Will We Be Honest in Our Healthcare Reform Effort?

I finally heard
an honest soul speaking about the healthcare reform efforts thundering
ahead in advance of President-elect Obama's inauguration. And
that's a big step in the right direction.

Single payer supporters - hundreds
of thousands of healthcare professionals, the 90-plus Congressional
members, learned people and regular Janes and Jims - who believe in
a publicly funded, privately delivered healthcare system have suffered
to be at these magnificent "tables" full of selected stakeholders
meeting feverishly but fairly quietly to support an already crafted
agenda while appearing as though they are vetting all options for the
healthcare reform that is decades overdue. Some honesty here would
be good.

The bodies continue to pile up like
cordwood while the polite conference table inhabitants smile and applaud
one another for their ever-so-conciliatory motion to embrace and enhance
and entitle the for-profit healthcare insurance companies and the big
pharmaceutical companies under the guise of true reform. Jump
for joy, we are told, you'll all be able to buy private health insurance.
Oh, and they'll be better controlled. Whoopee! A bail-out by
any other name would still smell as foul...

So, what was the honest response and
explanation I heard? I actually heard a relatively high level
Congressional staff member say we cannot consider single payer reform
because many members of Congress have a visceral reaction to that sort
of reform even being debated or discussed - or God forbid - seriously
considered.

What is a visceral reaction? "Proceeding from emotion or instinct rather than from intellect; deeply emotional,"
Webster's definition of a visceral reaction.

And why do so many members of Congress
have such a deeply emotional and intellectually void reaction to single
payer? Because they rely on insurance and pharmaceutical industry
contributions for campaign funds. It's that simple, said the
Congressional staff member. This is not a revelation, is it?
But it sure was refreshing just to hear it said straight up and without
any sugar-coating by a person who knows the ins and outs and who is
working directly on reform.

It won't be intellectual honesty
or even what's best for the nation and its people that decide this
reform effort, I heard. It will be the big campaign contributors.

But, wait, didn't we - the voters
for whom no similar visceral reactions are had - hand over some pretty
big bucks to the Obama election effort? And with great joy and
great promise? Yes, we did.

And aren't we dying at the rate of
60-plus each day as we go without access to healthcare while the visceral
reactors smile and preen and pat each other on the back for carefully
crafted plans and carefully staged public hearings during which carefully
selected witnesses bolster the plans that will hold visceral reactions
at bay? Yes, we are still dying for healthcare. Death is just
about as deep-feeling as it gets.

Isn't the nation struggling with
industry and public entity collapses and budget crises pushed and fueled
at least in large part by health benefit and insurance costs for employees
and retirees and public employees and poor folks on Medicaid and uninsured
folks showing up for care in the most costly ways? Yes, we are.

Aren't millions of folks struggling
without jobs from which they can get employer-based healthcare and therefore
also without enough income to afford any COBRA benefits or private purchase
of coverage? Well, yes, there's that too.

But, are we now hearing all the realities
of every plan - the true costs to the nation, the true costs to us
as patients and as taxpayers and as voters? And, the true cost
in lives, in bankruptcies, in foreclosures and the fall-out from those
losses of those who will be forced to carry sub-standard coverage because
they are disabled or otherwise physically diminished from an insurance
underwriting perspective? I really wonder how the insurance industry
will wiggle around discriminating against those with serious illness - but wait, insurance companies already are allowed to discriminate
against women of child-bearing age while men of impregnating age are
charged less. Single payer has some outstanding cost saving and quality
control aspects - and inherently avoids some of the Americans With
Disabilities Act lawsuit (and EEOC related claims) potentials ripe in the multi-payer, for-profit
plans as being touted right now. Yet, no, we are not hearing all
of our alternatives honestly and openly debated.

I still have great hope that the truth
will prevail. President-elect Obama is putting good people in
place to work on healthcare even if some of our Congressional members
are struggling with single-payer induced visceral reactions (will those
be pre-existing conditions, I wonder?). Sen. Tom Daschle is one
of those good people (and is to be our new Secretary of Health and Human
Services and health policy czar), and I know him to be a straight-shooter.
His South Dakota roots and his upbringing compel that in his character.
More importantly, his intellectual curiosity and respect for the long
arc of history is well developed. I'm told that arc (at least
in moral terms said Martin Luther King, Jr.) bends toward justice.
And while one person cannot move mountains, certainly one person of
his stature can impact the process.

But I also see too much cozy and comfy
back-slapping, maneuvering of information release and glad-handing with
just one side of the equation right now, so I will remain hopeful but
guarded that the intelligent and committed people who espouse a single
payer way of solving the crisis will be at least as welcome to the banquet
as those devoted health insurance profit-takers and campaign purchasers
who print the menus, set the prices and then collect the checks.
The American people are growing a lot smarter through this whole bail-out
process and giving us more insurance salesmen isn't going to fool
us into thinking we've got better healthcare.

The nation's healthcare plan is too
important to allow less than full disclosure and full investigation
of all of the options - the flaws, the strengths, and the empirical
data that will help us all arrive at a place that bends toward justice
and better health. We've all been thanking our lucky stars that
we'll be welcoming more intelligent leadership into the discourse.
Now let's not allow them to give in to visceral reactions that leave
the intellect behind.