The first misconception in the health care debate is the portrait of all of us as "consumers" of health care.
If we are ever going to build a genuinely humane society, we need to discard the notions of consumerism when it comes to the most basic factor of our humanity -- our health.
We already have that expectation when it comes to our personal safety with publicly guaranteed police and fire services. But somehow our health, our life, has become a commodity.
Sen. Barack Obama's healthcare plan, announced today, is yet the latest to perpetuate the present misguided system that sacrifices all of us to this concept.
Mirroring others before him, Obama's plan rests on expanding the girth of the private insurance industry, largely through federal subsidies to help uncovered low and moderate income individuals and families buy insurance.
While Obama would not force all individuals to buy insurance, in contrast to the John Edwards plan or Massachusetts-Arnold Schwarzenegger model, he would require all children have to health insurance; presumably the kids themselves will not be paying the premiums.
There's yet another gift to the insurers, and to big employers to boot, using public funds to reimburse employers for catastrophic healthcare expenditures.
Borrowing from the Massachusetts law, Obama also sets up a National Health Insurance Exchange to guide individuals through the convoluted insurance maze, with the supposed stick that insurers would have to offer "fair and stable premiums" and meet other standards to qualify for participation. It's not working in Massachusetts, and won't work for Obama either.
Under Obama's plan -- and all the others before him, of course -- the insurance industry continues to govern our health. No matter how many layers of transparency or sweeteners are piled on top of the system, the insurers are not going to change their intrinsic behavior, any more than you can expect an alligator to stop eating meat by giving it time outs.
In his brilliant new documentary Sicko, Michael Moore gets it completely right. The problem is not enough insurance or even making insurance "affordable." It's the insurance industry itself. Until we can pry our health out of the cold, cruel hands of the insurers, the system will never fundamentally change, and millions of Americans will continue to be abandoned and mistreated.
Moore explains with heart wrenching profiles of people with insurance who are nonetheless denied the care they need. None of those individuals need more insurance, they need more care. He then deconstructs the insurance based system to show us how it works, and how the industry maintains its power through the buying and selling of Congress.
And, Moore contrasts our healthcare debacle with other industrialized countries where enriching the private insurance industry is not the first focus of healthcare policy.
Obama could have easily gone down another path. He once suggested that a single-payer model, such as exists in Canada, one of the countries Moore visited which has a genuinely universal system, would be ideal, but then backed away.
Obama's speech today was filled with recognition of the plight of those millions who face bankruptcy for high medical bills, and even concludes that "the biggest obstacle in the way of reforming this skewed system of needless waste and spiraling costs are those who profit most from the status quo - the drug and insurance companies."
But when Obama notes "it's time to let the drug and insurance industries know that while they'll get a seat at the table, they don't get to buy every chair," he's missed an opportunity, and made the wrong choice.
The insurance companies have not just bought the chairs, they've bought the table as well. Or to thoroughly mix the metaphor, we won't cure the sickness by using public money to buy more deck chairs on the insurance industry Titanic.
There are only two approaches to healthcare reform. Keep sailing on that insurance Titanic, or enact a humanitarian system that ends the insurers' stranglehold. There is such a proposal. It's John Conyers' HR 676 in Congress, or similar state versions, such as SB 840 in California. They establish a "single-payer" system in which one public entity collects and distributes all the funds and dispenses them for delivery through our current, mostly private hospitals, clinics, doctors, and other providers with guaranteed, comprehensive healthcare for all.