Doc Says You’re Fine, Or Dying

They say you can't put a price on good health, at least I know I couldn't put a price on my own. It's more difficult for me to say whether I can put a price on your good health.

I've heard endless loops about the things people disagree about on the new health care law, but there is actually consensus on a few big things: 30 million people that do not currently have health insurance will have health insurance, coverage under Medicare and private insurance improves, and the changes will cost at least $100 billion per year. So it seems to me that the effect of the new health care law is that the health of many people will be improved but it's going to cost a lot of money.

It's a complex issue and I realize that is a rudimentary simplification, but I believe it's true.

The similar simplifications I've heard against this new law are: the new health care law is a violation of American liberties and will bankrupt the United States.

Is the simplified decision, then, how much liberty and money am I willing to give up to improve the health of my brothers and sisters?

I'll admit I've lost my right to go uninsured, but every other liberty I've heard I'm losing has been settled in the US since the 1920's. Other cries of lost liberty I've heard ring hollow to me as accusations of what might happen later or are too wide-ranging and frenzied to take seriously. As for the cost, I agree this is costly. I take the cost seriously and I want accountability. But I also understand that we find the money for what we believe is important (few Americans blink at spending over $600 billion per year on the defense budget).

Wait a moment... See how quickly and easily this can turn into a discussion, a debate, or even a fight over liberty and money?! And as we turn on each other in this debate that has been more bitter than accurate, we leave the sick to the side... The sick. This group that Jesus favored, and that we all eventually join.

With my focus again on compassion, I push past these superficial distinctions I create of wealth and health and Americanism, and I find myself without support for clutching to control and to my wealth. Instead, I am impressed again that EVERY human being is Yahweh’s child and protecting the health of every human being is a profoundly important personal and communal responsibility. This new law is a mere drop in the bucket, an imperfect step toward human equality. We will really have to roll up our sleeves and soften our hearts if the goal is to value and care for every person, if the goal is equal opportunity for health and care for every child in Philadelphia, every senior citizen in Flagstaff, every mother in Los Angeles, every father in Des Moines... and then on to the rest of the world...

The Rich Stay Healthy, The Sick Stay Poor

Health care reform is moving again in Congress. I believe there are two viable bills in the Senate and one in the House. The belief is that the two Senate bills will be combined in some way, then the House and Senate bill will go to conference.

It's hard for me to call these bills "reform." I guess it might change things for the better, but I apparently need to grieve the lost opportunity for what I believe to be the needed change: universal coverage and a single payer system.

Here's where I start the health care discussion: EVERY human being is Yahweh’s child and protecting the health of every human being is a profoundly important personal and communal responsibility. The proposal that best meets those values, that I have seen so far, was put forward by George McGovern. To steward my energy, I copy his proposal:

It's Simple: Medicare for All
By George S. McGovern
Sunday, September 13, 2009
Washington Post

For many years, a handful of American political leaders -- including the late senator Ted Kennedy and now President Obama -- have been trying to gain passage of comprehensive health care for all Americans. As far back as President Harry S. Truman, they have urged Congress to act on this national need. In a presentation before a joint session of Congress last week, Obama offered his view of the best way forward.

But what seems missing in the current battle is a single proposal that everyone can understand and that does not lend itself to demagoguery. If we want comprehensive health care for all our citizens, we can achieve it with a single sentence: Congress hereby extends Medicare to all Americans.

Those of us over 65 have been enjoying this program for years. I go to the doctor or hospital of my choice, and my taxes pay all the bills. It's wonderful. But I would have appreciated it even more if my wife and children and I had had such health-care coverage when we were younger. I want every American, from birth to death, to get the kind of health care I now receive. Removing the payments now going to the insurance corporations would considerably offset the tax increase necessary to cover all Americans.

I don't feel as though the government is meddling in my life when it pays my doctor and hospital fees. There are some things the government does that I don't like -- most notably getting us into needless wars that cost many times what health care for all Americans would cost. Investing in the health of our citizens will enhance the well-being and security of the nation.

We know that Medicare has worked well for half a century for those of us over 65. Why does it become "socialized medicine" when we extend it to younger Americans?

Taking such a shortsighted view would leave nearly 50 million Americans without health insurance and without the means to buy it. It would leave other Americans struggling to pay the rising cost of insurance premiums. These private insurance plans are frequently terminated if the holder contracts a serious long-term ailment. And some people lose their insurance if they lose their jobs or if the plant where they work moves to another location -- perhaps overseas.

We recently bailed out the finance houses and banks to the tune of $700 billion. A country that can afford such an outlay while paying for wars in Iraq and Afghanistan can afford to do what every other advanced democracy has done: underwrite quality health care for all its citizens.

If Medicare needs a few modifications in order to serve all Americans, we can make such adjustments now or later. But let's make sure Congress has an up or down vote on Medicare for all before it adjourns this year. Let's not waste time trying to reinvent the wheel. We all know what Medicare is. Do we want health care for all, or only for those over 65? ...

As We Divide Against Each Other

I’m all for dissent and challenging authority. So when I heard the buzz about these raucous crowds at town hall meetings on health care reform, I thought “good for them” even if I don’t agree with the dissent. I finally got a chance to see one of these town hall meetings. Sen. Specter held an open meeting in Lebanon, Pennsylvania, and I watched the entire meeting on CSPAN.

I’m not a political fan of Sen. Specter, and from a distance his party-switch sure seemed opportunistic. I also understand (as I’m sure he does) that he chose this job and that means dealing with people, whether they like you or not. To make matters worse, the senator started the meeting off with some unhelpful words that displayed an insolent attitude, something like “I don’t get any extra pay for being here and I don’t have any requirement to be here.” Not a good way to endear yourself to your constituents. None of that, however, excuses being rude or mean to the man, and many at the meeting certainly were. But they were angry and we often do regretful things when we’re angry.

It’s that anger, though, that astonishes me. At times the expressed dissent was downright hateful. Unfortunately for everyone, most of the concerns expressed were based on misinformation or distortions and the questioners’ general sense of anger and distrust seemed to completely cloud their ability to reason (again, certainly a common human issue when we’re angry). A few good questions were raised, but the overall theme was definitely one of anger and resentment.

Before the question period could begin, a man rose and began shouting in anger. He was literally shaking he was so emotionally upset. Shouting just a few feet from Specter’s face, he accused Specter of trampling the constitution and that “One day God will stand before you and judge you and the rest of your damn cronies up on the Hill and then you will get your just desserts." I have to believe the man was sincere and I take him at his word, which means this man believes that God has taken a position on interpreting the US Constitution and to violate the Constitution is a sin! Beyond that this man’s anger is palpable and his desire for someone to “pay” for how he feels is very real.

The crowd cheered loudly for another man who believed part of the health care solution is to “round up the illegals and get them out of here.” It was heart-breaking to hear my fellow citizens cheering at the “rounding up” of men, women and children. An older gentleman expressed concern, in a respectful manner at least, that the Koran orders Muslims to kill non-Muslims. President Obama was accused several times of the auto bailout even though that was actually proposed by and signed into law by President Bush.

The loudest reaction from the crowd was for a woman who declared that the anger was about “the systematic dismantling of this country, we don’t want to turn into Russia!” It was not clear if she thought Obama was accomplishing the dismantling in the last 6 months or if she was unloading years of anger (though I believe the Republicans controlled all 3 branches of government for 6 or 7 of the last 10 years). This was a recurring theme and also one that astonishes me - whether or not someone or some idea is “American.” With no awareness of the irony, the crowd bristled at having been called un-American by some but then turned around and shouted angrily when Specter said “President Obama knows he’s an American.” The mere fact that Specter even had to say that is jaw-dropping; the crowd’s reaction is beyond belief.

In similar style, one dissenter was concerned that the proposed health care was “not American” and was “socialist” and then admitted he was currently unemployed and receiving unemployment benefits! I am glad for him and his family that the socialist program of unemployment is able to help him.

You might think I’m cherry-picking but I assure you I am not. The video record is available. The best-expressed concerns were about whether we can afford the proposed health care plans and questioning the financial sense of the cap-and-trade bill. The best question of the night was “why would the government buy an auto maker who makes cars no one wants?” But these few financial concerns were quite small compared to the charges of un-American, socialist, turning into China, etc.

Serious topics often come down to such buzzwords, sadly. Two buzz words even more loaded than those already mentioned are euthanasia and abortion. A woman said that according to the current House of Representatives’ health care bill, “Section 1233 of the proposed health care plan… What it says is, as a 74-year-old man, if you develop cancer, we're pretty much going to write you off because you're no longer a working citizen who will be paying taxes.” I read Section 1233 that she’s talking about and for her to say that flat-out amazes me. I believe someone told her what that section means, because it’s not at all as she stated. Section 1233 is a favorable provision for patients; it offers to pay for something that right now is needed but not a covered expense. That section offers to pay for (but does NOT require) a doctor to talk with a patient about a living will, advance care planning, durable power-of-attorney, the roles and duties of a health care proxy, and what all this stuff means. These things are incredibly important and far too many people are without them. I would abhor euthanasia and this Section 1233 does nothing to advance euthanasia. In fact, it looks to me like this would get more people making their OWN decisions. Absolutely incredible that something like this would be so blatantly distorted.

I am also highly in favor of reducing abortions and am sensitive to the concern about abortion funding. This issue is also being distorted, but it only came up once at Specter’s town hall. My caution regarding shouts of “I don’t want my money paying for someone’s abortion” is that we already do. If you pay taxes, our taxes help pay for abortions. If you pay insurance premiums to a private insurer, it is most likely that your premiums help pay for abortions. Depending on the medicines you buy, the doctors you see, the hospitals you pay - your money helps pay for abortions. That’s a stiff wall to climb, and it may be one you’re willing to pursue, but it bothers me when people get twisted around by this sensitive topic during a discussion of health care reform. If your goal is to stop any of your money from helping to pay for abortions, you have to head straight to amending the Constitution, not stop a health care reform that maintains the status quo.

I’ve gotten into more specifics about the dissent than I intended, but once I got started I thought it best to provide examples of the anger and resentment I saw. It’s difficult for me because, as I said, I respect dissent and challenging authority. And I believe these were sincere people, I know them, they are some of my friends and family. They are afraid and have been hurt and they are angry. When I’m feeling those things I get even more defensive and self-focused than I usually am, and anything that looks like it might take something from me (or did take something from me) is an easy target for my anger. My heart goes out to the people I saw on CSPAN and I wish for all of us a health care discussion that has as its central values that EVERY human being is Yahweh’s child and that protecting the health of each human being is a profoundly important personal and communal responsibility.

Need

What's stalling progress in health care, in my opinion, is any sense of "need." I read a recent Rasmussen poll that said 68% of voters considered their health insurance coverage "good" or "excellent." It's difficult to achieve change for only 32% of voters (I think we can safely ignore non-voters when discussing achieving political change). And it's VERY difficult to achieve change for a minority when it may cost the majority something.

I want health care reform because health care is rationed here in U.S. and I believe we can be more equitable in our rationing. Personally, I'm happy with my health insurance coverage. I consider it expensive and the costs have risen every year the past 10 years, but I am able to adjust finances and I have been fortunate enough to avoid all major illnesses. But I also understand that our health care is rationed here in the U.S., I just happen to be at the head of the ration line. Because I can afford my premium, deductible, co-pay, and co-insured payment, I can afford most health care I will need. When we needed help for Casey's migraines beyond what was covered by our health insurance, we were able to pay the bill from our own pocket and she was able to gain some relief. I can afford preventative medicine with my son's asthma. Others may have emergency care available for free when an asthma attack hits, but because I'm at the head of the ration line I can obtain preventative care. The health care system rations care and gives it to me and my family because I can afford it.

I want health care reform because I am already subsidizing the care the system gives to people with no health insurance coverage at all. The hospital charges me more to make up for the care it gives to people who receive care even when they can't afford it. The ambulance service costs me more because it's cheaper for some people to call 911 and get emergency care (for non-emergencies) than it is to go visit a doctor. Doctors and hospitals have to charge me more because people who could not afford care neglected to see a doctor for problems that have now gotten much more serious, but their ability to pay hasn't changed. Since I'm already paying an extra cost for this broken style of care, I'd rather see these same people get preventative care.

I want health care reform because getting sick shouldn't cause bankruptcy. A recent Harvard study showed that 62% of all personal bankruptcies in the U.S. in 2007 were caused by medical debts. The study found: "Most medical debtors were well educated, owned homes, and had middle-class occupations. Three quarters had health insurance." It makes me wonder if very many of the 68% who think their coverage is good or excellent have yet weathered a serious illness. How many times have we seen collection cans on the gas station counter to help pay for the out-of-pocket costs of some hard-working family hit by illness or tragedy? Just last week a guy in this area saved a toddler from certain death and suffered severe injuries in his efforts. Of course, a fund raiser was immediately scheduled to help him pay for his medical care not covered by health insurance.

I do not believe that tweeks will resolve my concerns. I believe we need serious change.

Yes, I'm concerned about what the financial costs of health care reform may be. But when I can progress beyond my desire to protect what's mine, I realize something MUST be done. The status quo is not an option. If I approach the current legislative proposals with an understanding of need and desire for serious change, I am much better able to ignore the lies and distortions about what the proposed reform is (and is not).