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Monthly Archives: October 2009

The original response to the Huffington post blog(Sheri and Allan Rivlin):

Forgive me for being new to your blog but I honestly have been struggling  to grasp what the relationship is between what you state as being “the important provisions of the proposals that would do the most to help real people” and what people are genuinely hoping comes out of the political wrangling in Washington as it regards health care.

Maybe I can reconnect these two things with a little bit of semantic juxtaposition- for as stated by you there seems to be 2 distinct issues at hand: 1) what people are genuinely hoping for and 2) “the important provisions of the proposals that would do the most to help real people” . Now of course what the people are hoping for and any kind of legislation are qua definition two very different things-yet when people hope for something that should be addressed by legislation, they are hoping that the legilation being debated “embodies” in some sense their own hopes, moreover they hope that with passage of such legislation that the the newly drafted laws and regulations help make their own hopes manifest. Yet the gap I see between what the*(qualifier: many, many people beyond their ideological and/or political identities) people are hoping for and that described in what you have posted here is another type of difference, not merely the difference between hopes and legislation. Your formulation of the issues at hand here reduces the entire debate to being a simple matter of regulating the insurance industry.

If I take the phrase “health insurance reform” and replace it with “heath care reform” I can almost hear something which resonates tangibly in the ears of millions of Americans. But somehow “insurance” is the only issue left to discuss here. Perhaps “insurance” has become *the* issue at hand because it is seen as the universal problem in our oh so grandiose health care system. Yet if that was the case we might be having senate hearings to abolish health care insurance, but in our sad reality, rather, we are having hearings in the senate which are ultimately designed to guarantee the existence of said insurance corporations for all eternity and provide them with legally mandated clientèle-customers-citizens who *must* make an offering of %10-20 of their earned income per year to these mega-conglomerates which are the primary sources of injustice in the American health care system.

Perhaps I am simply to naive, for nowhere in  the issues at hand regarding our health care system do I see any real place for insurance.  In fact the rasion-d’etre of health insurance eludes me utterly. Collectively, as a society, each and every person in that society has a right to health care and a responsibility to utilize whatever resources are at their disposal to ensure their own well being. Failing this, the society must pay to take care of those who due to illness cannot contribute economically to society. Failure of society to pay for this leads to grand social injustices which rip at the fabric of the society itself. What the* people hope for is that when illness or injury comes, unexpected and unplanned, as is inevitably the case, that competent caring health care providers will be there to provide and ensure our recovery, and failing this to mitigate the suffering when recovery is not possible, and they hope for an environment in which access to health care, including preventive care, is second nature-common sense-where one need not worry about their economic status when it comes to deciding if and when they should visit a health care professional.

Health is an intangible thing, when we have it we rarely notice or appreciate it, and it can vanish in an instant, and recovery, if possible, can be a lifetime affair. Medicine can only define that which is not healthy, health itself is not quantifiable or definable, by definition. Yet almost everything in our lives depend on our health. Our dependency upon our health is but one of the roots of our common interdependency, that which make us human, our lives mortal, and defines us as human beings. When we are sick or ailing-we cannot, and ought not must, think about whether we will be cared for, much less whether we can afford such care and whether or not such care means our financial ruin. Any other way of looking at this issue is literally *unhealthy*.  Yet, as a society, Americans have relegated access to health care and the quality of that health care to a question of socio-economic status. The unthinkable does happen in this wondrous land, each and every day. The consequences of this equation of value of life and monetary value of health insurance-of the equation of human dignity and our socio-economic status are far, far to profound to ponder in any depth here.  But this entire debate has been reduced to questions of insurance, so all of this debate is meant to be captured in terms of cost(taxes, tax exemptions, tax incentives, costs of providing for the uninsured, the underinsured, emergency room bills etc.).

Interdependence can be viewed as a cost. We can view our fellow human beings as parasitic organisms which leach  on our paychecks and rob us of our relative economic freedom. We can deny that our fellow human beings, who we label as “illegal”, are the same fellow human beings upon which we depend. We are free to be ignorant and to ignore the consequences of our failed health care system until that day comes when we are ill or wounded and need the help of utter and absolute strangers-whose names we will never know-who will hold our lives in their hands and choose to care for us. Nothing less is at stake in the health care debate. We, as a society, could perhaps one day learn to OWN these costs, in which case they would form a foundation for our mutual obligations unto one another, because one way or another we are already PAYING these costs and nothing in this legislation will change that.

Hold on to a couple of simple relationships:
1) Everyone NEEDS health care at some point in their lives-nothing optional here
2) There is a significant body of the population who are trained to provide health care, many of whom have dedicated their lives to this.
3) There exists a need for a system which bridges 1) and 2) ,providing unfettered access to health care for everyone and ensuring just compensation for those who provide such health care.

Insurance, as a for-profit enterprise is, by definition, at odds with 3). There never will be a for-profit based Insurance system which provides *universal* coverage and *just compensation*. Not in my lifetime, nor that of any future generations yet to come. We can reform health insurance until the cows come home but what the* people hope for will never come to fruition in any health insurance reform.  The so-called “Public Option” is the only thing left in the current health care debate which has any real bearing on health care. If our legislators fail to pass legislation including this “Public Option” they will have failed to actually address the health care issue at all, and they will have signed into law the greatest entitlement legislation for a particular industry which any nation has ever seen-forcing Americans to tithe 10-20% of their income to for-profit Insurance corporations(argri-subsidies and the military-industrial complex  would be utterly dwarfed by such.) There can be no middle ground on this issue: conditio sine qua non=Public Option. Public Option means OWNERSHIP of mutual obligation, the thread of which every society is woven.

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Just a couple of points:
1) Everyone NEEDS health care at some point in their lives-nothing optional here
2) There is a significant body of the population who are trained to provide health care, many of whom have dedicated their lives to this.
3) There exists a need for a system which bridges 1) and 2), providing unfettered access to health care and ensuring just compensation for those who provide such.

Insurance, as a for-profit enterprise is, by definition, at odds with 3). There never will be a for-profit based Insurance system which provides *universal* coverage and *just compensation*. Not now, not ever. We can reform health insurance until the cows come home but what the* people hope for will never come to fruition in any health insurance reform. The so-called “Public Option” is the only thing left in the current health care debate which has any real bearing on health care. If our legislators fail to pass legislation including this “Public Option” they will have failed to actually address the health care issue at all, and they will have signed into law the greatest entitlement legislation for a particular industry which any nation has ever seen-forcing Americans to tithe 10-20% of their income to for-profit Insurance corporations. There can be no middle ground on this issue: conditio sine qua non=Public Option. Public Option means OWNERSHIP of mutual obligation, the thread of which every society is woven.
Read the Article at HuffingtonPost