December 18, 2009 06:16 PM UTC

When Half a Loaf is None

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• by: JO

To vote for a health care reform bill that offers some goodies but not everything, or to vote against it because it offers some goodies but not everything? Should senators vote for the current bill out of concern that they won’t come back to the subject soon if ever? Or should they vote against the current bill out of concern they won’t come back to the subject soon if ever?

I suppose the current status of the health care debate has all the makings of a dilemma. Except that it doesn’t.

Congress, aided and abetted by the media (including the blogosphere) got it fundamentally wrong from the get-go by casting the subject as “health care insurance.”

No one needs health care insurance. Everyone needs health care.

Therein lies a tremendous difference. Do we think people need “education insurance?” Or “police protection insurance”? No. Everyone needs both–for themselves and for their neighbors (i.e. their neighbors’ children)–for the orderly conduct of society. We do not choose to have vast numbers of people going about illiterate, or to give criminals the idea they can commit crimes without fear of getting caught.

The same principle applies to health care. Would we have people literally dying on the streets? Would we choose to live in a society in which such people are left to writhe and die without our help? (Well, yes, actually, except that the expectation is that they will do their writhing and dying behind drawn curtains.)

THAT was the issue at hand, and THAT is the issue that is ignored.

Health care is and ought to be recognized as a right. Get sick? Go to a doctor who received his/her education at public expense, almost certainly, at least for some period.

IF the debate had been cast as “Make Health Care a Right, Like Education,” we would have had a very different outcome! We should have had a very different outcome.

Instead, we have a dog’s breakfast of guarantees for Big Pharma, protection for the built-in monopoly of private insurance companies, and a mandate for people to buy policies the price of which is unregulated!

The details of how we got to where we are now don’t matter so much as the fact that we ended up in a swamp because we didn’t properly define our goal, which should have been to convert health care to a social right, rather like Social Security recognized that retiring was, at some point, a right, and that a government program should be established to extend that right to everyone, including people whose incomes never were high enough to enable them to save enough for retirement.

Having gotten off on the wrong path, are we now obligated to push forward into the swamp, entrenching our initial error into law?

No.

This should be the Central Issue of 2010. Health care reform has never been at the center of any political campaign year (in 2008, it was Iraq and the Great Recession, not necessarily in that order). We need to get away from this notion that “Clinton failed, Obama will have failed.” Neither failed to establish health care as a right because neither really tried to do so, explicitly and in so many words.

The current bill should be scrapped entirely. Possibly some small bills can be passed that bar, for example, any insurance company from canceling a policy once claims are made and from denying covering based on previous conditions (although from the insurer’s viewpoint, the latter makes perfect sense! It illustrates why the issue isn’t insurance but rather care.)

If our representatives and Senators cannot or will not see this, that is a good reason to choose someone else to go to Washington in January 2011.