Monday, September 14, 2009

Enough Talk. Let’s Act On Health Care.

Much of the recent attention on health care reform has focused on Town Hall meetings, reaction to the anger reported during some of those meetings and President Obama’s address to a joint session of Congress last week.

But I think that President Obama’s remarks to a group of nurses on Sept. 10, the day following his address, really cut to the point. “…we have talked this issue to death, year after year, decade after decade. And the time for talk is winding down. The time for bickering has passed.”

And, if the time for bickering has not passed, then it is time for the nation to come to a decision. Do we really have the will and the desire to pass health care legislation? If we do, then let’s do it. If we don’t let’s accept the fact that dissension, fear or pure selfishness are too strong to fight in this country and let the matter go. The truth is maybe we have become too selfish a nation to really care what happens to those who are underinsured or not insured. If that turns out to be the case, then it is an ominous omen for where the country is heading. But, at least the nation can come to terms with that fact and move onto other issues.

Fortunately, I don’t believe that we as a nation are at that point. I think there is momentum to get the job done. But in order to tap into that momentum and will to look after all Americans, I think it is necessary to go back to our nation’s source.

As I watched President Obama’s health care address before Congress, I imagined what the 56 signers of the Declaration of Independence would have thought if they were watching the address. More specifically, I would have liked to have watched the address with the four signers who were physicians: Lyman Hall of Georgia; Josiah Bartlett and Matthew Thornton of New Hampshire; and Benjamin Rush of Philadelphia.

No doubt they would have been proud and amazed that their Declaration had resulted in the creation of the body of lawmakers on the television screen. Perhaps, they would have been a little dismayed at the lack of respect shown the President. There is a way to disagree. They respectfully but strongly did so in the Declaration when they spelled out why they were disenchanted with King George III. Saying that the President is lying is not only wrong but a sign of bad breeding. And, in a very real way it points to the deep, dangerous and intensifying partisan divisions not only on the health care issue but in the nation as a whole.

By the same token, I wonder if it was wise to chastise insurers during the President’s speech. Sure, they’ve done bad things in the past and possibly in the present and everyone likes a bad guy. But it is a little too easy to pick one scapegoat when a lot of different constituencies contributed to the current health care crisis. If coverage was wrongfully denied to people who died as a result of those denials or delays in coverage, then those companies should be tried both in the criminal and civil courts by states’ attorneys general. And, if they are found guilty, then they should not only be condemned. CEOs should be given jail time and court judgments should be imposed. And the courts should step in and establish plans to make sure that the culprits can’t do it again.

But alienating a key constituency in the health care debate will not advance the issue. America’s Health Insurance Plans, Washington, released a statement in which it states that “We agree the status quo is not sustainable” and noted that “We proposed health insurance reform to guarantee coverage to all Americans, eliminate pre-existing condition exclusions and rescissions, and no longer base premiums on a person’s health status or gender. To keep coverage as affordable as possible, these reforms must be paired with an effective coverage requirement to get everyone into the health care system.”

AHIP notes that it does not support a “government-run plan” but asserts that “the nation cannot afford to let this historic opportunity pass us by.”

The Founding Fathers would have been dismayed by the fact that it was necessary for the President to spell out why health care reform that covers everyone and prevents people from falling into the abyss of poverty is needed.

After all, they did help craft a document that says it is “self-evident” that “all men are created equal,” noting that “life” is one of the “unalienable rights.”

The President clarified the many unintentional and unfortunately deliberate attempts to misconstrue his plan. In that respect, it was a strong statesman-like speech that laid out the facts of his plan. He would like to see a public option available only for those who wanted it and you can keep the health insurance you want. And, granny, rest easy. No medical tribunal is going to put you down.

The message was clear and the outline of the plan well-defined. Where it was a little weak was on details. The President says that the plan will not put us in greater debt because there are ways to save in the current system. But, there doesn’t seem to be specifics on the savings.

Is that a death knell for the plan? I don’t think so. Did the four physician signers of the Declaration of Independence; Hall, Bartlett, Thornton and Rush have specifics on how the new government would develop and ultimately work? They might have had concepts but I doubt they had specifics. The Declaration itself is a very general document.

What they did have was a gut feeling that what they were signing onto was right and just. What they did have was the courage of their convictions and the willingness to take a leap of faith. I saw the same willingness in that speech.

I was heartened by the fact that the President still wants a public option. I think it can only help and not hurt. I was also heartened by the fact that he says he will listen to any serious proposal. The Republican response from Rep. Charles Boustany, R-La., a medical doctor, about making health insurance available across state lines, certainly is worthy of discussion although it may hurt the public option. But maybe it would be a reasonable way to ensure that Americans in areas where health insurance is not available could have affordable coverage.

Whatever the ultimate solution is, the overhaul is needed now. The situation is becoming too dire for too many Americans and we have too many other serious issues to delay this any longer.

With Congress back in session, it is time for its members to roll up their sleeves, keep the partisan politics to a minimum and remember the leap of faith that the 56 signers of the Declaration of Independence took when they signed a statement that left their future very uncertain.

And, as healers as well as Founding Fathers, the four physicians in that original group would have been as interested in healing the divisions in our country as they would be in providing health care for all.

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