Mad as Hell Doctors Signal New Era of Healthcare Activism

Single-Payer, Yes, Public Option, No

"I am not
the first person to take up the cause of health care but I am
determined to be the last," President Obama declared to great applause
in his recent speech before Congress."

It was a stirring moment, but in the end perhaps just one more
ephemeral moment on the stage of what passes now for political drama in
the United States. Whatever results from the final health care
legislation passed by Congress, we can be sure it will not come close
to solving the health care crisis. The cause of health care,
post-Obama, will go on.

That's the message of the "Mad as Hell Doctors" for single-payer, an
intrepid troop of Oregon physicians now on a three-week national road
tour fueled by a Winnebago and the energy of boisterous supporters at
every stop. They're on their way to Washington, D.C. where they'll
rally on Sept. 30 and ask to meet with the President to discuss the
merits of single-payer.

It's unlikely the group has any high hopes to win Obama back to the
single-payer cause he once formally supported. Actually, it's unlikely
Obama will even meet with the group. The White House has not exactly
objected to the efforts of Sen. Max Baucus (D-Mont.) and others in
Congress to shut single-payer advocates out of the debate.

The Mad as Hell Doctors serve as a counterpoint to everything wrong
with the current health care reform debate. "What we're mad about is
actually not health care," said group spokesperson Dr. Paul Hochfeld
recently on MSNBC's The Ed Show
with Ed Schultz. "What we're mad about is that the industry has once
again manipulated the political process for profits instead of health."

The emergency room doctor from Corvallis, Oregon suggests even Obama
may not have grasped the insurance industry's power before taking
office. But if the President now finds himself a political victim of an
industry whose profits are bought at the price of a society of victims,
he has also not shown the requisite courage to take on the industry's
real power.

Indeed, health care reform ought be the last issue the right wing is
able to exploit. Not when tens of millions are without insurance, while
almost everyone else faces derisory coverage with exorbitant premiums
and out-of-pocket costs. A dismal economy has only aggravated this
sorry state of affairs.

Yet thanks to Democratic efforts to limit and complicate health care
reform, the right has turned an unassailable moral imperative for
social justice into a stupid, noisy uproar over "death panels" and
other nonsense. Meanwhile, many progressive supporters of health reform
have been reduced to saying their prayers that some form of "public
option" plan at least makes it through Congress.

Unlike many liberals, the Mad as Hell Doctors doubt a government-run
public option will amount to much. "This is how we're doing to fix
healthcare [with the public option]?" ask Hochfeld. "We're going to
mandate that everybody in the country that doesn't have health
insurance buy a commercial product that's flawed. If you can't afford
it, we'll make you pay slightly more than you can comfortably afford
and the taxpayer will pay the difference. If you get your insurance
through your employer, then you won't qualify for the public option.
That's 'fixing' health care?"

As Hochfeld also reminded MSNBC viewers, employed people tend to be
healthier than unemployed people. Thus, it's likely under a mixed
public-private system that the public plan will gradually morph into a
mechanism for insurers to transfer the most burdensome patients onto
the public system. The healthier, wealthier, and more profitable
individuals will remain disproportionately represented in the private

In an interview with the San Francisco Chronicle, (Sept.
18, 2009), filmmaker Michael Moore makes the observation that no one
should be surprised by the dispirited turn health care reform (now
called insurance reform) has taken. "If you start, right off the bat,
compromising, don't be surprised if (Obama) is going to keep
compromising," notes Moore.

It didn't have to be. A New York Times/CBS News Poll
earlier this year found 59 percent of Americans in favor of government
national health insurance, with 49 percent saying such insurance should
cover all medical problems. Other polls show even greater support for
the single-payer concept.

Instead of mobilizing this base, the President has conducted himself as
if the most important concern in the health debate is bi-partisan
agreement with the opponents of reform. Apparently, Obama feels
constrained to keep the Republican valets of the health insurance
status quo in the loop for whatever change happens. Other than to
perhaps prove what a reasonable man the President is, the question to
be asked is just: Why?

Indeed, what kind of productive agreement is possible with people whose
motto is no, no, and no to reform? Actually, it's not so much that the
President necessarily cares about Republican support. But he does
accept the entrenched economic power of the health insurance industry
as here to stay. And the Republicans cravenly represent the latter.

If Obama truly wants to be the leader of historic change in health
care, he should call for a mass grassroots activist campaign to demand
insurance companies out of health care. He did once say that
single-payer was probably the best system, if we had the luxury of
starting from scratch. But is it really a "luxury" to try to make the
system right by tackling the root of what's wrong?

Unfortunately, while the crazed right screams about Obama's "Marxist"
mission to dispense Grandma to the gulags for some "end of life"
counseling, the millions of voters once galvanized by his run for the
Presidency have not mobilized with anywhere near equal passion.

It's not hard to grasp why. "He's only going halfway with this public option," Moore tells the Chronicle.
"He needs to remove the private, profit-making insurance companies from
the table." But here the deeper reality of the political status quo
emerges. When was the last time a Democratic President did anything to
promote grassroots mass action for a progressive cause, at least when
it didn't involve their own election?

The Mad as Hell Doctors remind us that the fight for health care reform
isn't really over whether private insurance is more or less good or bad
in taking care of people's health care needs. It isn't over whether
premiums are too high; or there are too many co-pays or policy
exclusions. It certainly isn't about anything the Republicans say it's

This is a battle for the way we define ourselves as a nation. Will we
be a society guided by a sense of compassion and justice, in which our
every medical resource is devoted to the well being of the people? Or
will we be a society in which in the end money trumps justice, and people
suffer and even die because it's just more important to let the
profiteers keep their good thing going?

We need to guarantee every American the right to the best care
possible, regardless of their income. That means private health
insurance companies out of the picture. That means single-payer into
the picture. And, as the example of the Mad as Hell Doctors teaches us,
that also means a new, long-term commitment to grassroots activism for
health care justice.

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