Dear President Obama,
Thank you for taking on the hugely important issue of health care reform in the first term of your presidency, demonstrating that this issue is a top priority for you.
You're quite right that the spiraling cost of medical treatment is affecting every American. You're also quite right to suggest that this is not a quick fix, or instant panacea, but instead part of a process of transformation. The question is -- what is the endgame? Where do we see ourselves as a nation 10 years from now? Do we see the same behemoth HMOs, and pharmaceutical companies, raking in record profits while the neediest and most indigent are without any coverage at all?
Is there an exit strategy for corporate greed?
What does affordable mean, and how will any newly instituted legislation ensure that the cost of medical insurance is never in excess of a certain percentage of a person's earnings? Who will safeguard us against unscrupulous employers -- those who deceive or refuse to divulge the exact amount we pay annually for that coverage?
What of the so-called public option? Will it be similar to Medicare? Will it do away with Medicare, or will Medicare itself be privatized? In the end, will the public option itself be privatized?
In an era of privatizing even our armed services, what assurance do we have that the
health management monopolies of today will not get even fatter than they are? After all, won't they be the ones to benefit the most from any reform that requires all Americans to carry insurance? Having all Americans pay out-of-pocket for health care is universal coverage of sorts, but it's not the kind of universal coverage that many of us had in mind.
We must not use the Massachusetts paradigm of Mitt Romney, which mandates health insurance, like car insurance, often at the expense of those who can least afford to pay for it. Mandating health coverage is no solution for rationing treatment, or superior access to those who are privileged.
During the 2008 presidential campaign, you articulated your belief that mandatory health coverage is not the same as universal health care. You indicated then that you recognized the difference, and would respect it. Has anything changed since that would make you change your mind?
We must consider taking the $2 billion shaved off the defense budget and, instead of spending it on a new supermax federal prison as Secretary of Defense Gates suggests, spend it to supplement monthly premium payments for those who can't afford to make them.
Further, we must lighten our military load, and troop commitments in Iraq, and Afghanistan, and re-route at least half of the $10 billion a month currently spent on war to cover as many Americans as possible.
The idea that, by now, the notion of taking defense money and spending it on education, and health care is a cliche shows just how cynical, and desensitized to the egregious, gaping needs of 45 million who are uninsured we have become.
The idea of forming health care cooperatives is fine, and very new age, if you can afford to buy in, but just as a food coop doesn't work for people who go to food banks, a health care cooperative won't work for those who can't afford to pay to play.
A revolution begins with a single step, and it often ends there. And, while many are ready to rise up against the gargantuan profits, and gluttony of the giant private insurance carriers, and drug companies, others are prepared only to continue to stuff their pockets.
The only viable longterm change in the health care is single payer, but until such time as that option can be implemented, there can be no animal calling itself reform that doesn't protect the public's interests. Anything less is tantamount to moving the furniture around on the Titanic.