fight over the details, we can get folks out of the Emergency Rooms and into clinics. But we can’t begin to haggle over cost controls unless we first decide collectively that health care is a worthy goal.

I mentioned two scenarios with the potential to play out in the great American narrative, but there is a third, an unlikely story that involves two oppositional parties working together to solve the central problem of our day. That’s the story I hope gets written because working collectively is the only way our country has ever accomplished anything of worth, and when we use it, we Americans eventually get things right.

Taking notice
Leave a comment Comments → 5
  1. elmerfudd says:

    As someone who has had some health problems in the past and whose wife is currently being treated for breast cancer, I have some major reservations about revamping our health care system under the control of the government. However expensive and wasteful our current health care may be, (and it is both), it still beats the tar out of not receiving health care when you really need it. In Canada and the UK you have to go on a waiting list to get chemotherapy, which IMO is criminal. You can say that citizens of these countries have a “right” to health care, but if you can’t get it when you need it what kind of a right is that?

    The real issue with health care in the US is out of control costs and since as consumers we don’t have much control over where or how our health care dollars are spent there is little to no incentive for the providers to make costs more reasonable. If consumers had the power to shop around, a financial incentive to do so and resources to make informed decisions regarding the quality of their care, then perhaps the costs would start to come back down out of the stratosphere.

    As it is now, insurance companies and the government foot the bill so neither consumers nor providers have any incentive to keep costs down. The folks who do pay the bills though are trying keep the costs down by limiting care and expenditures and it’s a lose-lose game for everyone.

  2. Karen Irwin says:

    Thank you for writing Elmer, (May I call you Elmer?)
    I hate to hear that your wife is battling breast cancer. I know first hand how cancer impacts families, however I am glad to hear that your wife was able to access first rate health care.
    You make an important point regarding consumer choice. Purchasing medical care is not like going into the store and buying a loaf of bread. Prices are all over the map as they are negotiated among insurance companies behind the scenes and often the ones who can afford the most pay the least. I agree with you that consumers need real choice, and a 250k deductible, an “affordable plan” some companies are selling, is not a real choice.
    My best to you and yours.

  3. ldozy1234 says:

    As long as health care and health insurance are ” for profit”, providing and buying insurance by company or private consumer will remain a joke.
    My insurance is “private” but runs off of Medicare guidelines- the result? a battle for things like oxygen, etc.
    Medicare/ healthcare is a joke in its current system because the federal oversight committees are too easily influenced by lobbying groups that also provide campaign dollars. The highest “bidders” tend to be insurance groups, medical supply companies, etc. HMO’s add to this and we have devolved to a health care system that is profit driven in forcing physicians to make decisions based no longer on patient care needs. Physicians first answer to their HMO/ group (profit based), then insurance ( profit based), then legal teams ( profit driven) Medicare ( profit/ lobbyist driven) and then finally, the patients health. Health care is a business- not based on patient care but profit.

  4. jimkingjr says:

    Cost containment is what uis missing from all of the current proposals, and without cost containment we get no where. And you do not get cost ciontainment without addressing malpractice and liability costs, and amounts spent on extraordinary beginning of life and end of life care. Defining extraordinary would be very difficult, but why don’t we start on liability and institute a no-fault system?

    We cannot afford to just “extend the current system to all people” as some think we can. Someone, somewhere, has to make rationing decisions.

    If we are to get true health care reform, it has to be more than just getting a bill passed so the politicians can check off an item and take credit- who cares if it really works (no one will know before the next election, anyway)? The current efforts are just more political gamesmanship.

  5. nonstopjoe says:

    Steps can be taken to contain costs of healthcare – just look at what Safeway has been able to accomplish.

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