Thursday, October 15, 2009

Health Scare Reform

I don't want to write this post. I don't want to relive the agony of watching family members wither and die because a treatment wasn't 'covered' or was 'experimental'. I don't want to be reminded of living six years in personal agony because my condition wasn't sufficiently acute to warrant a surgical repair. I don't like being reminded with each step I take of the permanent nerve damage that resulted from the delay. I don't want to recall my drug-induced fog of depression the family was forced to endure as a result. I don't want to think of the knife-edge my family still lives on because of pre-existing conditions and unaffordable health care coverage. I despise knowing that we can't afford to get sick. I don't want to write this post; yet I must.

As we are wont to do in this country, we have chosen up sides in the health care game and sent our warriors into battle. Shirts vs Skins with most of us on the sidelines rooting for 'our' team. Like some of the fans in this metaphorical contest, a few get way too deeply involved in winning at any cost and lose sight of the greater prize, the love of the game. It's easy for insurance companies to sway the poorly informed who lack the time, perhaps, or the resources, or even the capacity to understand what is at stake. It is simpler still to scare elders with misleading innuendos and damnable lies about what is proposed in reform packages. It is cynical, dangerous and ultimately not in the best interest of the public or the forces that seek to defeat reform. It is time to embrace the word re-form in its most fundamental sense. Let's 'improve by alteration, correction of error, or removal of defects' as the dictionary suggests.

Let's begin with the notion of what health care is and isn't. It is essential in a modern society. Maintaining a healthy populace is not optional in the age of the Internet. Economies worldwide depend on a well trained cadre of producers and consumers to keep things humming along. Interconnectedness is the rule now, not the exception and keeping up means keeping fit and ready for action. This cannot occur in the system currently in place in the U.S.

In the rural, agrarian nineteenth century, health care was often distant, ill informed and performed in crude settings by people with marginal skills. Even in the best of circumstances medicine was performed by common sense and instinct with a dash of experience tossed in. In the same time frame producers, industry and labor were engaged in titanic struggles for control of the levers of power. Rail lines colluded to fix prices for transporting goods. Steel producers drove smaller competitors out of business with unfair practices. Oil giants cornered markets and crushed competition. Does any of this seem familiar? More recently financial manipulators created paper phantoms that were meant to look like money and profit, but in the end went right back to the heart of the nineteenth century; they stole dreams and dollars from the most vulnerable among us with our unwitting consent. Everyone was chasing the elusive American Dream right down the rabbit hole. The common denominator was money, corruption, collusion and manipulation (or outright purchase) of legislators. I ask again, does any of this seem familiar?

The solution at the turn of the twentieth century was for a courageous President to bully Congress into reform. Theodore Roosevelt, Republican conservative to the core and part of the elite moneyed American aristocracy, broke the trusts. He understood that when any industry corners a market it's first instinct will be to bleed it to death, then move on looking for another body to turn into a carcass. Unconstrained profit motives drive companies and their leaders to kill the host without considering the consequences to the parasite. It is an exquisite death spiral that is even now being played out in Washington D.C. Look no further than the financial industry crisis, the insurance crisis, the housing crisis and subsequent market meltdown as proof positive of the postulate.

So, what to do? What we have now clearly doesn't work. It seems to me that we have missed something in the analysis of What To Do Now. From time to time government has seen fit to alter the relationship between business and consumer by deeming a business as essential to the modern functioning of society. We call those businesses utilities. When it became apparent that electricity was going to be essential, governments set out guidelines. Everybody needs the service so yes, Mr. Businessman, you may make a profit, but you may not rapaciously exsanguinate your customers. Water, sewer, garbage hauling, cable TV and sometimes even cemetary districts are all public utilities. Employees are properly compensated, CEOs make a decent living, investors make safe, if relatively modest returns and the public is provided with an essential service. Sometimes those services are provided by government agencies, like Medicare and Social Security, sometimes by private companies like Puget Sound Energy or Con Edison, but they are provided. Is their performance perfect? No, humans haven't quite conquered perfection yet, which is why our Constitution seeks to work at perfecting; understanding it will be a task always in progress.

Until meaningful reform occurs we are all at risk. Our nation, our status in the world of nations and our chance to compete into the future hang in the balance. Those who claim to love the health care plan they have now have probably never had to truly test that plan. I pray for their sake they never will. Let's support another President seeking reformation of dangerous business practices. Let's not screw this up. Let's not settle for second-rate. Let's win one for the gimper. That would be me.