Health care reform is not an emegency. Unless you're sick and can't pay for it without going broke.
By Reg Darling, copyright 2009
My grandfather was born in 1900, in a small village in Forest County, Pennsylvania. During his early teens, his neighborhood was inhabited by a fairly standard curmudgeon—a perennially ornery character who confiscated baseballs that landed in his yard, and shouted angrily at children who took a shortcut across his covetously owned property. Naturally, the neighborhood kids hated him. One Halloween, my grandfather and his friends decided to go well beyond the realm of soaped windows and smashed pumpkins in their annual rite of revenge against the tormented soul who tormented them. They picked up the man’s outhouse, moved it back several feet, and laid sticks and leaves over the pit to disguise their trap. Shortly before sunrise the following morning, their victim made his customary trip to the privy and fell into the hole.
Unable to extricate himself, the man yelled, as loudly as he could, “Fire! Fire!” All the adults in the neighborhood came running to the scene immediately, bearing buckets, shovels, and axes. After they rescued him from his predicament, someone asked, “Why did you yell ‘fire’?” He replied, “Would you have come running to help if I’d yelled ‘shit’?”
The desperate man yelled “fire” because a house fire was a huge catastrophe that could strike by such sheer happenstance or small oversight that it was universally perceived as an affliction of innocents. Coping with it was regarded as a collective responsibility. Such shared responsibility has, for millennia, been one of the founding principles not only of community, but of civilization itself.
In a small village, all it took for the shared responsibility of dealing with a fire’s horrific threat to be recognized and summoned was a shout or perhaps, a bell. As communities grew to encompass distances beyond earshot, and rising individual anonymity veiled personal disasters in abstraction, coping with collective responsibilities became more organized. A small town needs a volunteer fire department. A city needs a crew of full-time professionals. Instead of running to the scene with a bucket, we now respond to a scream of “fire” with a phone call to 911 and an annual tax bill. No one calls this socialism.
There is no movement to abolish fire departments and replace them with corporate, profit-making enterprises (which would bill the victims of disaster for their services) on the grounds that such enterprises would be intrinsically more efficient and effective. Although I’m sure they carry their standard, inevitable share of human dysfunction, I’ve encountered no credible suggestion that fire departments are doomed to inadequacy and fiscal irresponsibility by virtue of being governmental agencies. I believe the same could be said of our police and military forces. But the reason any proposal to privatize these aspects of government would be generally regarded as absurd is at least as universal as theoretical cynicisms about the mythical impossibility of governmental efficiency. The needs they address are fundamental aspects of the collective responsibility that is the raison d’être of community and government. As such, they do not rationally or morally belong in the realm of commerce. The values they represent are not, and should not be, for sale.
Consider the fundamental purpose of government. It’s not something defined by a constitution. The purpose of a constitution is to confine the action and power of government within a structure, so that it can effectively fulfill its purpose without violating individual rights in overzealous or misguided pursuit of that purpose. The purpose of government is to act as the agent of society’s collective responsibility. I realize I’ve taken something worthy of a long book and reduced it to a couple of sentences here, but the mostly ignored issues at hand in the current pseudo-debates about health care are so fundamental that there is far more risk of simplistic thinking to be found in arguments about pre-existing conditions or public options than in bringing the discussion down to the level of basic moral, social, and philosophical issues.
Though the ways and means may differ, human freedom is as constrained in an authoritarian society with a democratic government as it is in an open, democratic society with an authoritarian government. Protecting the open space of democracy is a collective responsibility that extends far beyond simplistic definitions of legal rights. This is why we have public schools and public libraries. Without universal access to education for the young, and to all forms of literary culture for adults, society would devolve into feudalism with frightening rapidity—a calamity every bit as devastating as an earthquake or flood. We do not abandon these things to the limited and capricious mercies of the marketplace because nurturing the spirit of democracy is a responsibility and a blessing shared by all; they are not items of commerce. Everyone benefits from living in an educated, literate, well-informed society.
In a civilized society, the sick, wounded and infirm are neither shot nor eaten. They are not abandoned. We pay taxes to support schools, police, fire departments, the military, libraries, and a postal system. When someone runs from a house screaming “fire”, we call 911 and perhaps run to help. But what is the greater undeserved calamity, a house fire (assuming the occupants escape relatively unscathed) or pancreatic cancer? In this country, when someone cries out “cancer!” or “heart attack!” or when someone who makes ten dollars per hour and drives twenty-five miles each way to work cries out “My child has a sinus infection and the antibiotic of choice costs $150!”, any claim to collective responsibility is dismissed as “socialism”.
If we lack the common decency to be ashamed of our lack of compassion, we ought to at least be angered by the insult to our intelligence; the straw man of socialism is bullshit so shallow it would embarrass any self-respecting con man. Indeed, it is the degradation of health care to a market-driven commercial enterprise that is functionally an instrument of repression.
By taking the place of government in addressing a basic aspect of natural collective responsibility, the health insurance industry is a de facto government controlling our health care from outside the constitutional and moral constraints of democratic government and social responsibility. The health insurance industry’s profits are taxes paid into the pockets of its leaders (and their corporate shareholders) rather than its ostensible purpose of protecting us from calamities that are often far worse than fire or flood. Taxes levied and taken by authorities other than a legitimate, democratic government are taxation without representation and should be regarded just as the founding fathers regarded such taxation—as tyranny and thievery.
Requiring a family to mortgage their home in order to keep their child alive is not entrepreneurship or even capitalism; it is extortion. That it is legal in this country does not diminish the intrinsic criminality of its spirit any more than it excused the Nazis who engineered the Holocaust or the soldiers who eviscerated unarmed Native American women and children. To call it free enterprise is a vicious insult to every independent businessperson, entrepreneur, farmer, and crafts person in America. Hell, it should insult drug dealers, mobsters, and prostitutes, who all stand on moral high ground by comparison.
Is universal health care a right? Perhaps that doesn’t even matter. Providing universal health care is a responsibility we all share by virtue of being civilized. Our failure to embrace it as a collective responsibility has nothing to do with free markets, socialism, the Bill of Rights, the theories of Karl Marx, or even concerns about administrative efficiency; it is savagery.
Our political leaders have not, and are unlikely to truly address this issue, and it’s not because they’ve chosen to take a tough, principled stand as guardians of our liberty—it’s because they don’t want to. They’re afraid that attempting to row against the torrent of right-wing swill pouring forth from the health insurance industry and talk radio, into the public’s collective cynicism and fear, would dump political careers in the outhouse. Without the votes of Bubba and Bubbette, our elected representatives might lose their jobs and their health insurance.
The pervasive, institutionalized anxiety of an insurance-dependent system contributes to a widespread spirit of apathy, impotence, and defeatism that is toxic to all the social and political possibilities of democracy. You’re not going to see much dissent or even thinking outside the box coming from people whose families will lose access to health care if they lose their job. You’re not going to see people up to their necks (or over their heads) in medical debt seeking creative new career possibilities. People living in constant, solitary fear—whether of fire, lawlessness, foreign aggression, or medical catastrophe—cannot be truly free in mind and spirit, regardless of the legal rights guaranteed to them by a constitution. Our insurance-dependent system is the whip that drives the galley slaves rowing the ship of state. A single-payer public health care system would not diminish democracy; it would enable and enhance it and, frankly, that’s why both sides of the aisle are yelling “shit” instead of “fire”.
I would like to believe that the semi-literate demagogues who are braying so loudly that universal health care would be the beginning of the end of human freedom are merely deluded, but I suspect the reality is far sleazier than mere dysfunction. There’s nothing we can say to them that wouldn’t apply equally to the horses they rode in on.
The real issue isn’t a matter of pre-existing conditions clauses or public options. The issue is that we’re all Americans and we’re all in this situation together. Are we going to join hands and take care of each other, or not?
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Reg Darling's family has been in the area since The Flood. He is a fifth generation Warrenite and an Onondogan descendant. If you liked this column you will probably also enjoy his other short writings.
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