On the Eve of Obamacare: Too Smart to Really Fix Our Health Care System, So We Count the Dead
Way too many times I've landed myself in rooms with lots of intellectuals who know everything there is to know about single-payer, improved and expanded Medicare for all for life and who are determined to share every bit of that knowledge over and over again. The audiences are often pretty much the same single-payer activists and advocates sprinkled with a new person or two. Often these audiences are predominantly white, older, and not hurting for money. Again, there are sprinklings of others, but rarely do single-payer community forums, educational presentations or public events attract many of the people for whom single-payer reforms would do the most good.
For many people, learning more about health care reform sounds like just about as much fun as getting teeth pulled. For others, they've stopped trusting that anyone is really telling the truth about health care reform. And for an even larger number of people, life's daily pressures -- including working to hang on to health benefits and pay household bills -- is the absolute priority. Dabbling in any political advocacy is something left to students and other young people, the wealthy who don't have to worry about earning a living at a regular job, and retired people with time to spend volunteering and life-longexperience with the dysfunctional health care system. Then there are also the substantial number of progressive intellectuals who populate the movement for single-payer and other movements where they can wield their mighty minds for all to see.
Ever listen to the late William F. Buckley, Jr., speak for long periods of time? The drone of his uber-intellectualism was certainly filled with facts we might all have needed to know, but I often feel a similar pallor wash over my brain when the uber-smart of single-payerdom begin their soliloquies.
I am often no match for their brain power or even for the fierce passion intellectuals can show for promoting their positions. But sadly what I also see is way too many of these very intelligent people showing that they are more determined to be the smartest person arguing for single-payer than they are to win the issue. It looks like many people need the personal win more than they need the real policy progress. Have you ever seen someone sell a product or service and then be unable to shut up and close the deal? I think we've all seen that happen in various settings in life. And many progressives want to over-prove their positions. Intellectualizing those issues has its time and place but can also turn off large numbers of people who might otherwise be allies.
So, how do we turn the movement for single-payer into one that truly reflects and promotes the needs of the widest number of people? We might start by really engaging as leaders of our movement the people most injured by the market-based, profit-driven, dysfunctional system. That was happening a bit as patients and caregivers were used as props during the debates about the Affordable Care Act/Obamacare. But being used as a prop for a politician's or group's policy agenda isn't the optimal way to engage the health care system refugees. Far better to allow us to tell our stories, recover our dignity and begin to lead the movement forward with the kind of wisdom that comes from authenticity and clarity of purpose. Many of us are plenty smart, by the way.
In Colorado alone, after Obamacare's exchange is up and running, as estimated 400,000 people will remain uninsured and hundreds of thousands more will be under-insured. These people will not be from among the poorest of the poor or the wealthy classes. It will be more working class people who continue to suffer for appropriate health care. Access to health insurance is not the same as access to health care. Large deductible, co-pays and out of pocket expenses will make many people unable to use the health coverage they must purchase to be compliant with the law. I know that's the case for me right now. $875/month for my Aetna coverage, and I cannot go get the care I need as a cancer patient. Talk about a broken system.
We need the facts and all the data. We need the people who have built this movement and kept it alive for decades. But what we really must find is the courage to bust out of the "way-we-have-always-done-things" mentality to include those people whose presentations may not be as polished or professional but who can teach us all with their honest accounting of the realities for working class people as spoken, recorded and documented by working class people. The intellectual class needs to stop looking down its nose at the working class and stop speaking for us. Our voices are as valuable as anyone's. But our voices won't be heard if silenced by those in the single-payer movement who want to see themselves as the more capable saviors just because they have the societal, financial, and intellectual standing to do so. Many working class people might rather suffer the cruelties of the greedy system we already understand than be crushed by hypocrites who pretend they give a damn.
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