I’ve listened and listened to the ever ratcheting rhetoric about the increasingly vilified Public Option in the Health Care reform bill. And what strikes me is that the vast majority of the people fear mongering about it fall into two distinct camps: 1) those who believe “all government is bad, nothing the government runs can be good or efficient” (my response to this later) and 2) people who are actually currently enjoying the benefits of government run health care coverage but don’t want to share it with others. That latter camp would include the Seniors who are inexplicably waving “Keep Your Government Hands Off My Medicare” signs at Town Hall scream fests. So whose hands do you think are giving Medicare to you? Yup, it’s that bad old government and the simple gist of the Public Option is: Medicare style coverage for all SHOULD THEY CHOOSE TO TAKE THAT OPTION. So you like your Medicare coverage? Let’s extend it to your non-senior neighbors. If they don’t want it, they can choose Blue Cross or a private insurance program. Period. End of story.
Then there are the Congresspeople who have the same low cost, full coverage plan that is available to our military, but don’t want to make that sort of comprehensive coverage — which doesn’t recognize restrictions like pre-existing conditions — available to their constituents. Why is nobody standing up and demanding that any Congressperson who is bent on denying a government coverage option to his constituents must immediately and voluntarily relinquish his or her government coverage and place him or herself at the tender mercies of commercial insurance companies and big pharma?
You don’t hear of anyone taking that step. Because let me tell you, that coverage your Congressperson enjoys? Well, I grew up and thrived under that same coverage thanks to my career Army officer father. It was a coverage plan that continued to provide for my father until his death and still covers my mother. It is excellent and comprehensive coverage that is unmatched in the private sector.
Don’t believe me? Well, under Obama’s plan, you will be free to chose something else. And if you really think it will be that bad, well what’s the fear? If it’s crap, no one will chose it and it will die. Why do you think Big Pharma and the insurance industry are fighting this tooth and nail? Because they know it’s going to be better, more comprehensive and a real challenge to them. They’re scared shitless.
But back to my point, here’s what that government backed coverage did for my family:
1) It deducted a reasonable premium from my father’s pay (which was adjusted fairly over the years in response to his increasing salary).
2) It covered the entire family, including medicine, completely and with no co-pays and with nothing excluded.
3) It allowed us to go to whatever doctor or hospital we wanted — including some of the best in the Nation such as Mass General, Stanford and UCSF — and it covered even experimental and cutting-edge cancer and heart treatments.
Here is what it didn’t do:
1) It didn’t make me, as a teenager, run out and get an abortion (even though that would have been covered.)
2) It didn’t ration our health care. In fact, it covered second opinion visits at a variety of different institutions as well as treatments such as cutting edge pediatric heart procedures for me as a child and aggressive and comprehensive cancer treatments for my father toward the end of his life.
3) It didn’t make me put my parents in front of a Death Panel, even though it offered comprehensive End of Life Counseling.
Want to know what End of Life Counseling is? Well, let me tell you because I’ve been through it. When my father’s cancer had spread to Stage Five and it was found that his liver was slowly shutting down, we were able to have a consultation with medical professionals and receive comprehensive and valuable information about our options. Should we keep on a round of invasive procedures and hospitalizations which would, at best, prolong my father’s life for maybe a few months? Or was there an alternative? Turns out there were a lot of options for home health care that would allow my father to end his life with dignity in his own home, surrounded by family and without being hooked up to tubes. He participated in the discussions of these options and he chose the latter. We could only have made that choice comfortably with the help of health professionals — whose services were fully covered by our government-backed insurance program.
Once my father had chosen Hospice Care, we were provided with home health care nurses to help with his care as well as counseling to help the family through the process. When he died, my father left a family in grief, but not in debt.
It was a coverage that, by its nature, seemed to have some built in efficiencies. Because it was so comprehensive, my parents never missed a check up from well-baby through our teen years. We went to the doctor for every cough, sore throat or health concern. As a result, we naturally fell into a pattern of preventative medicine, getting things checked before they became larger, more expensive and less curable issues. My mother, who has major lung issues (which were a pre-existing condition from her teenage years) has received such good care that, while most other people with her condition are walking around tethered to an oxygen tank, she’s riding horses on trail rides into her late Seventies. Could more be done to promote preventative medicine? Sure. But when you don’t have to weigh the cost of a check up against the cost of dinner, you are naturally more likely to go every six months.
It is the sort of coverage that should be available to all Americans. It’s the sort of coverage that is available to all citizens of France — who according to the World Health Organization have the world’s best health care. In fact, the WHO rates 36 countries ahead of the US in health care effectiveness. How do they rate that? On statistics such as longevity, infant mortality, major disease rates, etc. Okay, you can get all patriotic and split hairs, wave the flag and say our hospitals and doctors are better than any damned Frogs’. Maybe they are. The problem is, not all of us have access to that highest level of care. Too many of us put off doctors visits until it’s so bad we can’t avoid it. At which point, it usually costs much more to address and the problem may be not so easily cured. And that’s when many are forced to make that tough choice between dinner and health care. Or home, college funds, investments, savings and health care.
You want to talk about rationing of health care? Baby, we have that now. It’s rationing by price and by the whim of the insurance companies. On the military plan and the plan your Congressperson enjoys? No rationing. Well, there must be some point where the plan says “we just can’t cover this.” I’m not sure where that point would be. We had my father go through multiple aggressive courses of chemotherapy, radiation, surgery and other treatments for his cancer. At a certain point, we were told that the cancer had spread so aggressively that his liver was failing, which is pretty much the beginning of the end for a 78 year old man. Would they have denied us a liver transplant if we’d demanded it? Possibly. But my father didn’t ask for it. He weighed his options and his expected lifespan. No matter what was done, the outside estimate at that stage was 6 weeks (which he exceeded by sheer determination). He made the choice, backed by the honest information provided by End of Life Counseling, to live the last days of his life without recovering from yet another procedure that wasn’t promising many more weeks.
My final parting shot? That whole argument that government is bad and government can’t possibly do anything efficient. My friend, government is not some big entity in a parallel universe. Because we live in a democracy, our government is us. Go ahead and rail against it. That’s your right under the freedom of speech we enjoy here. But be honest and accept part of the responsiblity for anything you don’t like about government. Because its failings are your failings. They are a direct result of our failure to research the issues thoroughly and make the informed choices that would put representatives in office that will carry out our will. It is our failure, once those representatives are in office, to demand accountability from them — on a constant basis. It’s our tendency, when our party isn’t in power, to vilify the opposition. No matter who gets elected, they are sworn in to represent ALL their constituents. Barack Obama is everyone’s President, whether you pulled the lever or punched the chad for him or not. Let him know what you want — in a civil and proper manner. Let your representatives and Congresspeople know what is important to you.
Call me a starry eyed optimist, but I think it works. I did not vote for Ronald Reagan or George Bush Senior, but I had a long-standing correspondence with both of them. When they did something I didn’t like, I wrote to them. When they did something I liked, I wrote to them. They were my Presidents and I wanted them to hear my voice. And you know what? They wrote back. Several times. I still have the letters. Well, I’m sure it was low-level functionaries that wrote back. But in the aggregate, I think such communication is effective. Did I make a difference? Who knows? But I bet if there were hundreds of thousands of us who wrote to them as I did, they would have listened. On a more direct level, I helped elect the local, regional and state officials that I thought would more directly represent my interests and keep these Presidents accountable.
I have to accept that a small part of Bush Jr.’s failures must be laid at my door. I allowed myself to give in to the whole “I didn’t vote for this guy, I hate him” trap. I dropped out of active citizenry for awhile. Maybe if I, and thousands of Democrats like me, had stayed respectfully participatory, things would have been different. I won’t make that mistake again, no matter who is elected next.
What didn’t I do during the Reagan and Bush Senior years? I didn’t storm into town meetings and shout people down. I researched the issues and I wrote respectful but firm letters outlining what I wanted and expected from my Presidents. If the return letters I received back weren’t written by Ronnie or George themselves, they were answered by someone who actually read them. Because they always answered the exact points I’d raised with specific thought-out answers. It’s a start. And, as a participatory democratic effort, it beats painting a Hitler mustache on a Presidential portrait.
But I’m a long way from my main point. Which is that the government can indeed run an efficient, fair and medically sound coverage option. My entire family — and every military family I grew up with — is proof of that. Ask me any questions you want about my experiences. I’d be glad to share. If you’ve been covered by a similar government-backed coverage option and haven’t had my positive experience, I want to hear about it.
I think we’re all closer to a solution that we think. And I think it can be done without shouting and violence.
I’ll leave you with this food for thought.
Need a common-sense, plain-spoken explanation of the Public Option? Robert Reich lays it all out in two minutes:
Here’s conservative pundit Bill Kristol admitting that the government runs a first-class health care coverage program for the military, but the average American doesn’t deserve it.
Ready for a laugh (through your tears)? Here’s Paul Hipp with a rousing response to the US status as the Number 37th in health care (as rated by the World Health Organization).