Healthcare Reform: Representative-less Democracy
We may have reached the point where it’s necessary to dump the “representative” part of our representative democracy. That is, if we want healthcare reform that in any way resembles actual, meaningful, reform. Word got out last night that now the Senate is backing off the early Medicare buy-in because of predictable pushback from providers (I was going to write about the buy-in; now, not so much.) Medicare expansion was the only meaningful reform left in the ongoing Senate slaughter of HR 3590. Providers, insurers, other special interests – they are all represented in Congress. We, however, are not.
Reform means “to put an end to a wrong.” But we are relying on people who aren’t nearly as bright as their opponents. Take the latest insurance ploy: give Facebookers virtual cash to play their favorite online games, or give them real money for trying a vendor’s products or services. All the Facebook crowd has to do to get the cash is press ‘send’ on the petition to Congress that opposes healthcare reform. How diabolically clever. GetHealthReformRight.org of course denies doing any such thing, now that the letters have landed in D.C. Wrong is definitely not meeting its end.
Meanwhile the latest free clinic has landed in Kansas City, MO, to shame Claire McCaskill (that's a picture of the early-bird line above.) Little good it may do now, except to serve some very urgent local healthcare needs for three days. Let’s face it, nearly all of the Beltway’s inhabitants have lost sight of why we need healthcare reform. Drew Altman, CEO of the Kaiser Family Foundation, gives us a timely reminder of why reform was able to build up such momentum in the first place. It was because of [emphasis mine]:
“… people’s concerns about paying for health care in the middle of a deep recession … It wasn’t only that health care costs were going up or that people were paying more out of pocket each year, it was also that people’s economic circumstances were deteriorating, making it much tougher and more painful to pay their health care bills.”
It’s not that people are lazy. A full 83% of clinic attendees in MO are employed. You can’t distinguish them from anyone else walking down the street, as you can see in the video below. They are part of a consistent trend KFF sees in its polls, that 50-60% of respondents say they or a family member have put off getting needed healthcare because of cost. The KFF figure below goes a long way to explaining how the economic downturn exacerbates that situation.
If it was up to these folks, and if it was up to us, healthcare reform would have happened yesterday if not sooner. Reform would include cost-reduction measures on day one. It would provide coverage expansion on day one. Physicians and hospitals would be not just encouraged but required to improve care quality and safety within the next year. As it is, there are virtually no such inclusions in the bill until 2014, if ever.
There is no outrage in Washington. There is little in the media, and there is even less among the policy wonks. Why is that, besides special interest influence? It’s because none of these people are directly affected by the growing healthcare crisis in this country. They all have good jobs, with group healthcare coverage for which they pay very little. If they have pre-existing conditions, they are either unaware of them or unconcerned – it’s the false sense of security that the non-discrimination regulations governing group coverage can lull you into. Most are blissfully unaware of how unsafe and low quality typical healthcare is.
So it’s up to us. If you haven’t already, take action by telling Congress not to undercut a real public option. Now that Medicare expansion is under the axe, it may be all we have left.
COMMENTS (26)