Health Care Reform Debates Reveal Sickness in Our Body Politic

Like a rampant autoimmune disorder, there’s a pernicious process at work in our nation’s social “tissues,” and it’s causing a lot of damage. The symptoms were readily apparent during the health care reform debates.

I’m not talking about the reform plan itself. For the record, I’m not a fan of the Obama administration’s proposal or any variant thereof, simply because I’m not a fan of insurance-based medicine. Any “reform” that has expansion of health insurance as it’s primary goal is going in the wrong direction, whether it’s proposed by so-called liberals or so-called conservatives (remember that Massachusetts got its “universal insurance” reform from a Republican governor…more on that later).

The central question ought to be, “How do we improve the overall health of our nation, and stem the deluge of preventable chronic diseases that threaten the core vitality of our country?” And I’m talking about engendering actual health, not providing more “disease management.”

But policymakers never went there. That would be far too transformative, would require too many other reforms in agriculture, food regulation, education policy, environmental reform. Engendering health would interfere with business as usual, and we can’t let that happen, right?

Beyond the wrong-headedness of the goals, what was so disturbing about the health reform process was the ugliness, the barely veiled malevolence that characterized the “debates.” That, and the fact that as a country we’re completely unwilling to face the magnitude of the health care crisis, and muster up the will and intelligence to do anything about it.

The grotesque carnival into which Congress has degenerated reflects something sinister and corrosive at work in our national psyche. Congress is only the mirror; the disease is out there in the body politic. Frankly, it scares the hell out of me.

A few days after Scott Brown won Ted Kennedy’s Senate seat, the New York Times ran a post-hoc analysis entitled, “The Democrats’ Day After.” The article was a fair critique of Team Obama’s misreading of public sentiment. But two reader comments really put chills down my spine.

The first was from a gentleman named, Neil Underwood White, from Natick, MA, who stated: “I am an independent voter in Massachusetts, the moment I heard that Scott drives a used truck with 2000000 miles on it and Scott’s mother is on Welfare. I immediately decided to vote for Scott. He is one of us, a working poor Caucasian, and he will work for us: millions working poor Caucasians in Massachusetts.”

The second, from “Rick” in New York City, explains that: “The reason the Democrats are constantly in disarray is because they always have a socialist agenda that they demand to push in a nation that is not socialist. The American founding fathers would get up from their graves if they realized that the nation they founded is becoming more and more European than ever. That is not what they created this nation for – to be European. Obama campaigned for American leadership, however, all we get is a replication of European agendas. Obama wants to lead the world by doing what the world wants America to do. There is a socialist party in the USA its called the Democrats.”

Both comments seethe with indignation, but more than that, they hint at a hatred of anything that’s not “White” and “Real American.” It’s an “Us vs. Them” stance, one that’s quick to blame the nation’s prodigious problems on those “others,” —non-Caucasians, foreigners, “them.” Historically, that line of thinking, in any nation where it became prevalent, has led to some nasty places.

Mr. White is from a state where universal health insurance reform was implemented four years ago by Republican governor and former Presidential candidate, Mitt Romney. It was voted for by none other than Scott Brown himself!

The Mass plan has insurance mandates, and provides subsidies for those who cannot afford insurance on their own.

In its first years, Romney-Care has gone well over budget. It did increase the number of citizens with insurance, but there’s nothing to show it has substantially improved public health in Massachusetts. I’m sure the insurance plans are happy: those mandated premium dollars keep a’comin’. But with no increase in physicians or hospital capacity, and existing “providers” working at maximum clip, many citizens have no practical access to the care their new insurance is supposed to pay for.

Despite his support of Romney-Care, Mr. Brown has, of course, vowed to align with Senate Republicans to block national reform. In the old days, that was called flip-flopping, right? Oh, wait, I forgot….only Democrats flip-flop.

On Fox News, Brown defended his support of Romney-Care, explaining that it was based on “free market” principles, not the leftist agenda of Obama & Co. Frankly, I don’t see much distinction in principle. But alas, Fox didn’t ask the new Senator-to-be to elaborate.

Brown and Romney, who may yet be a Republican presidential nominee in 2012, claim that Mass Care’s cost over-runs do not reflect any inherent problems with the plan itself. No, they’re the fault of the current Democratic (and non-Caucasian) Gov. Deval Patrick, who eliminated the “cost and quality commission” that would have kept spending in line.

So, let’s get this clear: if it’s a state level reform that forces citizens to buy insurance, gives handouts to those who can’t afford it, and grossly over-runs budget, but it’s led by Caucasian Republicans, it’s OK. If it’s a national level reform that would force people to buy insurance, gives handouts to those who can’t afford it, and over-runs budget, but it is led by a Democratic (and non-Caucasian) President, it’s Communism??

This sort of double-think doesn’t seem to bother people like Mr. White, who in his few loaded lines voices the snarl of contradictions poisoning not only the healthcare dialog, but pretty much any discourse on domestic policy these days.

Mr. White is impressed that Scott Brown’s mother was on welfare. But wait, isn’t welfare a form of “socialist” public assistance? I guess that’s okay if the recipients are Caucasians, particularly if their offspring become leaders in a party with a deep ideological stance against “the welfare state.” Surely, it’s not Scott Brown’s mother that South Carolina’s gubernatorial hopeful Andre Bauer envisioned when he likened welfare to feeding strays!

If it had come out in 2008 that then-presidential candidate Obama’s mother had been on welfare, would Mr. White and people who think like him have viewed it as a reason to “immediately decide to vote” for Obama? I kinda doubt it.

Mr. White predicts that in the Senate, Mr. Brown will “work for us: Millions of poor working Caucasians.” Is the plight of poor working Caucasians somehow different and more deserving of public assistance than the plight of poor, working non-Caucasians? Is there something in the Obama domestic agenda (such as it is) that unfairly disfavors poor Caucasians to the advantage of poor non-Caucasians?

Or is Mr. White implying—without ever stating it—that any advancement of non-Caucasians in this country, embodied by the election of Barack Obama, is inherently at the expense of Caucasians?

Rick, the other Times commenter, voices a longstanding American anxiety that “foreigners” are going to destroy the good ol’ USA. In this case, it’s those lilly-livered socialist Europeans whose countries we saved and then rebuilt after WWII, but who thanklessly criticized us when we invaded Iraq, who refuse to plant our GMO seed on their farms, and who brag that their health care systems are better than ours.

I get a bit nervous when someone invokes the Founding Fathers, as Rick does. With all due respect for the high principles on which our country was founded, let us remember that many of the men who inked their names under “All Men Are Created Equal,” were slaveholders. Those who were not didn’t seem terribly bothered by their compatriots’ denial of dark-skinned people their basic human rights. Nobody was too troubled by the dispossession of native non-Europeans of their lands. And let’s remember that the Fathers were quite literal when they referred to “All men.” Women didn’t win the right to vote until the 1920s!

Perhaps that’s the secret fantasy beneath the “Real America” vision: to go back to a scenario where White guys ruled with impunity and could do and say whatever they wanted, Blacks did the heavy lifting for no pay, women (Mrs. Palin not withstanding) kept quiet & knew their places, and immigrants with funny names and dangerous ideas either stayed over in Europe or shut up and fit in.

But if we are going to talk about the Founders, I’d love to know how they’d feel about the way entrenched industrial interests have totally co-opted the democratic process they envisioned. How would Messrs. Washington, Jefferson, Franklin, et al, view the Supreme Court’s historic overrule of earlier laws limiting corporate campaign influence? Talk about threats to the common good!

None of what I’m saying here should be misconstrued as a defense of the Obama administration. They quickly proved that anyone—regardless of race, creed, gender, or place of origin—can and will play the tunes that the corporate interests call. Despite all the insistent right wing hollering, there’s little the administration has done in its first year that would even qualify as progessive, let alone revolutionary! Oh, wait, there was that organic vegetable garden.

What really worries me is that at a time when we are facing major national economic, security, environmental and health care challenges, our legislative process has devolved into an absurd theater of populist posturings, and the grass roots dialog is increasingly tainted with veiled racism and xenophobia. The “Us & Them” dynamic does not lead to constructive problem-solving or intelligent decision-making. On the contrary, it leads only to fear and violence.

Like a chronic autoimmune reaction, it is a sign of serious disease, one that threatens the basic social health of the nation. And like a serious disease, the first step toward healing is to acknowledge what is actually happening.

I welcome your thoughts & comments!

Subscribe to Holistic Primary Care