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.