Our American character

What is it about the "American character" that allows the kind of looney-tunes debate now taking place around our attempts create a rational health care system? 

This debate goes back to the beginnings of modern medicine, which came at a price. The first insurance companies, in the thirties, were more like philanthropic organizations for groups like the Elks. It was the fixed wages of WWII  that made employer-supplied insurance a way for GM and others to attract needed workers. 

President Truman tried to deliver universal health care as a natural extension of Roosevelt's "Four Freedoms," but a resurgent Republican party branded the policy, and him, as "communist." And it certainly helped that once the big employers realized how big that pool of insurance money was, there was no way they were going to give it up.

After decades of health care under this model we have a body of evidence that's pretty hard to ignore -- unless you want to. Consider:

• We are the only industrialized country in the world without a universal public health system (link).
• We pay almost twice as much per capita for the care we do get,
• Spend a much lager percentage of GDP,
• And our life expectancy is towards the bottom of the pack (link)
• Last year, in more that 62% of US bankruptcies, medical bills were the main cause, 
• And most of those people had life insurance (link)

And it's not as if this information is difficult to find. A few minutes with Google will give you hundreds of studies and sources that tell the same story.


Even more confounding, as reported by Robert Creamer,  "a poll conducted for Americans United for Change by the respected firm of Anzelone and Liszt -- completed last Friday -- shows that, by a 62% to 28% margin, likely 2010 voters would be more inclined to support President Obama's healthcare reform plan if it included a public option that gave people a choice between private insurance plans and a public health insurance plan."

An excellent piece in Slate by Timothy Noah, "A Short History of Health Care," makes the observation there is are two realities in this discussion: 

"The trouble with the policy debate that's slowly beginning to emerge as the medical-industrial complex spins out of control is that it pays maximum deference to Reality 2 (political reality) and minimum deference to Reality 1 (the thing itself). "

The take-away is that our legislative system is not, in itself, democratic. Specifically, the Senate's function is to blunt the voice of the people. It was formed to protect the interests of the large land-owners (who were also largely slave owners at the time). In the past few decades the Senate has been also become the guardian of the large corporate interests, and there is almost no corporate interest larger than the alliance of insurers and pharma. The fact is that a relatively small number of Senators can effectively block any action that threatens their corporate allies. Rep. Jim Wilson (a protegee of Strom Thurmond) calls the President a liar and immediately raises a half million dollars (which is about what he received the last few years from insurance companies).

Add to that a few entertainers who see an opportunity to build an audience, and have no compunction to ignore the factual evidence, and you can motivate a few thousand disgruntled (if not exactly unified) partisans to assemble and grab a few minutes in the media spotlight.

The fact is there are many people unhappy with the political process. From the left side of the spectrum we it looks like our modern Know-Nothing, troglodyte party is about to take down the one chance we may have to  create a rational health care system. But it ain't over yet.

For one thing, the American character may not be patient. It may want instant decisions, and not much palaver. We want the 80-yard touchdown play. Every time. But it seems we have a specific character in the White House who is comfortable enough with the reality of the thing as it is that he's willing to outwait the opposition, to stay with a strategy that is realistic about strengths and weaknesses and the critical importance of this opportunity.

It just might be that because of a singular American character, history, and time, is on our side.