Health Care: Yelling "Fire!"

It works every time. Yell “Fire!” and everybody panics. Doesn’t matter whether or not there is actually a fire. Just yell. That is what our concerned private health insurance companies have done. The panic they have engendered will probably kill any hope of effective health care reform.
It’s more drastic than what they did in 1993to Hillary’s bill. Then they merely whispered, “I smell smoke”. This time the threat was more urgent so they gave a full throated shout. “FIRE!!!” (Illegal in theatres and the like. Okay in Congress and town hall meetings.
What’s the threat? It’s very real. Health insurance companies are fighting for their lives. They are fully aware that the only way universal coverage—that transfers and that cannot be lost with a job or by a company that cancels insurance coverage—can be made at all affordable is by the use of a single payer system. In other words, like Medicaid and Medicare, the government.
When and if that ever happens, private health insurance will go the way of the buggy whip and the black smith. They’ll be left with a very small, select (and rich) market. Universal health coverage—with the looming necessity of a single payer system—is as deadly to private health insurers as the auto was to the horse.
To save themselves, like the people who shout “fire” in a crowded room, they are playing on very real fears among the electorate. Some of what they are saying is a flat lie. Other things have just enough edge of truth to them to strike a note of real anxiety among citizens.
It’s very true—as Republicans point out—that the anger on peoples’ faces when they start shouting and heckling at town meetings cannot come only from a few paid activists. Something there is coming from the gut. Something is terribly real.
If it’s real, it cannot be dealt with by temporizing or backing down on this or that portion of the bill. Somebody in the Democratic camp is going to have to take the terrible risk (and it is terrible—telling the truth in American politics is the quickest form of political suicide) and talk straight facts to the people. They won’t like it, for a time they will scream even louder. But it’s the only chance, however slim, of getting a sane bill through.
We know what the insurance companies are afraid of. When a corporation’s life is threatened, it will—as will an individual person—violate all the rules in the Marquis of Queensbury canon to survive. What are individual Americans afraid of?
In their gut, they honestly fear having their lives threatened. The average American, while perhaps inattentive, is not totally stupid. Anyone who has scanned a paper or a news magazine over the past few decades is well aware we are running out of money to pay for our present patchwork insurance system.
The same American is also aware of a fundamental economic law: when you run out of money for ice cream, you can’t have any more ice cream. In the normal course of events, when there isn’t enough money to buy movie tickets for everyone, somebody doesn’t get to see the show.
If I am insured by a company plan—either as an employee or a retiree—and Medicare if I’m over 65, if we don’t change ANYTHING, there is a fighting chance that I won’t be the one to come up short on movie tickets. So DON’T TOUCH ANYTHING.
That may be a selfish concern, but it is certainly an understandable one—especially if the person in question has a disease that might be fatal if left untreated, and he can only afford the treatment through his present health insurance.
So he’s scared to death of change—any change. Immediately the fear grips him: what if the particular drug that keeps me alive is taken off somebody’s new list? Will the cost of the treatments that I need be rationed (a few whispers from private insurers help aggravate this fear).
Will I have to wait longer to see a specialist, especially if my condition suddenly acts up? (I’m waiting six months to see a specialist under our present system—how much worse could it get?)
Where is the money coming from to take care of MY granddaughter with a birth defect or of ME if I become old and disabled. The latter wasn’t an issue when I was a hale thirty-five. It seems more pressing now that I’m seventy.
Everyone senses that the present system is going to fetch up on the fiscal rocks. Everyone hopes that if he or she sits very still we will somehow escape the wreck. That’s the terror you see in the eyes of the people who are disrupting town meetings on health care.
Obama has got to be forthright (the riskiest thing a politician can do. Churchill was being most un-American when he admitted to the British people that all he had to offer them was “blood, tears, toil and sweat”. And he isn’t very popular in England today.).
The President has got to force Americans to face, in their conscious minds, the fact that the present system is teetering on collapse—that rationing will surely come (like no money for ice cream) if we do nothing—that it will be far less unfair if we truly pool the risks.
As to “final solutions” and death committees, I have been through personally what he is recommending in his bill with both parents, a maiden aunt and two in-laws in just the past ten years. The nurse, doctor or social worker sits you down very routinely and asks how much intervention you want—how much pain you wish to inflict on the dying—and when to let them go.
This was in strongly church connected nursing homes—where the issue was to preserve life and make it comfortable. No death squad here. None in Obama’s bill. That’s just unconscionable lying, fueled by fear and the unscrupulous shouts of “FIRE!”
I’m afraid, Mr. Obama, that the time has come to fight “fire” with truth. That’s unfortunately all you have left to work with.
That’s a terrifying thought for ANY politician.