An electrifying young President sweeps into office promising change. He institutes broad legislation in the first few months of tenure. He moves mountains and the Hill stands in awe. Yet, one piece of legislation bogs him down, expends his political capital and stalls future change. Bill Clinton stalled on Gays in the Military – society was not ready.
Will Obama falter the same way with Health Care?
Fevered town hall meetings, Democrats refusing to fall in line, alarming allegations of “death panels” from Sarah Palin – it has become the intractable issue of the administration. Propping up failed banks, breaking apart GM, stabilizing the economy – are all Lilliputian tasks compared to the healthcare quagmire. Even the passing of Sen. Edward Kennedy may not be enough to rally politicians around this critical issue.
With Congress and the President on vacation, the issue will play out after Labor Day, a good chance for us to reflect on why the White House is losing this war.
Everyone recognizes the need. First, it is irresponsible for a developed society not to provide basic health care as a primary right for its inhabitants. Second, the current system is untenable with health care costs consuming a huge part of the nation’s GDP – resources that could potentially be used for other causes – primary school education, medical research, or climate control. So why are people so scared to implement this change when the need is so apparent?
Neill Blomkamp’s film District 9 is an electrifying portrayal of a society at odds with its own residents. An alien space ship docks above Johannesburg, filled with a derelict extra-terrestrial populace that eventually take up residence in the slums of the city. Shot on-location in Soweto, the allegory of the apartheid era is front and center. The citizens of Jo-burg – both black and white – allow the foreigners to reside initially but then turn against them. The aliens’ otherness is exploited by a multi-national corporation, reviled by humans, and forgotten by the government.
The human citizenry is unwilling to extend any rights or dignities to the strangers. They are essentially left to fend for themselves; cordoned off from the rest of the populace by high walls and barbed wire. Drawn in such stark contrast, the despicability of the act is apparent, and yet the analogy to our current circumstance becomes even more deplorable. Despite the fact that aliens almost look like humans, as a society we are willing to create a second class of citizens who are allowed to live amongst us, but for whom we choose not to expend our own money to afford the same rights.
Torchwood: The Children of Earth, the third in a series of BBC shows describes a covert quasi-government team that watch over a space-time rift in Cardiff, Wales. A spin-off from the show Doctor Who, the latest installment finds the Torchwood group resisting an invasion by extra-terrestrial creatures who demand a fraction of the planet’s children. The aliens’ plot is aided by the highest levels of government who make the trade-off in order to prevent a virus being unleashed on all the people of the world.
The story characterizes society’s ethical options when weighing one evil against another. The choices are not easy and no answer is “correct”. In the show, the government decides to sacrifice the poorer and less-educated children in the country, rather than make a random allocation across all strata. The answer is reprehensible to some and acceptable to others, but where the government universally falters is by making the choices covertly. The secrecy engenders distrust, and the purposeful distractions by the government reinforce the suspicion.
Given the sweeping regulatory changes that have taken place in the past few months, with health care the country may be saying it is too much to digest in one go. This is something that people need time to process. We know there is an inherent reluctance to extend healthcare to portions of the population that some consider are either undeserving or believe will unnecessarily usurp resources.
Building on the reluctance, there is wide-spread distrust in a government program making decisions around health care provision –whether it be end of life choices or basic preventive care. People are worried that they won’t be able to get the care they want. In any legislated program, there will need to be some choices – an elderly alcoholic with cirrhosis should not be given a new liver, when that money can be used to purchase free Measles, Mumps and Rubella vaccines for children. So are there similar choices hidden within this bill?
Our charming 70-year old, libertarian host at a B&B in Callistoga, CA expressed both issues quite simply. She is a hard-working lady who raised five children, cares about public service and came from a working class background. Her worry was that extending services to a broader population would only lead to a waste of her tax-payer resources on unnecessary procedures.
The administration is faltering because it is not addressing these two concerns of the populace. First, why it is critical to extend primary care benefits to the entire population and second, what implications this would have on the care being provided to people who are covered today. Similar to how Obama described the implications of his tax changes, i.e. people who make less than $250,000 will not see there taxes increase, he needs to make some clear and incisive statements on the implications of this legislation.
The sheer size of the bill – H.R. 3200 – which is over 1000 pages does not make it any easier to understand the two issues. The nation is asking for some clear answers, transparency around the decision-making and some time to digest. Let’s provide this and get this important bill passed.
August 30, 2009
Saturday, August 29, 2009
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