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Health Care as a Civil Right

Obama needs to reframe the debate.

 
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An unsightly condition caused by unsanitary health-care politics

 
 

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The United States has two parties now—the Obama Party and the Fox Party. The Obama Party is larger, but it is unfocused and its troops are whiny. The Fox Party, which shows up en masse to harass politicians, is noisy and practiced in the art of simplistic obstruction. As the health-care debate rages, it's the Party of Sort-of-Maybe-Yes versus the Party of Hell No! The Yessers are more lackadaisical because they've forgotten the stakes—they've forgotten that this is the most important civil-rights bill in a generation, though it is rarely framed that way.

The main reason that the bill isn't sold as civil rights is that most Americans don't believe there's a "right" to health care. They see their rights as inalienable, and thus free, which health care isn't. Serious illness is an abstraction (thankfully) for younger Americans. It's something that happens to someone else, and if that someone else is older than 65, we know that Medicare will take care of it. Polls show that the 87 percent of Americans who have health insurance aren't much interested in giving any new rights and entitlements to "them"—the uninsured.

But how about if you or someone you know loses a job and the them becomes "us"? The recession, which is thought to be harming the cause of reform, could be aiding it if the story were told with the proper sense of drama and fright. Since all versions of the pending bill ban discrimination by insurance companies against people with preexisting conditions, that provision isn't controversial. Which means it gets little attention. Which means that the deep moral wrong that passage of this bill would remedy is somehow missing from the debate.

Sure, it's important to fight for a public option (or a souped-up cooperative that can be made nearly as good). And we need to stand against a secret deal with Big Pharma, tighten insurance regulation, and assure that the bill includes language establishing clearly that doctors and patients—not bureaucrats, who are no better than insurers—make medical decisions. But these worthy goals have overshadowed the moral principle of nondiscrimination. The well-meaning woman who left a message at my office saying that she wouldn't demonstrate in support of any bill without a public option has lost her perspective.

The same goes for those who focus on cost ahead of principle. Whether we can "bend the cost curve" in five years or 10 years is fundamentally unknowable. Washington's elite policy mandarins obsess over "out-year" projections that never prove accurate. We must "pay" for the bill with new revenue streams, but let's not pretend that any of the real costs (and incentivized cost savings) are discernible now. Look at "cash for clunkers." The money that Congress set aside for a year lasted less than a week. The short-term projections were off by 99 percent. Any bill this big will be full of unintended consequences and will have to be fixed. The only way the system can't be fixed is if the bill dies and no one tries reform again for many years.

History suggests that major social policy unfolds on a continuum. The Social Security Act of 1935 disappointed liberal New Dealers because what was called "old-age insurance" covered only about half the adult population. It excluded farmhands, domestics, employees of small businesses, and most blacks. That was because FDR needed the votes of Southern Democrats, the Blue Dogs of their day. (The bill cleared the House Ways and Means Committee with only one Republican vote.) Similarly, the Civil Rights Act of 1957, immortalized in Robert Caro's Master of the Senate, was weak tea. It had to be strengthened by the Civil Rights Act of 1964 and the Voting Rights Act of 1965. In the later bills, Lyndon Johnson betrayed Southerners he had made deals with in 1957. If Nancy Pelosi can't break Rahm Emanuel's promise to Big Pharma's Billy Tauzin this year, she can try to break it in the future. And Tauzin will lobby for more favors as the all-important new regulations are issued. Nothing in Washington is ever set in stone.

The only thing that should be unbreakable in a piece of legislation is the principle behind it. In the case of Social Security, it was the security and peace of mind that came with the knowledge of a guaranteed old-age benefit. (Ronald Reagan and George W. Bush got slam-dunked when they tried to mess with that.) In the civil-rights bills, the principle was no discrimination on the basis of an unavoidable, preexisting "condition" like race.

The core principle behind health-care reform is—or should be—a combination of Social Security insurance and civil rights. Passage would end the shameful era in our nation's history when we discriminated against people for no other reason than that they were sick. A decade from now, we will look back in wonder that we once lived in a country where half of all personal bankruptcies were caused by illness, where Americans lacked the basic security of knowing that if they lost their jobs they wouldn't have to sell the house to pay for the medical treatments to keep them alive. We'll look back in wonder—that is, if we pass the bill.

Alter, a national-affairs columnist, is the author of The Defining Moment: FDR’s Hundred Days And The Triumph Of Hope.

© 2009

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Member Comments

  • Posted By: NewsWkDickG @ 09/03/2009 1:36:41 PM

    C'mon people, it is obvious, as plain and as disgusting as a badly infected sore. Put the prejudices, the biases, the emotional attachments aside and see through the rationalizations, don't accept the subterfuge, reject the irresponsible con being offered and instead see the truth and the drastic costs. And really let's stop the ridiculous game playing, the egotistic one-upmanship that is consistent with and as obnoxious as the actions of those supported. It really isn't Health Care Reform they are against; they are against any loss to them. As with everything they are totally against any change and they are really aggressively against President Obama; they have made that perfectly clear when they said they want to make Health Care Reform his Waterloo. The real problem is that they don't have any conscience and dishonesty is simply their standard. Other than to manipulate public opinion they have no real concern for the people; everything they say is either exaggerated, hyped up, inaccurate or just plain lies all aimed to excite. Is our memory so short that we don't recognize their self-serving tactics that have already cost us so much? Barack Obama was clearly elected because the people recognized that we desperately needed change, drastic change, in Health Care, in Washington, in government's focus, in everything. The voters recognized that without change we were going to continue sliding down the slippery slope of political self-indulgence, with the politicians being arrogantly focused on benefit for just the few and neglecting their responsibilities to the majority. There are those who didn't want any change then and who are aggressively trying to prevent it now. Look at the facts, find the truth and refuse to be pawns used at their will, refuse to allow them to return to 'more of the same' which has cost us so much! Don't allow your 2008 vote to now be invalidated!

  • Posted By: NewsWkDickG @ 09/02/2009 6:21:03 PM

    (continuing)
    Remember: Tax cuts for the wealthy benefits the economy; Global Warming is not a problem; Private Accounts for Social Security will solve the problems; The Bush admin did not minimize/ignore warnings before 9/11; There was sufficient solid and irrefutable real justification for attacking Iraq; Attacking Iraq didn't take away from the real effort in Afghanistan; Afghanistan is secure; Even though America has paid 95% of the costs it hasn't been a false coalition; Iraqi oil money would pay for the war; Pressure was not put on the intelligence community; Torture and departure from Geneva Convention rules were not authorized at the highest levels of the Bush Administration; Ongoing reporting on the status of the War in Iraq never misrepresented the truth to manipulate public opinion; No bid contracts to Halliburton totaling $100s of billions, was responsible use of taxpayers' money; Giving responsibility for our port security over to Dubai Ports would not be a security risk; The humungous deficit and growing trade deficit are not problems; The administration did not react to the hurricane Katrina aftermath with apathy and irresponsibility; Bringing American drugs back into the US at lower costs would be unsafe; The Bush administration had nothing to do with exposing the CIA agent's identity; The squelching of the 'wiretapping without court order' story was done for national security reasons; Raising the security threat level just before an election in 2004 was not a political ploy; The financial problems we are currently fighting are not problems of excessive deregulation and the lack of responsible oversight favoring a few and resulting in unchecked greed, gross dishonesty and run-away self-indulgence by the few; Even though it is totally inconsistent with his sociopathic personality and displayed actions GWBush is really a committed 'born again Christian'; it goes on and on with these just being a few of the manipulative distortions. See any current similarities? I am an ex-registered, forty year Republican who wants them to turn their act around and offer the average American honesty and real benefit, conservative or otherwise, but I also feel to ignore the obvious and support them now in 'more of the same' would just be 'shame on me'!

  • Posted By: NewsWkDickG @ 09/02/2009 6:20:18 PM

    It isn't hard to understand being controlled by self-interests, biases, prejudices and emotional attachments, we all have been guilty of it. And when it is the result of others' deception, who boldly use gross dishonesty, their advantage of power and wealth, their positions of trust to appeal to our emotions and to coerce our support it is 'shame on them' but none the less it is still very costly, costly to many others and, whether we accept it or not, costly to ourselves. The prime current example being those who trusted and supported Bush-Cheney and who now can look around and see the drastic costs of the arrogant and cocksure, self-serving gross dishonesty that was employed to pursue their private agenda benefiting only Special Interests and a select few, who then returned overt and covert support, substantial contributions and promised kickbacks, all while 95+% of Americans were given apathy, the costs and an abundance of subterfuge and simply taken for granted. Should there be any resistance to accepting this truth let me list some of the subterfuge offered by Bush-Cheney, stubbornly and totally supported by the Republican Party.
    (continuing below)

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