What We Need in the Next Four Years

I wrote a column in January entitled A Dime’s Worth of Difference in 2012.

The central premise of the column was that this year’s health policy debate would fall short of what we needed.  It would instead resonate with the words “Obamacare,” “Romneycare,” “government takeover,” and “individual mandate.”  That is exactly what we got – and then some.

But we needed something more.

We needed an honest debate about:

• the future of Medicare for our elders;
• the importance of Medicaid to people with chronic conditions;
• the growing mental health needs of our population – including our returning veterans;
• the essential role of public health in our lives, no matter what our socioeconomic status;
• the fact that health and social assistance providers are the real job creators in our 21^st century economy, and must play a key role in our recovery from recession.

What we experienced instead was a tsunami of concern for our more selfish instincts – that we should not have to pay anything at all for our own health and well-being, and that there is nothing of value in the lives of those less healthy or fortunate than ours.

We have just gone through a campaign with a blizzard of mostly negative advertising in a handful of swing states, but not a minute devoted to what more we might do in the next four years to help:

• children whose plunge into poverty compromises access to the food they need to grow and thrive;
• young men and women returning from war with PTSD;
• older Americans facing hundreds of thousands of dollars of long term care expenses that we fail to insure;
• communities around the country whose decaying infrastructures have proved inadequate in recent days, months, and years to hold off environmental devastation caused in part by the radical changes to our climate we created.

We have heard nothing about jobs and health care.  We have, however, heard much from demagogues around the country about the $716 billion cut to Medicare, as if that were going to determine the fate of a nation. 

Think about it.  A bipartisan, consensus item – essentially limiting the future growth in the Medicare to 5% per year instead of 5.7% - took on such a life in campaign commercials that one could conclude that no greater threat to America’s health could exist than to limit inflationary growth – while expanding benefits – in our most popular entitlement program. 

And the irony was that the proposed solution to save Medicare from this devastation was to eliminate the program as we know it.

When I was a legislator, the people of my district clearly understood that only a rare person who walked the tightrope through life could do so without a safety net beneath them. 

They didn’t blame people for falling off that tightrope from time to time, they just asked that we legislators work together to get them back up again as soon as they were able.

In the area of health, this meant that:

• we cleaned up our environmental messes with government support;
• we immunized our children with government funding;
• we built public and nonprofit hospitals and clinics and regulated the care they provided with government involvement;
• we developed long term care services financed with government dollars;
• we provided for the basic needs of people with physical and mental disabilities and diseases with government assistance.

And we didn’t think this was a bad thing, because we realized that our government was purely and simply a reflection of us.  And, by the way, the second-leading creator of jobs in our country.

Maybe some think that our uniquely American form of government no longer works for us.  I’ve heard those echoes, but I don’t see them as representing the majority view.

In the next four years, we need to insist that our governing leaders take us – and themselves – more seriously.  We need them to stand together, not fall apart, in tackling the health issues that confront us.

We need both progressives and conservatives to understand that health and social assistance providers – not small businesses in general or manufacturers – are the real job creators of the 21^st century, and drive a large share of our economy.

We need them to understand the meaning of compromise.  We do not live in an either/or, all-or-nothing-at-all world. 

And what we need most is for the pandering to end.