Get a cup of coffee or your beverage of choice and settle down at your computer. Today’s post is about four times longer than average and you need to think about this stuff. It is important to your health and well-being and it is important to the health and well-being of our country for decades to come.
The mid-term election campaign begins today. Yes, Congress is on vacation until later in the month, but those senators and representatives are not idle. They are back home in their states beating the bushes of their constituencies to figure out how best to get themselves re-elected in November.
Personally, I think we should jettison every member of this do-nothing, rubber-stamp, 109th Congress and start from scratch. (What a powerful message to politicians it would be for citizens to take back the government in that manner.) But there may be an exception or two - Pennsylvania’s John Murtha comes to mind – and we need to be well-informed before we vote.
All 435 representatives are up for re-election along with 29 of the 100 senators. Elders, particularly in mid-term elections, vote in much larger numbers than younger people. Therefore, we can make a difference in the outcome of the 2006 election, and it is incumbent upon us – as elders and therefore, presumably, more informed by the experience of our years than younger folks – to make wise choices.
Those choices cannot be made selfishly. With the recent media blitz on the oldest baby boomers turning 60 this year, already there is an undercurrent making its way from certain quarters accusing elders of being greedy geezers. That is not always off-base, though it is more often unfounded, and the accusation will spread in coming months and years. But it does not change the fact that as elders become a larger percentage of the population, some will need medical care and it must be provided no matter how many there are in need.
As the system stands now, many – though not all - elders are adequately covered by Medicare, but many millions of younger Americans, including children, go without health care because they cannot afford it. This must change.
How to do that is a complex issue that our elected officials, whose job it is to anticipate and solve such problems, have pointedly ignored since the first year of the Clinton administration. Time is now of the essence before the numbers in need of care overwhelm the system.
There are a lot of big political issues to concern us: the Iraq war, domestic spying, energy prices and resources, government secrecy, torture, the federal deficit, incompetent political appointees, hurricane rebuilding, global warming, immigration, terrorism.
And Mr. Bush will probably create a new one early this year by pushing for tax reform. Watch that one carefully; his proposal will seek to further enrich the wealthy while harming the poor and middle class or, what’s left of it.
All of these are important. But after a couple of months of research, reading until my eyes water, weighing many ideas and points of view, and thinking hard while shuffling hundreds of notes on 3 x 5 cards, my number one priority in considering my vote for anyone running for federal office has come down to this: universal health coverage – enacted in the next congress, after the mid-term election and before the presidential election in 2008.
I hope it will become your priority too because by relieving every American of the fear of financial ruin caused by catastrophic health problems, by getting health coverage off the backs of employers (who are in the process of divesting themselves of that obligation anyway), and by giving each and every American access to healthcare, we can also make a good-sized dent in other public financial problems.
You probably know the facts in the list below, but they bear repeating:
- 45 million Americans are without health coverage
- Each year, fewer employers offer a healthcare benefit
- Corporate pensions and promised health coverage in retirement are being cut back or eliminated
- Private health coverage is out of reach of average Americans
- The population of the U.S. is aging; a larger percentage of us will require more healthcare than in the past
- More physicians are establishing “boutique” practices for wealthy patients only, creating an unfair, tiered healthcare system
- Many elders take lower dosages of prescribed medications and some never fill their prescriptions because they cannot afford to and also eat
- Pharmaceutical manufacturers spend more money marketing their drugs than they do developing them
- In a last-minute, stealth inclusion by Senator Bill Frist of Tennessee (a physician!) to the 2006 Defense Appropriations bill, pharmaceutical manufacturers of flu vaccines were granted immunity from liability if the vaccines sicken or kill anyone
- The U.S. ranks 36th in the world in infant mortality
- The U.S. ranks 48th in life expectancy at birth
- The U.S. is the only first-world country without universal health coverage
All of this is on track to worsen if we don’t fix our broken healthcare system, and the only possible solution is universal healthcare.
The most recently touted idea by government and corporate America to solve the healthcare crisis is health savings accounts in which, in exchange for a tax deduction, individuals can put money aside to pay for future healthcare needs and thereby rely less on insurance. There are many things wrong with this idea, most importantly:
- No average individual can save enough in an entire lifetime for heart surgery
- The accounts become tax-shelters for the rich
- The accounts don’t solve the problems in that long list above
The current savings rate in the U.S. sits at 0.2 percent. Average income in the U.S. is about $44,000 a year, before taxes, and workers’ salaries have lagged behind inflation for the past decade.
In addition, the federal minimum hourly wage has been stuck at $5.15 an hour - $10,300 a year for full-time workers - since 1996. Economists say that a family of four needs $34,920 to cover housing, food, health and childcare (no extras and no big medical bills).
So a minimum-wage, two-income family with two kids lives below the poverty line. Asking them to add another savings account to what little they can set aside now is not reasonable, possible nor could it be large enough to cover even a few, simple medical tests which, these days, can amount to hundreds of dollars before you can blink.
Our healthcare system is headed for a train wreck – sooner rather than later – and for Congress to put off the admittedly hard work to create a universal system is criminal.
It’s not easy to do. Americans have been lectured on the evils of big government and the miraculous efficiency of an untrammeled marketplace in healthcare since at least the Reagan presidency.
And Congress members, in weighing, debating and writing a universal healthcare bill will be lobbied unmercifully against it by powerful special interests who contribute to their campaigns. These will all be rich people who don’t need universal coverage. Many misguided, ordinary citizens will campaign against it too, some on the basis of that mid-20th-century bugaboo, “socialized” medicine. Some physicians may object as it will undoubtedly reduce their income.
But it will become economically essential for the U.S. to adopt universal healthcare eventually and the longer we wait, the harder and more expensive it will be.
No plan will be perfect. Such huge public programs never are. But it will be better than what we have now and if done with reasonable thought, it will ensure basic and catastrophic coverage to every citizen of America.
There are already universal coverage ideas and proposals from many sources. Try typing - “universal healthcare” proposals – into any search engine and you will find hundreds. And there is also the experience of every other industrialized country to guide Congress.
And here's a thought worth considering: we already have partial universal healthcare in the form of Medicare for elders, and it works pretty well. Why not expand it to everyone?
[I would be most appreciative for any Canadians, Britons, French and other nationalities who have read this far to jump in here in the comments section and tell us about your countries’ healthcare systems: how they work, how well they work, what doesn’t work, how they have been tweaked and changed over time to work better, and what it costs - your government and yourselves. Don’t worry about length; space is cheap in the blogosphere. And here’s a converter to help readers translate from your currency to U.S. dollars.]
Universal healthcare, for me, takes precedence over every other campaign issue candidates may raise this year. I want to hear them talk about it. I want preliminary proposals in their speeches and position papers. I want them to discuss the problems and potential solutions. I want tradeoffs to be offered. (Eliminating $27.3 billion in pork projects, as Congress passed in 2005, isn’t a bad start.) I want opposing candidates debating the best way to enact universal healthcare.
And then I want the follow-through in the 110th Congress, prior to the 2008 election. Two years is plenty of time to create a universal healthcare program and the bonus, when they do it, is each one can be pretty well assured of easy re-election from a grateful electorate.
Elders are in a unique position to push candidates into working on this legislation. We vote in large numbers and according to The Wall Street Journal [paid subscription required] on 15 December 2005, in a report on a survey done with NBC, we are “a pretty cranked up bunch” who are angry with Congress and incumbents are running scared:
“By a 65% - 19% margin, Americans 65 and above disapprove of the performance of Congress…Moreover, their unhappiness extends across the political horizon beyond issues traditionally of concern to senior citizens.”
We can put our anger and our voting power to use this year for the good of all Americans.
When I was a child, diphtheria, whooping cough, measles, tuberculosis, small pox and polio were still terrifying, potential killers and every year when school began, one or two classmates had been lost to one of those diseases. Parents and grandparents, in those days, were fond of saying, “As long as you’ve got your health…” meaning that all else is irrelevant if you don’t.
And they were correct. Science and medicine have made enormous advances in just my lifetime but those advances are unavailable to millions of Americans.
I believe that healthcare is a human right and a public responsibility we all share. It is our moral obligation, individually and collectively, to ensure that every citizen has access to healthcare and if we do not guarantee that, if it is available only to the rich, we have failed as human beings and as a nation.
U.S. leaders of all stripes and every era like to remind us that we are the richest country on earth. Although the current federal deficit (let us not forget that President Clinton handed over a surplus to the Bush administration) makes that an open question for the future, we are not lacking in the resources to make universal healthcare a reality.
All it takes is the will of our legislators to reallocate those resources, and the will of the people – you and me – to demand it.