TAKE THIS VIRAL

[Joanne98]

Mon Jun 08, 2009 at 08:21:33 AM PDT

I count myself lucky. Mostly. I live in a state in which my two Senators and Congressman are generally on the side of the angels and I rarely lose sleep over their votes in Congress. Many of you are not in this position however. I found myself wondering what I would be saying to my elected representatives if they were on the wrong side of the single payer debate...and that is the genesis of this diary. For those of you gearing up to have such a conversation, I hope this helps.

Momus's diary :: :: Generally, I would be responding to their already articulated position on the issue and would want them to know the following:

Please do not tell me that "we don’t need this because we already have the best health care system in the world." The US health care system ranks first on one dimension and one dimension only: cost. No matter how you slice the apple--total costs, per-capita costs, proportion of GDP spent on health care costs--we have the most expensive health care system in the world. We also have the only health care system among our relevant peers--the western industrialized democracies--that systematically excludes more than 40 million of our citizens from health care through un-insurance and condemns another 10-15 million or so to economic desperation through under-insurance. For all of this, we get oodles of elegant, expensive, over-utilized, high-tech medical procedures and specialists, primarily available to those with access to academic medical centers in major urban areas who have the "right insurance," and a list of health care outcome measures for the general population that make us look like a banana republic. There is no excuse for this. None. Not now; not in the past. If you continue to focus on how we’re doing just fine with what we have because "we’re number 1", I will assume that you are intellectually incapable of understanding the differences between health care systems and the local football team. I assure you that I will do everything I can to see that you are removed from office going forward. If I have to stand at the polls in freezing weather and six feet of snow with a sign calling you "DUMB AS DIRT", then I will do it. You want to be repeatedly disingenuous about matters of public record, fine...you can do it on your own time after your early, forced retirement from Congress.

Please do not tell me that the Democratic Party is pushing us into "socialized medicine." When there is actual legislation on the table that transfers ownership of all US healthcare facilities to the government and requires that health care clinicians (i.e., physicians, nurses, allied health, etc.) become government employees , then you can talk to me about socialized medicine. Until then, I will assume that your references to socialized medicine in this debate are not the product of casual ignorance or even determined stupidity but, rather, an attempt at calculated deception and I assure you that I will do everything I can to see that you are removed from office going forward. If I have to stand at the polls in weather hot enough to fry eggs on a car roof with a sign identifying you as a "LIAR", then I will do it. You want to talk about socialism, fine...you can do it from the front porch of your vacation home in Cuba when you are no longer a public official in the US.

Please do not tell me that "we need affordable health insurance." The private insurance industry has spent billions of dollars to ensure that you--and the public--will incorrectly define the problem this way. What we need and want, what the US public needs and wants, is affordable health care. Private health insurance is one vehicle, and only one vehicle, for getting there. History and reams of comparative outcome data suggests that it is far from the best vehicle, but I will grant you that it is a vehicle. If you continue to babble about "affordable health insurance" though, when this is clearly not what we need or are asking for, then I will assume that you are incapable of either seeing through gross propaganda or making fine distinctions and as such shouldn’t be in public life. I assure you that I will do everything I can to see that you are removed from office going forward. If I have to stand at the polls in a raging hurricane with a sign identifying you as "UNFIT FOR PUBLIC OFFICE", then I will do it. You want to eat the crap handed out by the armies of overpaid private health insurance industry PR flacks out there, fine...you just don’t get to force feed us with it.

Please do not tell me that there is "legitimate disagreement about how to best resolve this problem." If you put ten health policy experts in a room for a morning, at the end of that period nine of them would have reached consensus on broad design principles for a new US health care system and it would look remarkably like a single payer system. The tenth would be one of those free market loons whose ideas have served us so well this past decade and who persist in seeing markets where they don’t really exist. Add four politicians to this mix--particularly those sated on a steady diet of campaign contributions from the pharmaceutical industry, the insurance industry, medical device manufacturers, the hospital industry, and medical societies and associations throughout the US--and all of a sudden we will get "legitimate disagreement." We made a terrible mistake back in the late nineteen-twenties, early nineteen-thirties: we allowed the seeds of private health insurance to be planted in the US. Other western democracies had similar infestation problems, but our devotion to the principles of laissez-faire capitalism allowed those seedlings to grow into an invasive weed--choking out all other possible species in the garden. As a consequence of this, and other developments, the health care system in the US has become a zero sum game: you can’t make substantial changes in it without one or more players losing substantially. Since Congress can never decide which ox to gore, so many there having been paid well to ensure that specific oxen are not gored, they always throw up their hands and put it off to another day. Congress has more or less been doing just this since November 19, 1945, the day on which Harry S. Truman submitted the first piece of National Health Insurance legislation to Congress. The simple fact of the matter, though, is that there is an ox being gored. Every single day since November 19, 1945, every single person who has had healthcare postponed, delayed, withheld or denied and all of the unnecessary pain, suffering and early death caused by this is, I think, a pretty large ox even if the members of Congress--with certain exceptions--are apparently unable to see it. Maybe they see it but just think it is an unimportant ox, since it is only something as amorphous as the American public. If the best you can do for the health and welfare of the American population is to dissemble about "legitimate disagreements", then I will assume you are more interested in serving one of the many economic interests that have a stake in this matter rather than the American public. I assure you that I will do everything I can to see that you are removed from office going forward. If I have to stand at the polls in a hail storm with a sign pointing at you and saying "NEED CASH--WILLING TO LET MEMBERS OF THE PUBLIC SUFFER AND DIE FOR CONTRIBUTIONS" then I will do it. You want us to wait another sixty-four years before all Americans have the same access to health care that citizens in the other western industrialized democracies--and not to get personal, but you too--already have, fine...you can spend those years unemployed, playing golf with former Senator Rich Santorum.

Please do not tell me that "the votes aren’t there." You don’t get to have your title, sit in your splendid office, and collect what many in this country see as an exorbitant salary just so you can tell me what can’t be done. If I was asking you to repeal the law of gravity, redefine pi, or attempt to raise the dead en masse, then I would understand the votes not being there. I am asking you however, and the legislative body you purport to help lead, to do what every other western, industrialized democracy has done for its citizens and I am asking you to do this at a time when a significant proportion of the both the population and the health care profession endorse single payer as an outcome. If the best you can do for US citizens is to mumble crap about "the votes not being there", then I will assume you have been bought and paid for and are owned and operated by the private insurance industry. I assure you that I will do everything I can to see that you are removed from office going forward. If I have to stand at the polls in a raging hurricane with a sign identifying you as a "CORRUPT HACK", then I will do it. You want to be pragmatic, fine...be pragmatic about your political future, not the future of my health care.

Finally, please do not tell me that "we can’t afford it." Canada, Britain, France, Switzerland, Spain, Italy...and others with comparably smaller economies, somehow or other manage to provide their citizens with universal access to health care. This is not a matter of us not being able to afford it; this is a matter of some people not wanting to pay for it and others not wanting us to kill their golden goose...regardless of the fact that it is rabid and is systematically killing off the other villagers. This is a matter of us being the last western, industrialized country left that still considers it socially acceptable--and even praiseworthy--to squeeze the last dollars possible out of human pain, suffering, and death. There is no other way to explain what we have let happen here.

I spend several thousand dollars a year on political contributions; I spend several hundred hours a year working on political campaigns. You are often a beneficiary of these activities. Unless you do everything in your power to secure the passage of a single payer health plan, I promise you I will devote all of that money and every minute of that commitment to your opponent--whoever that person is, if I have to drag him or her from the unemployment line to run against you, and however much I may disagree with him or her on other issues. This is a make or break, life and death issue for me and there will be no free passes.

If some of this strikes some of you as a bit harsh, well, it is...and it needs to be. I can assure you that the other side is being as harsh, if not more so, and they have many more cards to play. They’ve been gearing up for this battle for more than a decade now and we won’t get anything close to what we want unless we lay it on the line to the political powers that be. They need to be reminded--forcefully--that they are supposed to be working for the public interest, in other words, us, and they need to be told that there will be consequences if this issue gets mishandled again because of their actions or lack thereof.

Now...I am not exactly a babe in the woods. I understand that the deck is stacked against single payer advocates and, if the truth be known, I could probably live with a fully functioning public option. If we start out there though, surrendering the single payer option without a fight, we'll end up with a dysfunctional public option, with or without a lengthy trigger--and true reform will be lost for another decade or more.

I grant permission to anyone reading this text to use it in any way, shape or form you think helps further the cause.

Citations available upon request.
http://www.dailykos.com/storyonly/2009/6/8/740029/-Single-Payer:-A-Perspective-on-its-Politics