Healthy Communities

Healthy Communities
By Shea Howell
Michigan Citizen, August 23, 2009

The debate over health care has entered a critical moment. At the beginning of the week the President and his team signaled they were willing to back away from a public option and were open to talking about other possibilities for covering the more than 47 million people who do not have insurance today. The core idea of this public option was simply to extend Medicare-like coverage to all those uninsured. This notion has become a flashpoint for opposition, fueling the aggressive protests at town hall meetings, the vehement outbursts on talk radio and an array of scary images from “death panels” to government dictators.

This onslaught seems to have forced the administration to shy away from its original approach. Kathleen Sebelius, Health and Human Services secretary, said that a public option is “not the essential element” for reform and was the first to float the idea of a regional co-operative alternative to a single payer, federally-financed system. President Obama, in his effort refocus the debate, also suggested that the public option is just a small piece of a broader effort to control costs, expand coverage and protect consumers. Speaking at a town hall in Colorado the President said, “The public option, whether we have it or don’t have it, is not the entirety of health care reform. This is just one sliver of it, one aspect of it.”

This shift away from the public option has produced a fury among progressives. Some are blaming the right-wing fringe for spreading lies and deceit. Sarah Palin has resurfaced to fuel fears of government-run “death panels”, and we are all urged to call our congressional delegates to get them back to reality. Beyond the obvious fear-mongering and lies, some analysts are pointing to the manipulative hand of the medical-industrial complex.

Over the past ten years the insurance industry has ranked second in dollars spent on lobbying in Washington. Pharmaceutical and health products hold the number one spot. The potential of health care reform to drastically cut into their profits is driving their opposition to a public option. Health care reform is an opportunity for windfall profits as private insurers take on the uninsured at public expense. They have poured billions into making sure that their profits are protected.

The tragedy in this is more than the loss of real reform of a health care system that already costs more and delivers less than that in any other wealthy nation. It is an effort to destroy the opportunity to talk about why we are such an unhealthy nation and what healthy living would really look like.

The medical industrial complex would like us to focus on individual health care and on the technologies they provide to repair and sustain life. Such an individual focus misses obvious and more serious questions. Why are so many people sick? Why are murder and suicide the leading causes of death for youth? How can children be healthy in cities where the very air they breathe is toxic? How can adults provide nurturing care while coping with stress and depression?

We will never have real reform of health care if we allow the discussion to be simply the question of how individuals get access to doctors and hospitals. We have the opportunity and responsibility to ask much more fundamental questions. What does it mean to live in healthy communities? Can individuals be healthy if their communities are sick? How do we create ways of living together that promote safety, vitality and care?

Of course, everyone should have access to health care. But everyone should also be engaged in the creation of healthy community life. This requires more from us than access to a system that is clearly broken.



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