My take on health care reform

For months I have been assiduously avoiding commenting on the current national health care reform debate. My reasons for this were many: I was too busy; I was cynical about the chances and didn't want to dampen anyone's spirits and most of all, I was out-of-loop and ignorant and didn't want to face the barrage of correctional comments I would invariably receive since, given my background, if I waded into the water of health reform I would be unable to restrain myself from acting like I knew something.

What do I know? Oh, everything and nothing. See my little profile to the right on the blog page if you're not familiar with my background. Suffice it to say that I was a Washington lobbyist for national health insurance in Washington in the early 90's when Clinton tried to pass it and I've worked for arguably the four strongest single payer health care organizations in the country: Public Citizen, Neighbor to Neighbor, California Nurses Association and Physicians for National Health Plan.

Since 2002 when I left the California Nurses Association though, I have floated more and more to the fringes of health politics. Like so many before me, I have believed that we simply can't pass meaningful health care reform in this country without finding a way to counteract the effects of big health care industry campaign dollars on the parameters of the possible. Hence, I have largely confined my efforts to pass national health reform to a) working to pass public financing of elections and b) prayer.

Nonetheless, I couldn't resist a lump in the throat and a feeling of excitement this week as the health care headlines sailed by. From what little I know, I think it's a huge stretch to compare this legislation to Social Security, but it is historic. It's historic largely because it actually passed and for generations little else has (Children's Health Insurance Program and Health Insurance Portability Act notwithstanding).

My standard rant on this subject is that Democrats will never get anywhere on health care reform as long as they run away from government. Obama's effort proves that no matter what the specifics of the bill, Republicans will campaign against it as if its single payer national health insurance. It may be (and to me it looks like this largely is) basic no-brainer insurance reform mostly to increase access, without any major diminution (and perhaps a slight increase) in private sector power/profit and influence and the GOP will still call it socialism, government takeover, government taking away your doctor.

The thing is that if it really is single payer you can counter back with things like: yes, but every man, woman and child cradle to grave will have full health care coverage for the same amount that we're paying now to cover a fraction of the population. No matter where you work or live or who you're married to or what money you make we'll all have an insurance card and we'll take it to any doctor and we will all get coverage of everything we need. I don't think you can say that here. I don't think you can say it by a long shot.

This time around despite (or maybe because of) the win, I am enjoying being peripheral to this process and out of the loop. My strong guess is that if I were working for Public Citizen now I'd trade in the lump in my throat for a pit in my stomach. I can viscerally recall the contempt that familiarity with the Clinton administration bred in me and so many others. It can really be comforting to know nothing.