This socialist concept becomes “free-market” when the individual risk pools are limited and kept separate from each other so that each insurance company can figure out how to keep the healthiest, most financially secure people in their group and leave the sicker, poorer people for the other companies to insure. Sort of like a discard pile in a game of whist. To create a single risk pool in which no one is left out would take all of the fun out of this lucrative game.
The other attitude is one I find with people who are already well insured. Part of this is fear of change and the need to protect oneself, but what also so seems to come into play is a sense of status that people see in their health insurance policy. Either because they are well enough off to buy a good policy or even because their union has secured good coverage through hard-fought negotiations people feel that their coverage is an indicator of their position in society.
It’s as if the kind of house you live in or the car you drive isn’t enough to establish the pecking order; people see the kind of security one has in a time of medical emergency as a legitimate part of the free-enterprise system. That we might sink or swim in these situations seems integral to the American self-conception. It is somehow unbearable that someone with less education or who doesn’t exert themselves as much as you or who comes from a different social class should have the same package of benefits. That’s why keeping the less well off in a special category that relies on government funding that could just as quickly be withdrawn has a certain appeal for a large segment of the population.
There is no easy way to overcome this attitude, except that times of insecurity are when Americans have accepted the structural changes that created and strengthened the safety net in the past. I have a friend who was adamant that a single payer system where everyone is covered equally is exactly the kind of insurance that she wouldn’t want to be a part of. But she happens to be a public employee who is now worried about whether her own job will escape the looming budget cuts. If that were to happen I’m sure her view of single payer insurance that is not dependent on her job would change markedly.
Single payer healthcare, though I have painted it in a positive light, is not without problems. Canadians, Germans, French and Taiwanese I’m sure all have valid complaints about the healthcare that they receive. Whether it solves the unique problems we are facing here in America is open to debate.
Which is exactly the point! Who is controlling the debate? Why have the words single payer become as dangerous to utter in the mainstream media as opposition to the Iraq invasion once was? It is understandable why the health insurance industry would prefer to skirt the issue. It is surprising how influential they are in gaining the collusion of the corporate media. But why are the Democrats walking in lock-step with them imposing a virtual blackout on open discussion?
The puzzle of the Barack Obama administration is who has he actually come to Washington to represent. The soaring rhetoric makes average people feel empowered. The appointments he has made during his transition period point to control by the exact same entities that held sway during the Bush administration- the imperial military-industrial complex, Wall Street insiders, mining and ranching interests out west, the nuclear and coal industries. The healthcare reforms that Obama and Daschle hope to implement represent a windfall for the entrenched power of the insurance industry.
At the same time the Obama marketing machine is still in business, reaching out to supporters to help build support for his “agenda”. I have been attending these meetings and the energy and will to fundamentally address our problems by average people is palpable.
So what is going on here? Is all of this effort being expended to try to put us to sleep? To make us complacent sheep even as our own interests are betrayed? Or is Obama truly the stealth progressive who, like FDR is exhorting his followers with big ambitions to “now go out and make me do it”?
Time will supply the answer to this question. It may be a combination of the two. But from the perspective of activists who want to address the predicament we are in with healthcare and our local budgets it doesn’t really matter. If the invitation to help shape the debate is authentic then it should be accepted with vigor. If it is a ruse to keep us distracted then we shouldn’t waste any time in seeing through it and transgressing the bounds of our expected behavior.
A confrontation between entrenched corporate power and a people’s movement for change is inevitable either way. The healthcare debate and the need to talk about single payer as the best option is the perfect place to begin this people’s movement.
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