A few weeks ago, Republican Scott Brown won Massachusetts's midterm US Senate election to fill the seat vacated at late Senator Ted Kennedy's passing. Many considered the race a referendum on the Obama administration and the Democratic Party in general.
Assuming all the hype about what the outcome of this race means is true, I'm not surprised a Republican won it. Whether Democrats and their liberal-biased media are willing to admit it or not, Obama's approval rating has been plummeting. Obama's perceived lack of action on issues that matter most on Main Street (as the political rhetoric goes), particularly on the economy and health care, has translated into understandable dissatisfaction about his administration. For someone who made so many campaign promises, he might rightly be accused of over-promising and under-delivering.
Truly, Scott Brown's victory in a state as blue as Massachusetts is something for Republicans everywhere to celebrate. Senator-elect Brown has promised, among other things, to be the 41st vote against the proposed Health Care Reform bill, thus subjecting it to filibuster and likely mitigating Democrats' ambitions to deliver their much-anticipated and highly-scrutinized government-option and coverage-for-all legislation. The conservative right has successfully persuaded Americans they stand to lose quality of care by providing basic care to the uncovered and under-insured.
In fact, the conservative right has successfully persuaded many Americans that Obama's change-bandwagon on which the whole country so enthusiastically hopped 14 months ago might be leading us down the wrong path yet. Moreover, they've been so successful in their moral crusade against all forms of lascivious Obamanation that siding with the president on anything... well, they might as well be siding with the devil in their conservative base's eyes.
The president pointed this out to Republicans at a retreat that House GOP leaders held the day after the recent State of the Union address. This tendency to oppose everything that could be perceived as coming from any source outside the Republican Party has paralyzed the political process. To be fair, Democrats haven't exactly been earnestly seeking Republican support for their ideas in recent months. Perhaps Senator Brown's election will open their eyes. But the notion that "if we can bring down the president on health care reform, we can defeat him" or that "this will be his Waterloo" isn't helping the situation. More recently, Republicans' continued obstinacy in the face of President Obama's outreach for discussion and compromise on health care is further evidence of their unwillingness to work with anything from outside their camp. The ensuing political gridlock isn't serving anyone, especially not the people we elect our officials to represent. Shouldn't we (and they) all be rooting for the Patriots rather than the Elephants or the Donkeys?
Our Declaration of Independence states that "Life, Liberty, and the pursuit of Happiness" are "unalienable Rights" "endowed by [our] Creator," and that "Governments are instituted among Men" "to secure [them]." These words are planted carefully in the hearts of children and rooted firmly in the minds of adults across our country. It's what we stand for.
Ironically, despite our nation's status as the birthplace of modern democracy, we are alone among our first-world peers in not understanding that it's hard to experience any of the three aforementioned unalienable rights when plagued by a chronic but curable disease or when worrying about how to pay for a desperately-needed but unaffordable life-saving medical procedure.
Our first-world counterparts in nations around the globe have made a choice we Americans have not yet been willing to make. To paraphrase a British friend of mine, Brits decided years ago that no one would die because he couldn't afford medical coverage. Not on their watch. There, citizens have decided that health care is a question of dignity, not one of dollars and cents or pounds and pence.
Is it really that far of a stretch to expand our understanding of unalienable, God-given rights to expecting that in the richest country in the world, no one should die or suffer unnecessarily when the technology and trained professionals are available to save and to heal? Are we so depraved?
How introducing the public sector into a previously private market will affect the competition in providing health care remains to be seen. This competition, after all, is what ensures options and second opinions as well as the research that develops the cutting edge treatments for which America has become renowned.
Or is it?
In looking around us, other countries, including Mexico, have successful public and private options for health care. In the UK, despite a fully-developed public option, many employers also offer successful private insurance plans. Furthermore, medical research and discovery continue at a healthy rate in the UK, despite public-sector health care coverage. In America, Social Security, Medicare, and Medicaid have neither destroyed nor crippled private-sector health care, despite the sentiment and arguments to the contrary at the time of their approval. These same arguments against a public option in today's debate are without precedent in this country or abroad.
The statistics on the issue of the uninsured are staggering. If 15% of America's population is uninsured, that's 45,000,000 of us. Even if you take the conservative estimate of 10% (which is the current unemployment rate, so it's hard to imagine an uninsured rate less than that), that's 30,000,000 Americans.
According to these conservative estimates, on average, between one in seven and one in ten of our friends and family members does not have health insurance. In certain parts of the country, the numbers are much worse. To which of our friends or family members would we choose to deny coverage? Which of our children does not deserve health care?
While we might not be aware of it, many of our immediate connections are uninsured. It's surprising how many of us fit the description. As a child of successful, self-employed parents, my family and I were members of this demographic all throughout my childhood. More obviously uninsured are the unemployed, but in these woeful economic times, who among us hasn't either been without a job or had an immediate family member lose a job? Will we choose to deny our families coverage?
Many of the uninsured are the very people who are trying to pursue the American dream. Their creativity and entrepreneurial spirit drive our economy. For them, this dream is just out of reach. With nearly 50% of American households involved in home-based business opportunities, we all know someone who works from home. When both parents work from home or for a small business, there's no affordable solution for health insurance.
Even university graduates can't afford health insurance. It is only now that I have found a job with a large employer that I am beginning to understand what it seems the insured 255,000,000 - 270,000,000 citizens of our country take for granted: the peace of mind that comes from knowing that if something terrible happens, I'm covered. For the last 6 months since graduation, however, I've been uninsured.
So why are so many Americans not insured? Is there any reason health insurance can't be purchased like car or homeowner's insurance? I don't have to work for a large corporation to purchase either of these latter forms of insurance at affordable rates, so why not health insurance?
The truth is, the only thing standing between the uninsured and affordable insurance is a corrupt health insurance industry and perverse incentives governing the health care delivery system.
But before we simply insure everyone in this country, let's consider the incentives involved and how their consequences will impact us taxpayers who are footing the bill and supposedly benefiting from it.
In our country, private firms have historically delivered health care as a business service. Like all businesses, health insurers and doctors' offices respond to economic incentives to maximize profits. To this end, these businesses must either increase their net income or decrease their expenses. And so in this, America's current health care delivery system, we shouldn't be surprised to see both health insurers and doctors' offices extracting every penny possible from us and each other to compete and get ahead. Moreover, we should expect insurers to raise premiums (increasing net income) and find loopholes in coverage policies to avoid paying out (decreasing expenses) to the extent they can get away with it. As covered as we feel as insured Americans, our private health care providers are still more motivated by maximizing profits than by paying out benefits.
In addition to insurance companies' incentive not to pay out, doctors and their practices bill--either through reimbursement from insurance companies or out of the uninsured's pocket--based on the number and types of procedures and tests they perform. What incentive do they have not to perform the most expensive procedures as frequently as possible, even when they're unnecessary and repetitive? What incentive do they have not to up-sell us on procedures we don't need?
Unfortunately, America's health care delivery system has reduced health care to responding to such economic incentives as these. If we are to demand the best, most-appropriate care for our medical condition, we must remove money from the decision equation. We need doctors who provide what is needed, not what costs the least or earns the most. When doctors' decisions regarding procedures and care are tainted by financial incentives, that is when we lose quality of care. Likewise, we need patients who aren't worried about price tags when they enter doctors' offices and ask about available treatments. Should we not exhaust all resources in a reasonable attempt to preserve human life? Doctors and their offices need the freedom to do what is appropriate and decent rather than what is fiscally prudent. Only then will we experience true quality of care.
And so we stand at a crossroads in our history: will America, the birthplace of modern democracy, continue to be the only first-world nation not to offer health care to its citizens? Will health care in this country continue to be a question of money and status, or will we finally grant to all our citizens the human dignity and unalienable rights our Declaration of Independence claims we endear?
The suspense is killing me.
