Every time I tune-in to the "debate" on health care, it amazes me how utterly asleep Congress and the media are with respect to this issue.
They, are, clueless.
Supposedly, the health care debate is between one group of people who make fortunes via the insanely profitable insurance and pharmaceutical industries and another group of people who want to make sure everybody in American has access to "affordable' health care. How do we do that? How can we twist and tie enough pieces together so that the health care needs of the many are balanced out by the concerns of this vast economic sector that employs countless people all across the country and generates a substantial portion of our gross national product?
Pushed to their political extremes, these two groups take turns shouting "socialism!" and "greed!" at each other in the vain hopes that the larger and louder will win persuade the public, nudge a majority of Senators, coax the White House, and win the day.
There is only one problem: health care should not be a technocratic debate about "affordability." It should be a conversation about solutions to the fear that cripples a vast segment of the American public. This fear has been with us for so long that "debate" is obscene by comparison to just stepping up and solving the problem.
Consider this simple fact: The number of Americans without health care coverage is so big, and has been growing for such a long time, that we can now simply say that the United States is a country with a systemic lack of health care for its citizens.
Now, answer this: Does it sound like a good thing to be a country with a "systemic lack of health care" or a bad thing? Is that something you want or something you do not want?
Obviously, it is bad. But why is it bad? What does a systemic lack of health care do to a country?
It may not seem obvious at first, but that question is the starting point of the kind of productive conversation that Congress and the media should be leading about health care.
The answer is: a systemic lack of health care (1) divides a nation and (2) cripples it with fear.
In a nation with a systemic lack of health care, there is a radical divide between the haves and the have-nots.
Those with health care live in a world that is radically different from those who live in a world without it.
The haves are able to treat their health like any other good or service in the economy. Because health care is a privilege of income, the haves can go out and buy health care whenever they want, even to the point of excess. And so health care becomes not just a means to feeling better, but a luxury good to be consumed with lavish abandon.
Because the private system thrives or dies on the profitability of health care providers, a nation with a system lack of health care orients its health goods and services towards those that yield the highest profit margin. Pills, treatments, operations, machinery, clinics -- all become health care "offerings" to be packaged and sold in a competitive market. This approach transforms health care into a market full of incredibly high quality, modern, and expensive procedures with fewer and fewer clients and customers to purchase them. Meanwhile, because prevention is a less profitable business, it becomes a bottom shelf item.
Those without health care, by contrast, live in a much different world. For the have-nots, appetite for procedures and pills in the health care market is replaced by constant concern about a future health crisis or incident. Life without health care becomes a constant game of odds making: I if I spend X dollars on this procedure, will I be able to afford Y and Z 18 months down the road? How long, at my age, would it be wise to go uninsured? Can I risk coverage for my children, but not for myself? Is 5 years too long to go without getting a full physical? How about 7? If the lump in my breast does not hurt, can it be that bad? And so on, and so forth.
What happens when millions of people spend decades without health care is so shocking and so heartbreaking, that anyone who thinks about it would be instantly offended by the current Congressional debate.
During the presidential election, CBS ran a piece about an American relief organization called Remote Area Medical (RAM) that ignores the health care "debate" and sets about doing what is right. RAM sets up free emergency clinics in Latin American and African jungles, but which had recently started setting them up in urban America.
I have spoken to countless friends and colleagues about this 60 Minutes spot, and each time I do I always say the same thing: I bet you cannot watch this short video without being moved to tears and without being utterly appalled at the selfishness and callousness of those who would deny Americans the right to health care -- the right to live without fear.
I will throw down that same challenge here:
That is America, right there -- the good and the bad. Those people in Knoxville, TN, are in desperate need of medical care, and they are getting it via the generosity of a few selfless doctors, volunteers, and philanthropists.
But we cannot stop by patting ourselves on the back. We must see that the people who turned out in the middle of the night, who stood in line for hours -- these are people living with constant, crippling fear. It is a fear caused by a "debate" that has denied them health care for decades.
Moreover, these Americans are not just in Knoxville. There are more than 50 million people in this country living without any or adequate health care coverage and 50 million is a number far too vast to imagine. They, are, everywhere. Wherever there are people, wherever you are, in cities or in the suburbs -- you are standing near people without health care.
To debate such a thing is folly. It is akin to debating which mode of production produces a better boat while sipping brandy on the deck of the sinking Titanic.
Instead we should be making a list of every possible way to lift people out of these health care dead zones -- zones devoid of health care for decades -- such that they are able to live lives free from crippling fear.
A "public option" for health care is not the only solution to the fear on the faces of the have-nots that turned out for to the RAM clinic in Knoxville. Nonetheless, a public option is one solution and for that reason alone, it should not be thrown out of a Congressional health care plan.
For the Congress or the White House to toss out the public option because they cannot win the debate would be to ignore the true goal of reform: ending fear.
Congress needs to sit down and watch the CBS spot about Remote Area Medical. Congress needs to see the fear on the faces of those good people in Knoxville and see it vanish when they are given the health care they need. Congress needs to wake up and do what is right on health care -- what is right for people, not what is right for debate.
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