Friday, November 28, 2008

Universal Health Coverage

In this week’s Nation (Dec 8, 08), Alexander Cockburn has a very good column that includes the following: “Last week I had the usual urge to machine gun the TV set while listening to the McLaughlin Group, all of whom presumably haul home at least $200,000 a year, as they deplored the unconscionable wages of the line workers in Detroit.” He continues on looking at the Wall St. Journal’s editorial policy (“…the WSJ’s editors have always taken a stern line on letting the weak die in the snow.”), and the fact that letting the US automakers collapse while bailing out the financial sector (and quoting Paul Craig in Counterpunch “A country that doesn’t make anything doesn’t need a financial sector as there is nothing to finance.”) is heavily anti-union in motivation and essentially racist in eliminating the strongest source of good jobs for black workers.

But the attitude of the McLaughlin Group is not limited to reactionary TV pundits, who obviously feel that they are contributing something valuable to the economy. All policy recommendations come from the “prominent” who, when they advocate implementation of restrictions and limitations, are never part of the group that will be negatively effected. Shortly before the election, at the recent national meeting of the American Public Health Association I attended a session inaccurately billed as a “Town Hall Forum” to solicit input on policy from the membership. (It was in fact an hour and a quarter of comments from five illustrious panelists; when a member of the audience went to the microphone as it was opened for the last 10 minutes of the session to express his opinion, he was cut off by the moderator asking “What’s your question?” Whoops.) The general tenor of the panelists’ opinions, with the notable exception of Quentin Young, President of Physicians for a National Health Program and a former APHA president, was expressed by the one who, in response to calls for a universal healthcare program, said “We can’t let the perfect be the enemy of the good,” presumably meaning that if we insist on covering everyone, we may not be successful in getting a program that covers some more people. I will not name that individual, nor the organization for which she works, not only to protect her honor but because the rest all said essentially the same thing. Suffice it to say, she will not be one of those left out if we implement the “good” instead of the “perfect”. The talking heads never are. When was the last time, even in private but certainly in public, you ever heard someone say “I’m really suffering without health coverage, but don’t worry about including me and my family in your health reform plan. We don’t want to let the perfect be the enemy of the good.”?

We hear a lot of talk about health reforms other than single-payer universal health care, such as health savings accounts, employer mandates, buying more people in to insurance-company policies, all of which will cost a lot more and not cover everyone. Last year the Kansas Health Policy Authority (KHPA), a government agency, on request of the legislature and with private foundation funding, commissioned a study on possible health reforms in Kansas. It found that a variety of programs that would cover a few or some more people would all cost about the same. Except single-payer, which would cover everyone and save a minimum of 10% ($800,000,000) compared to current costs, and possibly up to 30%! Of course, such a program, covering everyone while saving a lot of money, was too radical for the KHPA to recommend to the legislature, so they recommended one that would cost a little more money and cover about 1/3 of the currently uninsured. To no avail; not only did the legislature not implement that recommendation, they implemented none of the ones the KHPA made, including those urging people to lose weight and exercise more!

It behooves us to remember that all the talk about non-single-payer programs comes from politicians, policy wonks, professors, pundits and other talking heads. As Dr. Young said, there is only one movement for health reform that actually has regular people in in – labor unions, churches, professional and community groups, and plain old folks who may not have or worry that they may soon not have health insurance – and that is the movement for single payer. We need to make sure that they, and we, never let the pressure up, that the hope generated by our new administration is not smothered by the blathering of self-righteous “important people” who know what is best for everyone else, as long as they do not have to suffer the consequences themselves. We need to hold strong to the simple call to:

Cover Everybody!

Although I do think we need to respect difference of opinion, as long as they are honest and the proponents are willing to live with what they propose for others. I am thinking of a bumper sticker that says: “If you don’t think we need a program to provide health coverage to everyone, it’s ok. We can leave you out!”

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