Sickness & struggle, part 1
The urgency of reform
Published Aug 6, 2009 7:28 PM
The push for meaningful health care reform is in peril. Congressional Democrats
have advanced flawed legislation that fails to live up to their campaign pledge
of universal health care reform. Republicans allied with right-wing “Blue
Dog” Democrats have worked overtime to derail any attempt at reform.
Congress adjourned for the August recess without a floor vote on health reform,
leaving many observers to speculate that the plan is doomed to repeat past
failed health-reform attempts.
The need for quality universal health reform is more urgent than ever. More
than 50 million people living in the U.S. lack basic health insurance. Another
25 million are underinsured.
Families USA, a nonprofit advocacy group for health reform, issued a July
report detailing how rising insurance premiums and growing unemployment
contribute to an average of 44,230 people losing health coverage each week.
These figures, while important, tell only part of the story. The real-life
instances of tragedy resulting from a lack of health insurance tell the other
One such story emerged in February 2007 when 12-year-old Deamonte Driver died
in Maryland after infection from an abscessed tooth spread to his brain. His
mother, Alyce Driver, had spent a considerable amount of time prior to his
death trying to find dental care for her children. Deamonte died after weeks of
emergency hospitalization failed to save his young life.
Although Alyce Driver was a working mother, none of her jobs in a bakery,
construction or home health care provided insurance for her family. Her
son’s story adds to the picture of a health care system in crisis and
reveals the backdrop to the biggest struggle for health care reform in 16
Not since the 1993 Clinton health reform fiasco has there been such widespread
popular support for a radical overhaul of the health care system. Labor unions,
progressive health care professionals and consumer advocacy groups all agree
that the current system is untenable.
Many among these sections of the organized left have also concluded that the
current Democratic reform plan is woefully inadequate and prone to failure.
President Barack Obama’s former doctor recently came out against the
Democratic health plan, according to a July 29 article on the Huffington Post.
Dr. David Scheiner, a single-payer advocate who treated President Obama for 20
years, says: “I look at his program and I can’t see how it’s
going to work. There would be no effective cost control in his program. The
[Congressional Budget Office] said it’s going to be incredibly expensive
... and the thing that I really am worried about is, if it is the failure that
I think it would be, then health reform will be set back a long, long
This certainly would not mark the first time health reform has suffered a
severe setback. An examination of the struggle for reform throughout U.S.
history reveals an uphill battle with many major defeats for the movement and
some modest concessions from the state.
Medicare, Medicaid and the Children’s Health Insurance Program rank among
the most significant health care gains won by workers and oppressed people. But
despite a century of struggle, workers in the United States have yet to win a
system of quality, universal health care for all. Access to adequate care is
now considered a basic right in every other industrialized capitalist
As the current push for reform teeters on the brink of collapse, the movement
must grapple with a new set of questions.
Why have past attempts at systemic reform failed? How did the modest reforms in
health care, such as Medicare and Medicaid, come about? What is the impact of
the scientific-technological revolution on health care delivery and patient
access? And last but certainly not least—how can quality universal health
care coverage be won?
President Obama often referred to “the fierce urgency of
now”—a phrase first popularized by Dr. Martin Luther King
Jr.—to appeal to voters during the presidential election. A fierce
urgency of now exists when it comes to the radical changes needed in the health
The U.S. spends far more on health insurance than other countries, according to
a 2009 Organization for Economic Co-operation and Development report on
comparative health data. U.S. health care expenditures account for 16 percent
of gross domestic product. France came in second on this measure with health
spending equal to 11 percent of GDP.
The OECD average was just under 9 percent. U.S. per capita spending of $7,290
was almost two-and-a-half times greater than the OECD average of $2,964. The
OECD has 30 member countries, including all of Western Europe, Canada, the
U.S., Japan, south Korea, Australia and four countries from Eastern Europe.
This same report found that, despite exorbitant costs, the U.S. has fewer
physicians and hospital beds per capita, a higher infant mortality rate, and a
lower life expectancy than most other OECD countries.
A 2008 study published in Health Affairs Journal found that the U.S. had the
highest rate of preventable deaths before the age of 75 out of the 19 countries
it examined. The study concluded that as many as 101,000 deaths a year could be
prevented by ensuring that all patients receive quality care in a timely
In this time of severe economic crisis capitalism might be sick, but it is the
workers who are dying.
Next: Cold War politics pushed Truman on health reform.
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