How Democrats Need To Frame The Healthcare Debate
[Originally ran June 9, 2009 -- see note at bottom]
The debate over what, exactly, "healthcare reform" means is about to hit fever pitch (so to speak), and instead of diving into the legislative details of what seems to be emerging from congressional Democrats, I would like to make a broad suggestion in how they should be framing the issue correctly. Some may call this approach naive, but I truly believe that rather than fighting for one species of reform over the other, Democrats need to first adequately define the core principle they are fighting for. Their "values" on healthcare reform, to put it another way. And while it may not be achievable this time around, I think the goal Democrats should loudly proclaim they are attempting is a very simple one: nobody should ever go bankrupt because they get sick.
Like I said, this is a simple idea. Which leads to the naysayers who may call it naive, or even simplistic. But I think it is powerful because it is so simple. It's easily understood by all. And I think it would resonate strongly with all members of the public, no matter what their political stripe. As a bonus, it forces opponents into defending the current system, where medical bankruptcies happen every day in America -- which is a pretty tough position to defend.
Not everyone, and not even every family, has a personal story of bankruptcy due to medical problems. But everyone -- whether it has happened to a member of their family or not -- is terrified of one day losing everything they have saved over a lifetime, just to pay a doctor's bill.
The statistics on this are staggering, and are a national embarrassment. A recent study showed that 62 percent of all personal bankruptcies in America are due to medical reasons. The majority of which were people who had health insurance. Which makes it even more embarrassing. There are thousands of stories out there of people who thought they were doing the right thing and thought they were covered, but tragically found out (too late to do anything about it) that they were not covered when medical disaster struck.
So why not hold some very public congressional hearings and showcase a few of these stories? Why not traipse out for the television cameras sob story after sob story of people who had insurance -- and yet lost everything anyway? This would focus the media's (and the public's) attention where it should be in this debate: the real scope of the problem we face. Rather than some high-flown debate over political philosophy, why aren't the Democrats staking out their position as trying to solve the worst problem that exists, and the worst fears Americans have in the healthcare debate?
I'm waiting, personally, for some Democrat to stand up and say the following on a national news broadcast:
"Our goal as Democrats in the healthcare debate is simple -- we think that no American should have to declare bankruptcy to pay their medical bills. We think this is a horrendous problem which affects millions of people in this country, and we think it needs to end. Hardworking Americans are -- on a daily basis -- being forced to give everything they have worked their entire lives for just because they got sick. We think that is wrong. We think that is the core problem which needs to change in the healthcare industry in this country. Now, we have a few different ideas about how to go about guaranteeing that no American ever again should have to face bankruptcy because of illness, but we all agree on this same goal. There needs to be some sort of safety net to keep this from happening to people -- even people who thought they had good health insurance before they got sick. We think it is unfair, and we are trying to fix it. Our Republican opponents think it is much more important to guarantee that insurance companies and doctors and drug companies rake in obscene profits, than to guarantee that those profits will not come at the expense of someone's retirement savings. They keep using words such as 'freedom' in this debate, so let me be crystal clear -- what they really mean by this is 'the freedom to go broke when you get sick.' That is unacceptable to me, and unacceptable to the Democratic Party. And that's why we are trying to change our broken system. We invite Republicans to join us in this fight, so that never again in this great country will anyone have to face a bankruptcy judge from their hospital bed."
Is that really such a hard concept? Or do you think it would resonate with the public at large? So why hasn't a Democratic spokesman stood up and defined the debate in these stark moral terms? What is holding them back?
Healthcare reform is not merely a matter of corralling the necessary votes in Congress -- it also means getting the public on your side. And, so far, Democrats have been all but absent in this public debate. This needs to change, or else we're going to wind up not with a monumental "New Deal" or "Great Society" sweeping change, but instead with some incremental window-dressing which is not going to fix the system at all. Which will mean, ultimately, that we are just going to have to have this whole fight again in a few years. And that would be a tragedy indeed.
[Grammatical Note: I am finally bowing to what is becoming the conventional usage of "healthcare" instead of "health care," and will be using this standard from now on. I don't know why, since I am usually at the forefront of making one compound word where others still use two, but "healthcare" has always just looked wrong to me. But with the debate heating up, I think it best to now lay this issue aside and get on the etymological bandwagon, as it were.]
[Program Note: This is a rerun of a column which was originally published June 9, 2009. As I was researching Obama's second 100 days in office, I came across three columns on healthcare reform tactics and strategy for Democrats which, sadly, are still just as valid as when I wrote them. Rather than have the site go blank, we are repeating these columns for the first three days of this week. Regular columns will resume on Thursday.]
-- Chris Weigant
My favorite visual so far: Why the Public Option Sucks!
http://www.farleftside.com/2009/8-3-09.gif
Actually, Dave that's not entirely accurate.
The more apt description, under Democrats and ObamaCare, is that "You Pay The Government" but then the government decides that you don't really need the treatment because A> Yer going to die eventually anyways and/or 2> There are people who need the treatment more than you do.
And then the government will keep your money and charge you even MORE for daring to pay for a treatment that said government decides you don't really need.
Welcome to ObamaCare.
Regardless, Democrats are on record as saying that the Single Payer program is on the chopping block anyways.
No one is denying that HealthCare needs reform.
Yet no one, not one single person, can show how ObamaCare = Reform.
Strange that, eh?
Michale......
http://www.huffingtonpost.com/arianna-huffington/is-health-care-reform-abo_b_256127.html
Very well said here....
Michale.....
The basic premise is that somehow if you have insurance through the government that you won't face bankruptcy? The fact is that we don't have to imagine what government healthcare looks like, we already have it in the form of Medicare. The simply reality is that of ALL the major medical plans out there, Medicare has by FAR the most coverage holes. You chance of a coverage gap or denied care are much higher. In addition to that, the number of doctors that can afford to take medicare payments (the one's Obama wants to reduce further) is shrinking fast. The end result is that we ALREADY have doctors refusing to see, or are limiting Medicare patients. As a side note, where do you think that the decrease Medicare payments are subsidised? Private insurers pick up that slack. While the idea is noble, the cost remains the issue and thus far, there is nothing coming out of Washington that trully (from an insurance standpoint) address' this issue.
A simple solution to your concern Chris, is legislation that protects the public from creditors in the event of major illness. In today's medicare world, you may not face banruptcy, you just don't get all the treatment options that are available. Sadly, most Medicare patients are not aware of this. As Michale so put, I am not against reform, but the government running insurance, for which it has a track record far worse than private insurance companies, just doesn't fly.
Dorkfish -
Ah, but who picks up the tab if patients are uninsured and show up at an emergency room unable to pay?
The answer, no matter how it is sliced, is "all of us." Either the insurance companies subsidize this in part, or the hospital subsidizes it in part, or it is reimbursed through direct or indirect payments from government (all our taxes). One way or another, the cost is spread around until it reaches almost everyone.
Insurance likes to claim that Medicare is underpays doctors, but this misses a key argument. Underpays by whose price? If I have insurance, walk into a hospital, and get an operation, my insurer may have bargained for a rate of $7,000 for that operation, since they pay for so many of them a year they can afford to bargain. Medicare maybe pays $6,300 for the operation. But if I am uninsured and walk into the SAME hospital, get the SAME operation by the SAME doctor, they will charge me something like $10,000 (or maybe $20,000, who knows?). Those with the least ability to pay get hit with the highest costs. That is the free market, and either leads to me not being able to pay the 10 grand and declare bankruptcy (see previous note on who winds up paying for this ultimately), or me paying a LOT more than either Medicare or insurance pays -- FOR THE SAME THING. Is that really fair, I ask you? Or is that discrimination?
-CW