To say that we've had only a brief time to celebrate the health care reform victory in the Congress is an understatement. It has both defined the Obama presidency and revealed just how dysfunctional we are as a nation. This is plainly going to be the watershed year for how the U.S. fares as the dominant power of the 21st century, and if we can't develop a national consensus on health care, jobs, education, and race, I don't think we can compete. Plainly, to have Obama as president at this particular time in American history has to give lapsed Christians like me pause, because it's hard to imagine someone better suited to take this country through this turbulent decade than he is. So divine intervention has to be seriously considered.
I come from a generation of black Americans who are somewhat paranoid about violence against black and progressive leadership. I was among the last Senate interns for Robert Kennedy, and still remember where I was when both Bobby and Martin Luther King were killed. So I was frightened for Obama when he was elected. That subsided with the general euphoria after his election and, more significantly, when the extraordinary, pragmatic approach of his presidency began to emerge - decidedly centrist and, for advocates like me, almost maddeningly inattentive to the concerns of the very poor.
But all my concerns rushed back when I was down in Washington last week, listening and reading the signs of the protesters against health care. They went up even more with the racist attacks on black legislators and the bricks thrown through Democratic House members' offices. This may only be the beginning of an escalation in vitriolic rhetoric and violence, so I'm getting myself emotionally ready for possible bad times.
But I think there are enormous reasons to hope. The recent polls show many Americans, despite their concerns, are beginning to understand and support health care and other efforts by the administration to dig us out of this recession. President Obama's decision to take the program directly to the people to explain what it does - protecting people with pre-existing conditions and expanding coverage for the uninsured - is a wise one. Plainly, despite the right wing attacks, people are willing to listen and make up their own minds.
One thing we hoped to get before Congress and the White House is the necessity of protecting individual health care consumers in the new health environment. I haven't met anyone who doesn't have stories of how difficult it is to deal with their HMO, particularly when it refuses to pay for all or part of a doctor's bill or denies access to certain treatments or drugs. In the new health care world, these problems are sure to increase exponentially, particularly because the public option was tossed out in order to get the bill through the Congress.
The Community Service Society (CSS) has been down in Washington for the last six months lobbying Senator Schumer and others to include language in the Health Reform Bill which calls for establishing local and state nonprofit ombuds programs to assist health care consumers in getting adequate coverage and assisting in resolving disputes with health providers if they can't get satisfaction on their own. It's incorporated in the bill at Sec. 1002. Much of our arguments in favor are based on the program developed by CSS, the Managed Care Consumer Assistance Program (MCCAP), a New York City Council initiative which has operated for a decade, assisting nearly 130,000 New Yorkers with their health care coverage. See MCCAP Annual Report 2009.
Programs like MCCAP are almost certainly required in virtually every community in America if the promise of health care reform is actually going to be able to reach every American, particularly the poor and vulnerable. Ombuds programs will also prevent the inevitable glitches in the expansion of health care from being turned into arguments by its opponents that expansion just doesn't work.