Hot of the presses from Facebook a couple of hours ago...
This time of year, where the weather cycles up and down between warm and cold tends to leave me with bad head colds that migrate between my head (leaving me with horrible sinus pressure) and my chest (leaving me staggering around, wheezing like a 65 year old with emphezema) so from time to time, I use an inhaler, just so I can, you know, breathe. So, when the day after the Health Care Bill passed I found myself in the Walgreens drive-through trying to get a refill for my inhaler, I was somewhat astonished to be told that I had to wait two days to get the inhaler if I wanted insurance to cover it. Now, I'm a big boy, so I can suck it up for two days, take an allergy pill or two and hope for the best, but the thought stayed with me: what if I wasn't such a big boy? What if I was working three jobs, barely scraping by and the inhaler wasn't for me, it for my kid? I could have, if I was desperate, paid the 48 bucks and gotten the inhaler. As it was, I decided to wait two days and pay 5 bucks, but my choice was easy. For other people, it may not be that easy, in fact, it may be damned difficult.
All of which stuck in my head: something has to be done about health care. In a country as rich and as prosperous as this one, no one should have to choose between housing and medical care. No one should have to choose between food, rent or health care. People should have access to quality, affordable health care. Unfortunately, once we move beyond that basic tenet, things get complicated. And despite the fact that I have serious misgivings about this bill that doesn't make me some kind of narrow-minded, gun-toting red neck. And because I think we need comprehensive health care reform of some kind, that doesn't make me a card-carrying member of some vast left wing conspiracy to turn this country into Cuba either. If I'm sick and tired of anything, it's of being asked to choose between the extreme left and the extreme right. Both choices are anything but palatable and I refuse to 'pick a team', especially if those are my choices.
But what do we do? Do we let the free market have its day or do we move to a single payer, purely government run system? Other than my Walgreen encounter the other day, I can't say I've had many negative experiences with insurances companies over here. On the other hand, being from the UK and having family in the UK I have seen what government run health care looks like up close and personal. I've never been treated by the NHS, but I've had grandparents who have. My Grandad was forced to wait for months to treat what was a fairly minor prostate condition. Over here, it would have been a simple outpatient procedure that would have been covered under the most basic health insurance. There, he was made to wait. And when you're getting on in years, a few months of having to get up and pee every few minutes or so is more of a task than it used to be and drastically impacts your quality of life.
When my Grandma's health began to decline, the family wanted to get her into a long term care facility, but was again forced to wait for a place to open up. That summer, we went to visit her and it was one of the hardest things I've ever had to do. The temporary facility where she was was tiny, understaffed and criminally overpopulated- the idea of 'care' if it could be called that was to wheel the old people out into the living room, turn on the television and pretty much leave them there. These experiences may not be an accurate reflection of what life is like under a single payer, government run system, but they left a very bad taste in my mouth and make me extremely uneasy about a purely government run system. Governments, wherever they are breed bureaucracy and inefficiency- they are not good at 'running' much of anything. And if you don't believe me, call me and tell me how it goes next time you go to the DMV.
Basically, what it comes down to for me is this: I don't trust the government, I don't trust corporations, I don't trust insurance companies and I don't have any faith in the magical powers of unrestrained capitalism. Given these four basic tenets, how then can I get a health care bill that works for me? For me, two things need to happen- first, this Bill needs a massive clean-up and trim down. Secondly, we need political leaders who are willing to work towards a true transformational moment in the early decades of the 21st Century.
But first- let's clean this bill up. I'll accept that political realities may have caused proponents of reform to make any number of crappy deals just to get something passed. But now that something is passed, the work shouldn't stop. In every way, every day, the fight should go on to make this a better bill. That means ending the payoffs for Big Pharma, for the Unions, for the states of Louisiana and Nebraska, closing the anti-trust exemption for insurance companies and forcing them to compete and some kind of tort reform so that Doctors aren't forced to charge everyone up the butt just so they can afford medical malpractice insurance to cover their own butts. As was pointed out to me, this is a start. Yes, it is a start and starts are good- but it wasn't the start I wanted and it sure as hell doesn't feel like a particularly auspicious start to me- and this whole big-ass mess of a health care bill has a long way to go before it's enthusiastically supported by me and certainly palatable to me.
The second thing we need to do is we need a national conversation about the true transformation that needs to take place as we dig further into the 21st Century. Everywhere I look, I see media accounts describing this as the most significant piece of social legislation in almost a century. And as the crowning jewel of the New Deal, it would be a brilliant piece of legislation- if this was the Johnson Administration. What do I mean by that? Well, the foundations of the modern welfare state- or the social safety net, whatever the hell you want to call it- for us and for most other Western Democracies, those foundations were established in the 30s and 40s during and after the Depression and World War II. Unfortunately, those economic foundations are increasingly irrelevant in today's fast-paced global economy. Our safety net was built around the idea that people go to college and then get a job they keep for thirty years until they retire.
And that's just not true anymore. In fact, the foundations things like the New Deal were built on are going to be increasingly unsustainable over the course of the coming decades- and herein lies the true transformational moment that the President missed. The opportunity to restructure and redefine the social safety net for the 21st Century economy we live in today. The opportunity to ensure that the promises of the last century will be available to generations to come- because as it stands right now, I'm not expecting Social Security, Medicare or anything when I retire. Such a moment would have ensured the President's legacy for centuries to come and would have given American Liberalism a much needed shot of intellectual vitality that would enable it to move beyond the dessicated corpse of the New Deal and actually into the future for once. It's time to end the reactionary strain that's infected the left. It's time to move into the future, once and for all and ensure that when the government makes promises, it can actually keep them.
But at the end of the day, something has to be done with health care. And Republicans, please note- I will not vote for any of you if you're pushing for a full repeal. I want to know how you're going to clean this up for the American people. I want to know that you want to excise the special interest kickbacks and give aways and actually work towards meaningful reform that's sustainable in the long term.
Yes, this was a start. It wasn't the one I wanted, it wasn't a super-good one, but it was a start and things like this need to start somewhere. We need to clean this thing up and make it better- and that needs to start right now.
So, who wants to get to work?
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