Obama's Speech on Health Care

I am writing after listening to President Barack Obama address the United States Congress and the entire United States last night on television. Obama appeared on TV to bolster support for his efforts to reform the ailing US health care system.The President had promised speedy action on health care as soon as he entered office. In fact, he promised a bill by August. What he supported was stricter regulation of insurance companies, cuts in wasteful spending, and the so-called “public option”, where the government would provide tax supported insurance for those who could not afford traditional private insurance. There would thus be a small government run insurance program that would help deal with the problems of the uninsured. The very thought that the government could enter into competition with the private insurance industry has made that industry absolutely frantic. Insurers are all for competition when there is none.  When suddenly, somebody or something can really compete with them on quality and cost then guess what.  They know they will lose.  So suddenly they want a level playing field. They are certain that the government can provide a cheaper, more effective service than the private sector and they worry – and rightly so – that they will eventually be driven out of business. Which is again, what competition in a market economy is supposed to be about.  You provide a better product at lower cost, the company or industry that doesn’t is out of business. Sorry, those are the rules.  But the insurance industry and those who oppose any reform at all, don’t like to play by the rules.  So they have unleashed a smear campaign against the public option. In fact, it’s clear that Republican demagogues both inside and outside of Congress do not want there to be any significant health care reform at all.

As a result, August , proved to be a cruel month for the president. Also July. Right wing opponents of any reform whatsoever began a campaign of lies.   Opponents of reform argued that any governmental input into how health care is delivered in this country constitutes “a government takeover” of health care. Right wing talk show hosts, and even congressmen and senators, insisted that any government attempt to control health care costs would be done at the expense of senior citizens and Medicare. They even went so far as to assert that the government would be setting up “death panels” – yes death panels is the word they used – to pull the plug on granny if her care gets to be too expensive.

What is so tragic is that a lot of people believe them.  Americans have become so thoughtlessly anti-government and so enamored of the private sector that they have forgotten the power of government to do good and the unregulated private sector to do evil.  It was not government — but the lack of it — that brought this economy to the abyss and nearly pushed it over.  It FIRE — Finance, Insurance, and Real Estate — all unregulated, all non-union, all out of control and motivated by greed and greed alone — that has led to the loss of millions of jobs and a recovery in which hardly anyone can find one.  (see next posting by my daughter). I have heard countless people — nurses among them — who tell me that the government can’t do anything right at all.  When one nurse told me this recently,I asked her, well what about the military, don’t you trust the military to defend us.  Her reply?  I kid you not, I wish I was kidding, was that “well the military isn’t run by the government.”  I almost fell off my chair.  If it’s not run by the government, I asked who is it run by, to which she responded.  Well by generals and soldiers. In fact, the hallmark of a democracy I reminded her is that the military is run by civilians.  It was George Bush, Dick Cheney and Donald Rumsfeld, civilians all, who got us into Iraq.  Not the generals.  It took an army nurse at Walter Reed to remind me of this three years ago.  We hate war, she said, we know what it’s like, it’s the civilians who started it.

When I read about the death panels and the charges of creeping socialism, I am always shocked.  It is unbelievable to me what people will believe.  For example, a common refrain in this debate, is that the Obama plan will make health care like the US Post office.  I want to know precisely what is wrong with the United States Postal Service.  Why don’t we love it.  I do.  Everyday I get my mail on time.  It takes a few days — and costs only pennies — to get a letter from Boston where I live to California — sometimes over night, if you want to pay more.  The mail deliverers are unvariably lovely and courteous.  I adore my local post office.  I visit it often.  The two guys behind the counter are always helpful — to everyone.  white, black, male female, you name it.  When I need help they give it.  If I don’t have tape for my larger packages, they provide it.  They always offer to staple the mailroll containers in which I ship my Just a Nurse Posters, so they won’t come loose.

The UPS office down the street is another matter.  You want some tape, buy a roll, they suggest.   A varying cast of lower paid workers is churned through their office.  And if you want to mail a letter to California that will be $15 or $16 thank you very much. Why don’t we defend the post office and our neighbors who work in it, I wonder.  Do I want a health care system that works like the post office, you bet you!  If I had one like that, I’d get help rather than hassels.

But I digress, sorry I can’t help it.

So death panels, smears on the post office, fears about creeping socialism, this was the level of civility – i.e. rock bottom – when Obama hit the airwaves last night. I was glad to hear the President forcefully articulate why we need reform so badly.  He outlined the sorry state of our health care system. We heard all the standard stories – 47 million uninsured (actually that’s probably a low ball estimate, it’s probably more like 50 million given the current economic crisis). Health care bills are a major, if not the major,cause of personal bankruptcies. Insurance companies won’t provide coverage to any who has what is known as a “pre-existing condition.” That means if you don’t have health insurance or if you lose your job or change your job, and have the misfortune to have diabetes or cancer or some other chronic illness, insurers can deny you coverage entirely or deny coverage of that particular condition. Insurers also deny people coverage if they have insurance and get diagnosed with a new and expensive condition. One of the President’s example was a case where an insurer stopped coverage because they found that a person had an undisclosed preexisting condition. What was it? Acne. They stopped coverage not because of the acne, but the person had been diagnosed with a serious illness.

The plan Obama outlined last night, he said, will offer greater security and stability to the already insured. There will be no more refusals of coverage based on pre-existing conditions. There will be no more denials or rescinding coverage if you get sick. There will be no more lifetime caps on how much you can spend if you get sick. As for the uninsured, there will be a mish mash of subsidies and help to get insurance. And maybe, just maybe, there will be a public option. But the president said he is willing to compromise on that.

I am all for insurance reform.  It is long overdue.  Yes we need to strictly regulate the insurance industry and his proposals are a good beginning.  But what I worry about is that all of this is too little and it may be too late. What I and many others fear is that the President is so entrapped by corporate interests – i.e.,big Pharma, the insurance industry, doctor’s and hospital organizations – that he can’t support what he knows is the only solution – which is some form of tax supported national health care system. You can have a system with private, not-for-profit insurance companies that are highly regulated, like France’s, Germany’s or the Netherlands or Japan’s. Or you can have a more public system like the UK, Scandanavia or Canada. But if there isn’t some way to get every body into the pool and leave no one out, you can’t solve the problem of affordability, access, quality and cost. That’s not a lie, it’s just the bottom line.  If the President compromises on the public option, we don’t have anything serious to build on.  I believe we need to raise our voices and mobilize.  Those of us who understand what it means to be sick, to care for the sick, and to work in this system need to call on the President and the Congress to act — and to act on our behalf not on the behalf of insurers, the pharmaceutical industry, the hospital industry and those few physicians who care more about their pocketbooks than their patients.  We have to support a strong public option, not a watered down one.  We have to talk to our friends and relatives and neighbors and politicians.

The other day I attended a health care march in support of real reform.  There I met an older woman on Medicare and a social worker who used to work in the state Mental Health system, which has been decimated.  They spoke eloquently in favor of government programs and of reform.  We need to hear more of those voices.  And we need to hear them now.

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