What Is the Health Care Debate Really About?

11/22/2009 04:57 pm ET | Updated May 25, 2011

What is the current health care debate really about?

Is it about cost? Is it government's inability to adequately deliver services that are best left to the private sector? Or is it a middle-class disdain for the poor?

According to the Congressional Budget Office, Senate Democrats this week unveiled The Patient Protection and Affordable Care Act at an estimated cost of $849 billion over 10 years. The act would provide insurance to 94 percent of the nation, extending coverage to 31 million more Americans.

This obviously takes the statement attributed to former Senate Majority Leader Everett Dirksen, "a billion here, a billion there and pretty soon, you're talking about real money" to a whole new level.

But the $849 billion price tag is still less than the cost spent on occupying Afghanistan and Iraq over the same time period. Sadly, health care has garnered far more congressional debate than did America's decision to enter into two wars.

That is not to suggest a vigorous health care debate is not warranted; it is. But the public option has become infamous in opposition circles.

It has fueled erroneous cries of socialism. But as Vice President Joe Biden said recently on The Daily Show, and what I've been saying for years, we already have socialism -- for the wealthy.

It is the poor who are given the message of rugged individualism and the virtues of capitalism exactly the way Adam Smith drew it up. This theory has long been debunked, but the narrative persists with the reality of any garden variety urban myth.

It is easy to portray government as Darth Vader and the private sector as Luke Skywalker in this epic battle of good versus evil.

But both have a vital role to play in the formation of effective public policy. It is when one is allowed to act unchecked that problems occur.

America's two worst economic meltdowns were not the result of high taxes or government regulation, quite the opposite.

The Glass Steagall Act became law in 1934, on the heels of the Great Depression. Glass Steagall kept banks from behaving like brokerage houses and insurance companies, while the Gramm-Leach-Bliley Act, passed by Congress and signed by Bill Clinton in 1999 loosened those restrictions.

What Glass Steagall held together for 65 years was undone by a less regulated market in roughly eight years.

I marvel that the arguments made in opposition to health care legislation are portrayed as novel. Read the dissenting argument to Social Security and Medicare and see for yourself if they do not possess the same hollow ring of fear.

Could it be that any health care reform proposals that include a public option reflect our collective disdain for the poor? The poor are the unwitting piñata within our public discourse, where we are free to blindly take whacks without fearing reprisal.

As former Sen. Bob Dole surmised over a decade ago, "There's no poor people's PAC." The poor have no K Street lobbyist working on their behalf. Therefore, the poor become tools for the opposition in their quest to misrepresent the health care debate for political purposes.

It tragically remains easier for some members of Congress to support a misguided war than to support health care reform that includes low income individuals.

Any serous attempt to decrease the estimated 47 million people who do not have healthcare is in the nation's best interest economically as well as socially. There is a correlation between healthier children and improved student outcomes.

Health care reaches into practically every aspect of American life. If we can't get this right we have no chance at addressing the other myriad challenges that confront us.

I don't expect the final health care legislation that President Obama ultimately signs will represent the policy I prefer, but I do believe in what theologian Reinhold Niebuhr called "proximate gains."

Nor do I think what passes will be the final word on the health care debate, but rather a beginning that will require multiple revisits during the life of the Obama administration and/or a Democrat majority in Congress.

But the subtext of this landmark debate has been regretfully framed by opponents as the fear induced us v. them -- the middle class v. the poor.

Byron Williams is an Oakland pastor and syndicated columnist and blog-talk radio host. He is the author of Strip Mall Patriotism: Moral Reflections of the Iraq War. E-mail him or visit his Web site: