Blog#62- 3/1/21
NO HOPE FOR REFORM
By Richard Davis
As the pandemic unfolded it became clear how dysfunctional the American health care system is. There was even talk among a wide range of people about the urgency for the need for systemic reform. Sadly, when legislators talk that way nothing usually happens. They recognize the problem, say something must be done and then move on to the next pressing issue. Anyone remember gun control?
This has been the case both nationally and on a state level. The Biden administration has done a few things that will tinker with the Affordable Care Act (ACA) to undo some of the damage that the previous administration did and make insurance a little more affordable for some people, but it is unlikely they will make any bold moves when it comes to health care reform.
The pandemic opened up the gaping holes of unequal access to health in this country. Currently 10.9 percent of the population, 44 million adults, do not have health insurance and another 38 million who are insured do not have adequate (insurance they can afford to use) coverage.
In 2010, 17.8 percent of the population was uninsured, so the ACA improved access to insurance for more people. But that model continues to rely on the private insurance market and as long as that is the case we will never have a universally accessible and affordable health care system.
One could make the case that a large part of the reason that over 500,000 Americans, the highest number in the world, have died from COVID 19 is because of the lack of access to basic health care for a significant portion of the population. Instead of looking beyond those numbers and trying to deal with root causes this country has fixated its attention on vaccinations.
Not that there is anything wrong with doing a good job at vaccinating as many people as possible, but politicians should be able to do more than one thing at a time when it comes to health care. That doesn’t seem to be the case.
When this pandemic is finally declared under some degree of control and we actually move on to a different life there will be no effort to correct the inequities in our health care system because politicians will be too busy trying to take credit for getting the job done.
The political process, on all levels, only functions within a climate of damage control. There is rarely effort made to do long-term planning. A good example is this country’s crumbling infrastructure. The Biden administration has given lip service to working on this but the only way that will happen is for there to be significant decreases in the defense budget. Probably not going to happen.
It is more important for the government to support companies making missiles and weapons of mass destruction than it is to re-build crumbling roads, bridges and power grids. The roads and bridges don’t send too many lobbyists to Washington.
It was not that long ago that Vermont offered a beacon of hope for health care reform for the rest of the country. We were on a path to implementing something close to a single payer system but that all fizzled out when the Shumlin administration decided it was not affordable. That move put the final nail in the coffin of major health care reform efforts in Vermont.
If we are ever to implement health care reform on a state level and have that be a model for the rest of the country we will need a new movement of activists to coalesce around a unified political strategy. Some believe that states cannot be such a model because the scale is too small.
The activists who did the earlier health care reform work are getting older (myself included) and the energy that has remained through organizations such as the Vermont Workers Center and Vermont Health Care for All just don’t seem to have the momentum and the attention of pathologically distracted legislators that they need to make the change necessary to transform and not patch existing health care institutions.
I don’t see any easy answers to creating a new wave of health care reform. Perhaps we have to wait until we live in a post-pandemic world for that to happen.
Medicare for All trick
Instead of waiting for them to lower the age for medicare (for all), I’ve decided to beat them and simply increase my age each year until I qualify. Nyah.
…
I think part of the activist enthusiasm problem is that health care is rather crappy in the US. Put a lot of activist energy in, work hard, and get results… and end up with rather crappy healthcare if you are lucky. The incentive is low.
Clever Strategy!
We seem to have stumbled upon the same strategy, and I’m accomplishing it more quickly than I’d have thought possible!
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Our human/social services availability is simply the lowest in the advanced industrial world now. And – all nations have ups and downs, we’ve had bigger problems – we can fix it. That is, IF we accept we have problem(s), and work on them. There is nothing wrong with being in a nation with flaws, they all have flaws. We are not perfect creatures, and 300+ million of us in a complex, convoluted, changing environment like the United States are going to have to work hard to get along and keep things humming and improving. But what is wrong is when its not ok to observe problems.
It feels to me like if a bunch of folks bought a bus together, and on a trip some folks mention they hear the engine making a bad noise. And when they say “hey, we should pull over and work on that”. In response they get “what, do you HATE this bus? Then *get off*!!!! This bus is the BEST!” And we’d reply “no, I love this bus – that’s why I want to tune it up and keep it on the road!”. Hearing back the chant: “Throw them off the bus! Throw them off the bus!!! This bus is number one!” etc.
Anyway – it a complicated universe, any nation is going to go up and down. Its not easy. But a certain way to doom is to not even be allowed to point out the problems, then they can’t be fixed! In some circles in the United States now its considered unpatriotic to consider the kinds changes that will have to be made to make this a sustainable system. (“We might have to change the gearbox! Or the muffler!” I suck at car analogies) Anyways, It feels like we are at a tipping point right now, and our healthcare system is one of the biggies.
Many Americans Don't Want Healthcare Reform
One thing I learned during the 2020 election season was that many people, including some I thought of as “liberal” were actually dead against anything that could be labeled socialism. That very much includes healthcare. The anti-socialist upbringing of many voters seems to be a major obstacle to getting any kind of healthcare reform, because anti-socialists are almost invariably pro-capitalist. I haven’t figured out whether it’s affluence or cold war propaganda that creates this bias, but it’s definitely out there, and frankly, I think people who hold these views outnumber those who don’t.
I Suggest Solidarity
I always appreciate Richard Davis’s perspective on health care and am thankful he shares his thoughts and experiences with us, and thank you to iBrattleboro for publishing them.
I’m also thankful Richard mentioned the Vermont Workers’ Center. But, I disagree with his statement that we don’t have the momentum we once did and that we’re unable to get the attention of legislators.
This past year has seen more and more people willing to get organized and active in political efforts in Vermont and nationwide. In case anyone was mistaken or otherwise unaware, COVID-19 has driven the point home: this system isn’t working for the overwhelming majority of us.
I joined the Vermont Workers’ Center this past summer and have gotten active in their organizing efforts and it has been incredibly rewarding. Working (remotely) with good people across Windham County, and statewide, has given me hope and solidarity in a time of extreme isolation and despair.
The Vermont Workers’ Center is actively working to bring actual affordable health care — not just “access to health insurance” — to all people living in Vermont. Remember Act 48, which was supposed to deliver this? We do, and we’re pressuring the Legislature to get it funded.
It takes many of us to make a difference and get the Legislature’s attention. And more of us are joining the Vermont Workers’ Center and working toward the goal of health care as a human right and a basic need.
You have a story, too, about how the current system has failed you, and you deserve to have your story heard.
Please visit https://www.workerscenter.org/ for more information, and for how to connect with the Center.
Thank you,
-Wendy
p.s. This statement and these experiences and opinions are my own, and I do not purport to represent the Vermont Workers’ Center or its members.