Health Care for All? Bah Humbug!
by: Craig Wiesner on December 25th, 2009 | 13 Comments »
My friend, the Rev. Geoff Browning is a campus minister at Stanford University and a peacemaking advocate in the Presbyterian Church’s San Jose Presbytery. He wrote this essay and has given me permission to share it with Tikkun Daily visitors. The title should give you a guess as to where Geoff is going with this one (don’t fall asleep while reading it or you’ll get three visitors……)
Health Care for All? Bah Humbug!
With every passing week, the debate over health care reform is sounding more and more like something out of a Dickens novel. In the wake of President Obama’s speech on health care, the raucous town hall meetings of August and the slow motion train wreck of reform legislation, we hear almost nothing about those who are suffering without access to health insurance or are denied care even when they have insurance. The current debate is about more than health care reform; it is a debate over what kind of future we want our country to have. And the story of Scrooge may or may not presage our own future. Scrooge, that infamous character in “A Christmas Carol,” has become a cliche for every greedy and selfish misanthrope. Charles Dickens describes his character,
Oh! But he was a tight-fisted hand at the grind-stone, Scrooge! a squeezing, wrenching, grasping, scraping, clutching, covetous, old sinner! Hard and sharp as flint, from which no steel had ever struck out generous fire; secret, and self-contained, and solitary as an oyster….
The anti-reform politicians, like Scrooge, want us to be “solitary as an oyster,” evoking the ideal of self-reliance and independence from our idealized pioneer past. But none of us is unaffected by the disasters of illness that may befall everyone else. Swine flu is only the latest reminder of just how interconnected we are whether we care to admit it or not. Is it in the common interest to deny people access to health care until their illnesses become critical? Is it in the common interest to withhold care until it becomes not only a medical but a fiscal disaster, spreading both infectious disease and financial ruin?
Martin Luther King, Jr. reminded us during the civil rights era that, “All [people] are caught in an inescapable network of mutuality.” So it is ironic that in our increasingly and unavoidably interconnected world that so many are attempting to deny that reality. And yet, the animus of their rhetoric intensifies in proportion to anti-government enthusiasts that are fomented and fueled by corporate money.
Dickens’ story continues,
“A merry Christmas, uncle! God save you!” cried a cheerful voice. It was the voice of Scrooge’s nephew, who came upon him so quickly that this was the first intimation he had of his approach.
“Bah!” said Scrooge, “Humbug!”
“Christmas a humbug, uncle!” said Scrooge’s nephew. “You don’t mean that, I am sure.”
“I do,” said Scrooge. “Merry Christmas! What right have you to be merry? What reason have you to be merry? You’re poor enough.”
“Come, then,” returned the nephew gaily. “What right have you to be dismal? What reason have you to be morose? You’re rich enough.”
Scrooge having no better answer ready on the spur of the moment, said “Bah!” again; and followed it up with “Humbug.”
Scrooge’s infamous reply to the merriment and generosity of the season is not unlike the rhetoric of the anti-reform advocates. Here we are the wealthiest nation in the history of the world, yet we are the only industrialized nation that doesn’t include health care for all of our citizens. We are “rich enough” and yet our collective response has been, “Bah Humbug!”
When Scrooge is visited by two gentlemen, who are collecting contributions for the poor, Scrooge replies,
“Are there no prisons?”asked Scrooge.
“Plenty of prisons,” said the gentleman, laying down the pen again.
“And the Union workhouses?” demanded Scrooge. “Are they still in operation?”
“They are. Still,” returned the gentleman, “I wish I could say they were not.”
“The Treadmill and the Poor Law are in full vigour, then?” said Scrooge.
“Both very busy, sir.”
“Oh! I was afraid, from what you said at first, that something had occurred to stop them in their useful course,” said Scrooge. “I’m very glad to hear it.”…
“I wish to be left alone,” said Scrooge. “Since you ask me what I wish, gentlemen, that is my answer. I don’t make merry myself at Christmas and I can’t afford to make idle people merry. I help to support the establishments I have mentioned — they cost enough; and those who are badly off must go there.”
“Many can’t go there; and many would rather die.”
“If they would rather die,” said Scrooge, “they had better do it, and decrease the surplus population.”
Nineteenth century England was a miserable place for the poor and destitute and while we have gratefully abandoned workhouses and sending people to debtor’s prisons, we are pushing millions into bankruptcy and poverty. The American Journal of Medicine reported that in 2007, 62% of bankruptcies were caused by the burden of medical bills. Yet poverty is not the only threat.
In June of this year, Laura, a 49-year-old nurse in Minneapolis who had been laid off and ironically without access to health insurance, began to have health problems of her own. Her heart rate had increased and she was having trouble breathing. She feared the cost of a doctor or hospital visit until finally, her family prevailed upon her to go to the hospital. She was relieved when they informed her that her condition was caused by a hyperthyroid condition and easily treatable. But she had waited too long to seek treatment. She tragically succumbed to a blood infection within 18 hours of arriving at the hospital.
Approximately 15% of our fellow citizens do not have health insurance because they can’t afford it or because they have a preexisting condition that makes them, in a bow to profits before people, uninsurable. Harvard-based researchers have found that nearly 45,000 people like Laura die every year because they lack health insurance. In effect, the anti-reform advocates say, “If they would rather die, they had better do it and reduce the surplus population.”
On Christmas Eve, Scrooge says to his lone employee, Bob Crachit,
“A poor excuse for picking a man’s pocket every twenty-fifth of December!” said Scrooge, buttoning his great-coat to the chin.
Scrooge was of course complaining about his employee expecting Christmas day off. We take these benefits for granted today and they serve not only to make our places of employment less burdensome and more enjoyable, they serve to make the harsh capitalistic contract between employer and employee more humane and civil. And both benefit from this humanizing and civilizing arrangement.
While most large employers offer health insurance to their employees, there are many that do not. And if employment is going to remain the primary means of access to health insurance, then we are ignoring the huge disparities that arise in the ebb and flow of employment in our boom and bust cycle of the economy. This situation can only be rectified through a public option that will be available regardless of employment or ability to pay.
Yet the parsimonious advocates of the status quo wail like sows in heat that government-run health care that covers those that are currently uninsured would be too costly, would be “A poor excuse for picking a man’s pocket….” And yet, ironically and hypocritically, many of those who warn against the evils and cost of government-run health care are themselves the beneficiaries of government-run health care, in other words, all of congress.
The reality is that whether employers provide health insurance coverage or not and whether there is a government public option or not, we all bear the burden of the cost of the uninsured in the form of higher insurance premiums, higher risk of infectious disease, lost productivity, lost economic vitality, as well as the ripple effect of broken families and lives in the course of poverty and bankruptcy.
Under the current system, we see that clinics, emergency rooms, and hospitals are closing because caring for the uninsured is bankrupting our system. And it is not a coincidence that the shrinking health care facilities are disproportionately impacting communities of color and low income neighborhoods. Even though emergency rooms and hospitals are closing in poorer neighborhoods, fewer facilities will affect us all.
Yet, the denial of coverage to all of our friends, neighbors, and fellow citizens diminishes us all. It fractures the bonds of community and makes our society more susceptible to the corrosive elements of poverty, crime, and the growing gap between the rich and the poor. The decline of civilization most often comes to pass not from the invasion of external enemies but from the decay of internal institutions of support.
When the Ghost of Christmas Present tells Scrooge that Tiny Tim is not likely to survive,
“No, no,” said Scrooge. “Oh, no, kind Spirit. Say he will be spared.”
“If these shadows remain unaltered by the Future, none other of my race,” returned the Ghost, “will find him here. What then? If he be like to die, he had better do it, and decrease the surplus population.”
There are times when we are able to keep the troubles and horror of the world at bay by keeping our distance, by the remoteness of their suffering as if it is on a distant and unknown continent. But everything changes when those who are suffering become proximate through acquaintances, family, friends, when they acquire a name. Those who are suffering and dying without access to health care, and sometimes with it, are our friends and neighbors, our fellow citizens.
In 2007, CIGNA denied the request of 17-year-old Nataline Sarkisyan for a liver transplant. Her parents and friends spent weeks appealing and eventually protesting the decision at the company headquarters. An overwhelming public outcry and support for Nataline caused the company to reverse its decision and approve her request. But the decision came too late. Nataline died while waiting for her operation after the company’s approval.
Scrooge hung his head to hear his own words quoted by the Spirit, and was overcome with penitence and grief.
“Man,” said the Ghost, “if man you be in heart, not adamant, forbear that wicked cant until you have discovered What the surplus is, and Where it is. Will you decide what men shall live, what men shall die? It may be, that in the sight of Heaven, you are more worthless and less fit to live than millions like this poor man’s child. Oh God! To hear the Insect on the leaf pronouncing on the too much life among his hungry brothers in the dust.”
Are those with access to adequate health care more deserving than those without? Who are we to say that some should be covered while others suffer and die without adequate care? President Obama quoted a letter from the late Senator Kennedy that said in part, “What we face is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.”
Finally, the Ghost of Christmas Future brings forth,
From the foldings of its robe, it brought two children; wretched, abject, frightful, hideous, miserable. They knelt down at its feet, and clung upon the outside of its garment.
“Oh, Man, look here! Look, look, down here!” exclaimed the Ghost.
They were a boy and a girl. Yellow, meagre, ragged, scowling, wolfish; but prostrate, too, in their humility. Where graceful youth should have filled their features out, and touched them with its freshest tints, a stale and shrivelled hand, like that of age, had pinched, and twisted them, and pulled them into shreds. Where angels might have sat enthroned, devils lurked, and glared out menacing. No change, no degradation, no perversion of humanity, in any grade, through all the mysteries of wonderful creation, has monsters half so horrible and dread.
Scrooge started back, appalled. Having them shown to him in this way, he tried to say they were fine children, but the words choked themselves, rather than be parties to a lie of such enormous magnitude.
“Spirit, are they yours?” Scrooge could say no more.
“They are Man’s,” said the Spirit, looking down upon them. “And they cling to me, appealing from their fathers. This boy is Ignorance. This girl is Want. Beware them both, and all of their degree, but most of all beware this boy, for on his brow I see that written which is Doom, unless the writing be erased. Deny it!” cried the Spirit, stretching out its hand towards the city. “Slander those who tell it ye. Admit it for your factious purposes, and make it worse. And abide the end.”
“Have they no refuge or resource?” cried Scrooge.
“Are there no prisons?” said the Spirit, turning on him for the last time with his own words. “Are there no workhouses?”
The anti-reform advocates are attempting to sell us a dystopic future where suffering and poverty flourish while a few proudly cling to the chant of self-reliance and government by the wealthy and for the wealthy.
But we can choose a different future. We don’t have to pander to the fear mongers and demagogues. President Obama said as much in his speech on health care reform,
We did not come to fear the future. We came here to shape it. I still believe we can act even when it’s hard….
That large-heartedness — that concern and regard for the plight of others — … is part of the American character.
We all know how the story of Scrooge ends, how he, became as good a friend, as good a master, and as good a man, as the good old city knew, or any other good old city, town, or borough, in the good old world.
However, we don’t yet know how our story will end. Will we like Scrooge choose to open our hearts to the world? Or will we, as the Ghost of Christmas Future portends, choose a dystopic future where fewer and fewer people of means squabble and fight over fewer and fewer resources?
The anti-reform protestors aren’t just protesting health care reform; they are protesting the vision of our common future, our sense of community and care for one another, our interconnectedness. When they employ tactics of fear and misinformation, they feed the paranoia and xenophobia of our society that lies just beneath the surface that has produced the violence of racism, sexism, and even genocide.
This is not the first time that we who are on the threshold of change have been challenged to choose carefully. We must weigh the risks and rewards of our rugged and stubborn individualism with those of community, of walking into the future together. We read in the Torah, “This day I call heaven and earth as witnesses against you that I have set before you life and death, blessings and curses. Now choose life, so that you and your children may live.” (Deuteronomy 30:19)
The choice is ours. May we choose wisely.
This post was written by Geoff Browning, a campus minister at Stanford University and peacemaking advocate in the Presbyterian Church.
Thank you for this beautiful article! I have been feeling incredibly dispirited since Lieberman demolished the Senate reform bill.
We need to take what we can get here and then prepare to slowly make the health insurance industry something like a regulated utility, as exists in some parts of Europe. The first step is stripping the industry of its antitrust exemption. The second is to make the industry’s accounting completely transparent.
Lauren–Don’t despair. This legislation is a beginning–however weak. This will cost so much that we will think twice about more unnecessary wars. This will take time. Most people seem willing to put their grandkids in hock for warfare but not healthcare.
The progressives should make one more effort to trim insurance company profits and make them more transparent.
In the long run, we have to shift gears. Single payer is best, but opposition to “socialistic” single payer is now the conventional wisdom.
We need to make the health insurance industry a utility which lacks anti-trust protection, except to the extent that the insurance companies go together to bargain for drugs, other goods and services.
The Democrats have been pathetic in handlint the politics of this and could suffer greatly at the polls. They should have front loaded many good features of the program so the effects would be felt before the coming elections. They also let the Right dominate the bebate.
The simple fact is that this is a right-center country. We were lucky to get this much.
All the Churches and synagogues should have been upfrong in supporting this legislation that makes the condition of so many a little better. They were not, but will later claim they were on record. How disappointing.
Sherm
.
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Your article was well put. I will add that I have unfortunately seen as many of my progressive friends be as angry as some of the raucous voices on the right. That to me is detracting from our (progressive) effectiveness in bringing justice and peace and joy to the world. One IMHO cannot heal the world through being judgmental – or from being passive. I see Jesus of Nazareth as being neither – although he confronted the unjust systems via shocking and provocative language because it presumable was the only way he could get the attention of the people in the “establishment” !
Merry Christmas!
Unfortunately, the goal of the Dems was “health insurance for all” not “health care for all.” We are far from having done the necessary organizing to achieve the latter (which I assume all readers of this blog support).
How do webalance the moral realities: 30 million people will be able to access the system who cannot do so now (a huge victory), no more Pre-existing conditions, etc, etc against the fact that the legislation will continue our paying monetary tribute to vested interests (insurance companies, etc). This is the cause of our angst.
If you read about or hear any of the stories of folks who have been screwed over by the exisiting system, it seems to me we have to be glad that those conditions will largely be ended by this legislation.
I encourage you to check out this article (http://blog.pdamerica.org/2009/12/the-courage-of-our-convictions/) written by Senator John Marty, a candidate for Governor in MN. His MN Health Plan (www.mnhealthplan.org) is a single-payer plan. Really encouraging! In this season, let us remember to have hope AND courage!
Beware, I say, beware of any whose favorite author is Ayn Rand or whose favorite book is one of hers, for such as they would have us all live in a Dickensian dystopia where they are at the top and the rest of us are at the bottom, if we survive at all. Beware the corporocrats, and beware the politicians whom they own. Claiming that such as this is a reform of health care, they have given us the gift of health insurance pseudo-reform, a gift we accept at our peril.
The bill which has passed out of the Senate meets what I refer to as the Potter criteria and must be opposed by any person of conscience:
“If Congress … fails to create a public insurance option to compete with private insurers, the bill it sends to the President might as well be called ‘The Insurance Industry Profit Protection And Enhancement Act.’” — Wendell Potter, former Communications Director for health insurance giant CIGNA.
The strongest opposition statement which I have seen, the strongest statement with an plan of action, was outlined by Keith Olbermann in one of his [in]famous Special Comments:
“The Senate bill with the mandate must be defeated, if not in the Senate, then in the House. Health care reform that benefits the industry at the cost of the people is intolerable and there are no moral constructs in which it can be supported. And if still the bill and this heinous mandate become law there is yet further reaction required. I call on all those whose conscience urges them to fight, to use the only weapon that will be left to us if this bill becomes law. We must not buy federally mandated insurance if this cheesy counterfeit of reform is all we can buy. No single payer? No sale. No public option? No sale. No Medicare buy-in? No sale. I am one of the self-insured, albeit by choice. And I hereby pledge that I will not buy this perversion of health care reform. Pass this at your peril, Senators, and sign it at yours, Mr. President. I will not buy this insurance. Brand me a lawbreaker if you choose. Fine me if you will. Jail me if you must. But if the Medicare Buy-In goes, but the Mandate stays, the people who fought so hard and so sincerely to bring sanity to this system must kill this mutated version of their dream, because those elected by us to act for us have forgotten what must be the golden rule of health care reform. It is the same one to which physicians are bound, by oath: First do no harm.” — Keith Olbermann.
Keith Olbermann and Howard Dean are two of my political heroes. Both said that the bill which has emerged from the Senate is cr*p designed to fertilize the insurance thieves’ — er, companies’ profits at the expense of the common citizen. Dean initially called for the death of the bill but now says that the problems can be repaired in conference with enough effort. However K.O. has gone further and called not just for the dismantling of this travesty but for active resistance to it. How many of us will follow him to the streets, to the barricades, to the jails?
Adequate quality health care will only become a basic human right here in the U.S. if we take to the streets in civil disobedience as those who marched and sat-in refused to cooperate with immoral laws during the earlier civil rights push of the 60s. Health care is the civil rights issue of our time.
“This struggle [for freedom] may be a moral one; or it may be a physical one; or it may be both moral and physical; but it must be a struggle. Power concedes nothing without a demand. It never did and it never will.” — Frederick Douglass.
The struggle for the civil rights issue of our time must be taken to the streets, to the community centers, to the corridors of power. We must not accept what is given if it is less than quality adequate health care as a basic human right.
“The work goes on, the cause endures, the hope still lives, and the dream shall never die.” — Senator Edward Moore Kennedy.
Let us pray that quality adequate health care as a basic human right does not remain a dream for our people and that we are not watching the health care system morph into an even greater health care nightmare for America. Let us pray that our hopes for real health care reform are not killed by institutional power. Let us pray tht the cause is not further eroded by the political equivalent of the “death of a thousand cuts”. Let us pray for the strength to persist in the work so that our children and grandchildren willl live in a culture which has finally caught up to the standard of care given by the Neanderthals to their sick and infirm (relative to their technology and resources).
And let us act in support of these prayers. When asked/ordered to purchase private health insurance, when given no choice of a single-payer/strong public option/Medicare Buy-in plan, we must be as Bartleby the Scrivner and reply, “I prefer not to.”
Tactically, there is a world of difference betw the civil rights struggle (with numerous points to display resistence) and what we will face if a bill such as this is passed (Obermann;’s comment is the ONLY one I have seen that goes beyond expressing moral outrage to actually considering tactics).
The reality is that it is unlikely that the Senate would ever pass something we liked. Maybe we have to organize to get senators to eliminate the super-majority for cloture (60 votes)–which, BTW, Harry Reid could change tomorrow with the backing of a majority of Dems in the caucus).
Quoting Ted Kennedy solves nothing. Progressives must move beyond outrage to real plans for action. In ACT/UP we said that “anger=action” and we did act. Voicing anger alone does nothing to remedy the situation.
Meanwhile, while we are furious that the insurance companies are richer, 30 million more people have some security about their health needs being met, numerous people who would be denied care because of pre-existing conditions, etc will be served, etc, etc. How does Obermann balance out these real gains with his outrage at corporate profits? why doesn’t he call for an excess profits tax (could be levied on other induistries too–say to pay for all these wars, etc such as was done in the past)? Call for organizing to remove anti-trust exemption that the insurance industry enjoys? etc.
He is wealthy enough to self-insure, so he wouldn’t risk loosing health care by his tactic. most others would–is that all we can do, ask folks to give up these real gains to try to pressure legislators? Why would legislators be moved by that when they have been so little moved by the existing situation of people going without health care. illogical.
At this point the “hope” in the good reverend’s message is a luxury for the Haves and those who-wanna-be-Haves. For those like me at the bottom, we’re trying to figure out what utilities we’ll be able to cut as we realize the mandates and the “insurance profit enhancement” factors in this “reform” we just got saddled with means a direct cash loss every pay period, every month. It has to come from somewhere.
We’ve already cut clothing, OTC meds (only enough to buy the required RX), treats and niceties like the monthly candy bar, gone. Most likely we’ll go back to the strategies we used when we were younger, only running one light or appliance at a time, nothing on during the day, showering once a week, walking rather than driving, cutting computer use by 70% (although internet access is a fixed cost and required for both our job-loads), and not using the furnace unless the temp drops below 40F. We already got a letter from Aetna announcing the “enhanced” insurance packet–most of our needs will not be covered, we already cut my mental health costs by not taking care of me, my son was next, my daughter, well, she’s no longer covered any longer. Math is hard enough for me. I’ve been having to do a lot of it lately. I never thought I’d be teaching my kids how to mooch off wealthier friends. But I just did that this morning, aware of just how much less income we’re about to have under the congressional debacle and our insurer’s quick action to cut coverage and increase premiums and copays.
Pretty tough to envision anything but a dystopia when the harder we work the less we have and now, after a decade of steadily losing everything, home, vehicles, clothing, and now, many more basics because we’re required to pay for Aetna’s executive-level opulence, thanks to Congress and the owning-class who have all the power. Fantastic. Just fantastic.
I’m out of the fight. There’s nothing more I can do. I cannot afford to do anything but become a hyper-conserver and hyper-vigilant against spending any money beyond my mandated premiums. I’m just overwhelmed with joy and gratitude right now.
We have the best government that money can buy. We have a fascist government that squanders our resources on war and armament. We have legislators that are well paid and well insured.
We have a problem.
“Democracy” is the new way to pronounce “fascism” in United States. From now on, a country that think how to avoid to take care of the health of its people is a “democratic” country.
I am not a democrat, I am a French citizen who see the new “democratization” process trying to get settled in Europe. It will probably be successful.
I’ve said this on several critical responses, and will say it one more time. In at least one hundred years we have said : “all or nothing.” And so we’ve had NOTHING that comes close to approaching the best answer, the single payer approach. We do not live in a dictatorship, which is good…or bad in this case, but still is the best overall. In order to improve what we may have in a few months, we need more progressive congresspeople. Obama cannot do it on his own. Sure, we’ve got a lot of compromises,
but when I hear of those who won’t vote anymore because they have a mad on or those who will vote for someone else (McCain/Palin??), they are shooting themselves in the foot. Yes, I would prefer a more progressive candidate at every level, but they have to get nominated AND elected. Get real and settle for what we have and work towards improvements. That’s what we did with social security, civil rights and a host of other progressive issues.
Nice post & nice blog. I love both.
http://godslegacytrust.blogspot.com
This is the solution to our health care crisis. We all ultimately turn to God during times of crisis. This will create a propagating, everlasting, taxable income stream that will create jobs, pay for socialized health care and rebuild social security.