Congress Needs to Wake Up on Healthcare
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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Every official should view the R.A.M. video from "60 Minutes" in this piece. It is incredulous for those inside the beltway to debate, cajole, argue and disagree on the need for healthcare - - - like one blogger recently put it, conversing about which wine to have for dinner - - - while on the Titanic after striking the iceberg. The time for debate is over with; now is the time to put into place a solid piece of legislation that will help all Americans so that Obama can sign it, and sign it this year.
Please sign these petitions!!
http://ga3
http://sta
http://www
Let those in Washington know we DEMAND a public option!!!!!
On the issue of health-care reform, the problem is that Congress and the health-car
Home Run Mr.Feldman
More programs like this should be shown to the Public, and Congress. Maybe it would shame them into doing something.
I remember Citys in S. Fl. in the 60s who were shamed into paying their Fire and Police a decent wage when the City Council found thier employees qualified for Food Stamps.
I also remember in the 40s seeing a small town Doctor in E. Texas, walking through the wet red clay mud road (impassable for cars ) Pants rolled up carrying his shoes in one hand and medical bag in the other. Comming to give a little sick kid medical care, that I doubt we were able to pay for. In the cold winter.
Didn't think the still made Doctors like that any more, BUT you found some in RAM.
Now thats HealthCare you can Believe in.
What America does with its current immoral and grossly unfair health care system will be one our nation's defining moments.
How we evolved into a nation based on Judeo-Christian values to one which now treats human health as a commodity in the marketplace is almost unfathamable?
The world is watching to see if we finally rectify this wrong.
And of course our sufferring fellow US citizens deserve better.
Dr. Rick Lippin
Southampton, Pa
http://med
Most members of the House and Senate simply cannot understand the plight of those with no health care. They have a great plan and most of them are wealthy, at least by the standards of those of us who never made more than $35K a year. Most of my working life, I made between $25K and $30K. After living through cancer in 1997, health insurance went from $360/month to $970/month, payable 3 months in advance. I could not afford that and gambled on waiting for an operation to remove a growing cyst for several years until I turned 65 and could get Medicare, a wonderful plan for patients at $96.40/mon
"a systemic lack of health care (1) divides a nation and (2) cripples it with fear."
Fear has been a tool of government for a long time and was the first tool of choice during the GW Bush administration. Unfortunately the use of fear has not diminished since we rejected Bush's policies, but have been taken up by think tanks, a lot of media outlets and most corporations.
President Obama, talking about golfing, said it got him outdoors and outside the Washington bubble. The rest of the time he and our lawmakers live within that bubble, divorced from the daily realities of the nation's citizens. No wonder the Neo-conservatives think they can create their own reality, they never have to see the reality of common people. It looks like our new President has fallen under the spell of that bubble.
Remember when being a Liberal Democrat used to mean something?
And who will get public healthcare? Will illegal immigrants have access to it? If so, does that not give them more incentive to immigrate here? And how will we pay for a program that will basically take over 1/6 of our economy? And how will it be different from Medicare/Medicaid, which have shown huge inefficiencies and cost states (like California) millions, if not billions, of dollars?
I understand that you feel for people without healthcare, but to say "let's not debate and just do it" is grossly irresponsible. The last Census Report done on healthcare showed 47 million people uninsured, of which have of that number related to people who could either afford healthcare but did not purchase it or were eligible for existing healthcare programs but did not apply. The remaining 23 million (or 7.7% of the U.S. population) includes illegal immigrants in the number. It's not as bad as you make it.
Actually it is worse than we make it. Even with private health insurance the deductible and co-payments can bankrupt people on the lower ends of the wage scale. At the same time wages and hours are actually shrinking in this recession.
Also, if a person without insurance needs an expensive procedure, medical corporations have been known to highly inflate the price of that procedure knowing the person can not pay. This then goes on the books as a loss (at an inflated rate) which affects the corporation's bottom line which is then used as an excuse to additionally raise prices. This is outside the large administrative cost added onto medical bills through insurance company paperwork and efforts to disqualify payments to increase their bottom line.
Economic freedom is being eroded away in the "land of the free", and our ability to live free is now threatened with extinction in our democracy.
No it's not. Lefties use the same argument when it comes to Cap and Trade and other Environmental protection laws. They say the debate is over, we need it now or dire consequences will happen. Forget cost/benefit, forget all the questions that arise from such huge expansions of government control.
This is how consolidation of power happens. By frightening the heck out of the masses so they'll give up their freedom for some promise of security.
So in your ideal world, people should not have to weight cost/benefits of medical procedures? What do you imagine that will do to costs? Oh yeah, you don't think costs are important. They will be when your standard of living plummets to pay for everyone's free health care.
Yeah, sorry you got that cancer. You should have gotten a better job, then you could REALLY afford it! Can't afford to get that check up to see if you have swine flu? Not MY problem. Gee, I hope none of your kids get sick because that's really going to affect your credit rating OMG NO!
OR how about gee sorry you have cancer but you'll have to wait awhile for the operation because we are rationing our services.
Our standard of living is plummeting as we speak, and we haven't gotten anything for it yet.
Cost/benefits SHOULD be weighed, and weighed equitably--that's precisely the problem. Right now, access to medical care is NOT measured in a cost/benefit analysis, except insofar as it will COST the insurance company and they will BENEFIT by not supplying it. in other words, it's all profit-driven, and that is immoral. It also runs counter to any notions of good medicine. Should we all have access to free MRIs on demand? No. But should someone with cancer have access to quality medical care? Yes. How should that be determined? By medical experts, using high quality data (gleaned from electronic medical records which help to determine standards of care) to make their decisions, and NOT by profit-driven insurance companies concerned about how much it's going to cost them.
Only someone who hasn't had to struggle with an insurance company to get NECESSARY MEDICAL CARE could be naive enough to imagine that we don't live under a system of rationed care already.
http://hea
Health Care '09 - March on Washington DC for Health Care that INCLUDES a Public OPTION. June 25th, 2009.
They're awake.
They know where the BIG money in their campaign chests is coming from and it isn't us.
Thank you for the thoughtful piece. We've reached the point of philanthropic "Doctors without borders" sort of aid here on our soil. Wow. Sad day. We, with the "best health care in the world" (LOL).
Have read numerous posts by Canadians talking about their love of their great health insurance system. Please Canucks! Help us! Bombard these sites with your stories and shine some light on the propaganda out there that your system is a disaster. Many (most?) here know its not, but it gets played to the hilt. SOS! Help!
Ha! Republ!can voters.
Congress is doing the bidding of corporations, not the people. Until we boot the lobbyists out of Washington and radically change campaign finance, they will not serve the people.
Congress gets big paydays from the health insurance companies and the AMA.
Maintaining that is their concern - they don't care about doing right or helping people in this country - they care about the money, and that is all.
I expect they will never give this country real health care.
mark
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