The first of the newly created Mother-Son Debates focuses on Health Care Reform.
Russell’s (Son) Position:
The US will have universal health care (some form of it) within 15 years. As the only industrialized nation without it there’s not much precedent against it. The United States does not yet feel the necessity for covering everyone and was very much lagging behind other countries in the discussion of health care reform. Most industrialized nations started the debate early in 20th century and were well on their way/done with the basics by the end of WWII – many countries out of necessity due to the high costs of WWII. The continued superpower status and relatively rich population keep reform at bay. A prolonged high unemployment rate and lengthy war deployments may push things along further faster. Major reforms do not come about because of consideration of specific/individual trials and tribulations – a country needs a statistically significant number of citizens experiencing general difficulties. Health care reform doesn’t differ drastically from education, transportation nor the military. These are things we all want/need but don’t see the immediate value in. We simply had several more centuries to figure out that a more educated, mobile and protected society is going to be more productive (no other justification is required for reform). Furthermore, health care didn’t need to be figured out before early1900s because most people didn’t live long enough (lifespans in industrialized countries were still around 50 years or lower) for end of life medicine to be such a burden on society. With the end of major world wars, improvement in nutrition, widespread clean water and germ theory people lived longer to be exposed to more complicated illnesses. Medical technology progressed enough in the 1900s to give people hope they could cheat death long enough to make death something we didn’t handle culturally very well. So here we are today: still wealthy enough to think we can pay for all this health care out of pocket, still avoiding conversations about death and still about two decades behind the rest of the industrial world on social issues. We’ll have universal health care, but it won’t be activism that brings it about. Activism might move it along a year or two sooner and help us integrate the inevitable reform.
Donna’s (Mother) Position:
Healthcare is a basic human right, and as such, to be protected as a public good. All of a civilized society benefits from providing a progressively financed, single standard of high-quality healthcare to all of its citizens.
In the United States, a healthcare system centered on employer-based health insurance benefits developed and expanded in the mid-to-late 20th century. But this system leaves large segments of the U.S. population with either no coverage for even basic healthcare needs or inadequate coverage.
Costs are exploding for individuals, companies and public entities, and though more than 16 percent of the U.S. gross domestic product is now consumed by healthcare, more than 45,000 Americans die every year simply due to lack of access to care.
The U.S. is the only industrialized nation not to provide universalized access to healthcare to its citizens, and the World Health Organization reports that in several of the major measures of health outcomes, the U.S. lags well behind (life expectancy, infant mortality — to name just two). We spend more than twice as much per capita on healthcare and yet our outcomes do not reflect it.
I’ve heard it said that if we had this level of spending on our Olympic team and our results were as poor, we’d have a society up in arms about making fundamental change. It’s like paying for the Yankees and getting a minor league team or less.
Generally we agree on the state of affairs suggesting that it’s time for reform. The economics of the current health care set up don’t work at all – it’s just not obvious to everyone as not everyone has a health problem right now and not enough people suffer from the broken system yet.
The WHO numbers and GDP numbers mean nothing to most people. Those are just numbers out there in the ether and its hard for anyone to use those as motivation to change things.
Citizens need to be up against the wall in massive numbers OR we have to have a very strong leader that can push change through.
There’s no such thing as “human rights”. We establish rights because they benefit our particular desired society. There’s nothing written in the stars that says humans have the right to freedom, education, health care… those are things WE, as Americans, value. Appealing to non-existent human rights doesn’t help move things forward all that much. Making people understand they will go bankrupt if they don’t push in reform is more tangible and is accurate.
MLK, Jr, surely did not share your view that arguing basic human rights was meaningless, nor do I. “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane,” King said. Though this topic will be more appropriately vetted in the context of other debate topics we may engage, the issue of deciding that healthcare is a right and not simply an economic or social privilege is central to the argument for fundamental change.
We could fix the financial issues for many or even most people related to healthcare and deny it or severely ration it to others if we decided not to address the human rights issues. Either it’s a right for all or it’s not. I say it is.
We must decide that all people who need healthcare should get healthcare.
The other problem with only arguing the financial implications of health reform is that it changes the tenor and the quality of the argument and ultimately taints the outcome. If we start the debate about healthcare, it will be about healthcare. And if we have the debate about money, it will remain so. Though I do hear all sorts of value judgments tucked into the financial discussions. And so it has gone with this effort so far in the U.S. We didn’t get into the sticky wicket arguments about whether every baby or every mother or every homeless person deserves the same access to healthcare. What we did was frame the discussion about making sure we’re “revenue neutral” on the federal level and not funding abortion rights with public funds.
On to your other point, which is critical, because we view those who go bankrupt in the U.S. so negatively regardless of the causes of the bankruptcy (and we punish that with years of bruised credit ratings, loss of social status, difficulty in securing housing or even jobs, damaged personal relationships), correcting the conditions that allow personal bankruptcy to follow illness are central to not only our economic well-being but much deeper societal conditions. But in order to truly end the conditions that allow bankruptcy to follow a cancer diagnosis or years of chronic illness treatments, we will have to create a healthcare system that value all human life equally. There is no other way in my view.
We cannot keep all individuals or families from experiencing financial disaster from a wide range of calamity, but other nations have certainly found ways to prevent it for those with health problems. For instance, in some of the Scandinavian countries, during a period when you are too ill to work or the primary wage-earner is too ill to work, the family’s housing costs and basic expenses are covered. Period. Here in America, a family sliding down the financial tubes due to similar health related trauma has a much less available security net and must often wait for months into a crisis for any assistance to be made available — we also force a loss of all or most assets before many programs are opened.
Additionally, we allow health providers to aggressively go after patients and families with uncovered and unpaid healthcare bills and thereby push people toward bankruptcy who might otherwise make some recovery from the brink given some temporary relief.
Tied up in all of these policy decisions are value judgments about people and the work-ethic run amok, in my experience. Fixing all of these complex systems will be nearly impossible without the declaration that healthcare is a basic human right and from that right some protections need to flow.
Ah, good points!
So now we get to a bigger impact of reform… beyond solving the fundamental problem of how can we afford this all…. the integration of reform into our actual way of living.
You’re suggesting, I think, that if we don’t have a change of values and social behavior (the way we talk, the way we “view others”) we’ll not really succeed with reform.
I’m not yet ready to give into your human rights argument but the MLK reference is interesting because really we still don’t have the full integration of Civil Rights. Though we have laws, the laws really haven’t completely changed behavior. A good many folks still behave as though women and non-white/non-straight people are lesser (examples include college football coaching jobs, women’s pay, recent prop 8 in Cali…)
I still maintain that reform in law on health care is still 15 years off because not enough people see immediate pain in their health care. I will agree with you that even after we get reform 15 years from now we’ll still have people/corporations abusing the situation unless we hit on all those social stigmas you bring up. That’s where activism does work…. it builds associations for people where economics cannot.
A bit like how we remember the American Revolution as Freedom and a Spirit… when you, as a history buff, know that a lot of it came down to some really rich dudes sitting here in the “new world” on some pretty deep natural resources that didn’t want the King and others taking their riches…. We can wrap up that reform in patriotism so that it has power beyond its mundane economic roots. no?
Oh, but the unintended consequences can be quite something, eh? When we look back to the founding fathers we do indeed see the rich fighting the rich to secure more wealth. But somehow in all that fighting poured out some pretty powerful messages about individual rights and also the common good. Getting enough people invested in the struggle against the crown required some gathering of the masses in a common struggle and for a common goal.
And even now with the healthcare debate, those same contradictions and messages are at play. Some argue that individual rights will be damaged by most any reform that doesn’t just leave the market to handle the whole mess while others believe individual rights cannot be protected at all in only the market when one’s access to care within that market is dependent on money alone. The common good is best served by freedom of choice which some think is best granted in the private sector. Yet others argue that giving every person access to quality care is a common good and grants freedom from fear and want. Give us all one funding source and let us choose the providers in a Medicare for all type system, and wow, we would see some competition for our care, some of us believe.
Are enough people hurting yet? Yes, I think 45,000 dead a year and a medically related bankruptcy an estimated every 12 seconds is enough trauma. I just think we have a serious media and message issue along with a large number of the people hurting who are broke or sick or both and focused on staying alive rather than fighting a political or social change battle. It is very hard to be outspoken and heard when you are ill or shamed by financial trauma.
How different would this discussion be if every newscast led with the number of dead in the nation every day who lacked healthcare? If it bleeds, it leads, so the saying goes. But not really. Do the math. It’s like a plane going down every day of the year in this nation due to a lack of access to care when it could be prevented. If we had people who cared enough to make this war against human suffering in America as newsworthy as the wars overseas, the discussion would change rapidly.
Blackwater and even the larger war on terror doesn’t hold a candle to Blue Cross or Aetna of Humana or Cigna or United HealthCare. But the discussion is being bought and paid for by some very big money interests. That we must change.
Two issues you bring up:
Views on freedom: “Yet others argue that giving every person access to quality care is a common good and grants freedom from fear and want”
and the Media’s coverage of important matters:
“How different would this discussion be if every newscast led with the number of dead in the nation every day who lacked healthcare? If it bleeds, it leads, so the saying goes. But not really. Do the math. It’s like a plane going down every day of the year in this nation due to a lack of access to care when it could be prevented.”
First, freedom. Frustratingly there are millions upon millions of americans that think that ANY government involvement means No Freedom. It’s a really lame elementary school approach – but that’s when most people integrate their politics. These same millions of people fail to realize that most of their life has been funded by the common good…. roads, fire, police, education, grocery store unions, united states post office, federal reserve, military, airports, libraries, parks…. the things businesses don’t want to pony up for and aren’t good at doing anyway. I can’t disagree with your view on how freeing it would be to have a funding source that forced the caregivers to really compete.
As for the media… the numbers you publish add up… but the on screen stories don’t. 100,000 dying slowly in hospital beds is not nearly as sexy as a high speed chase or a triple murder AND the story would be the same every single night. No one, not even you wants to watch a newscast of everyone’s grandma succumbing to cancer in the wee hours of the night every single newscast. It sucks, but health care isn’t scandalous nor sexy enough to sell ad spots. and it isn’t dirty enough to rise to the top of search engines… YET!
Those millions who have allowed themselves to be conditioned for a knee-jerk anti-government reaction to any public plan discussion in healthcare are often the same millions who are on Medicare, VA benefits or in some of the most conservative farm-belt states receive farm subsidies or other government help they would kill to keep and enhance.
We saw that played out this summer in the ridiculous tea-party movement. And that movement was given loud voice and prominence by the mainstream media or it would have never have mushroomed as it did. It was such a powerful example of what lazy, controversy-hungry reporters (I refuse to call it journalism) can create.
For the masses who view news only in quick sound-bites or 1-2 minutes of on-line video, it appeared that Congress was on the verge of creating a communist state with the scary death panels and government control of healthcare that fed into old fears and biases. Telling the truth about the effort to reform didn’t create the same drama because the reporters were too lazy to tell the real stories.
Grandma’s fading off in the night with cancer? Is that who you really believe the 45,000 dead are due to lack of access to healthcare in America? If so, that’s dead wrong. Grandma’s on Medicare and gets treatment for her ills. The brunt of this crisis is not happening in the fringes of age or income. It is playing out in working families in what many thought might be the “prime” of their lives as health insurance became either unaffordable, unavailable or ineffective or all of the those things.
The poorest of our poor have some access to care via Medicaid (not always very good or available though). The rich, well, they have access. The elderly and the severely disabled have access via Medicare (though the disabled must what two years after a disability determination to access Medicare benefits).
It is largely middle income workers — sometimes with tow or even three jobs — who are not able to access care. Mothers and fathers, teenagers and single parents. Dead. Broke.
Paul Hannum of Santa Monica — 42 years old, soon-to-be-father, construction worker — dead when he waited too long due to money worries to return to an ER with belly pain that was ruptured appendix.
Yolanda Coleman of Las Vegas — 38 years old, single mother of two, full-time hotel work, breast cancer — on the verge of death as treatment cut off and hospital bed repossessed when benefit exhausted.
Jenny Fritz of Indiana — 24 year old, mother of one, and seven months pregnant — dead because she was sent home once from ER and then not treated quickly enough for respiratory illness. Oh, the baby died too.
Nataline Sarkisyan of Northridge, CA — 17 years old, denied liver transplant by CIGNA — dead after insurance company reveresed the denial too late to save her.
These are just some of the tragedies. You get the picture. Lives cut short needlessly.
If these stories were told along with pictures of the parties and perks purchased for lawmakers and the amount of money it would have taken to save each of these lives, it could make a difference. Or contrast the healthcare given to these kinds of patients in some of the non-scary nations of the world. There are many ways our media could be doing its job and simply is not.
How many of us have become so used to negotiating a broken system that we don’t realize that a minor paperwork glitch or other for-profit insurance system failure that we solve in a non-crisis situation could become the delay or denial that costs the life of a loved one or even our own deaths?
These are the realities of this struggle, yet individuals without strong supports in their lives may never survive to help shape the debate. Their stories matter; their lives matter.