A question for the campaign season: What is plummeting, in addition to the Standard and Poors credit rating, employment, and the dollar?
Answer: the collective IQ of voters.
In the Heartland, the Good Ole Joes, those ordinary tea-slurping Americans disgusted with Big Government (BG), are cheering. They know the country needs a robust economy. And they see BG as a Big Hindrance, hobbling the entrepreneurial energy of grassroots citizens. So whenever folksy politicians promise to eviscerate Medicare, slash money for highways, axe the Department of Education, and abolish clean air and water regulations, a statistically alarming swathe of voters cheers. When politicians promise to repeal Obamacare, the cheerers wax giddy. The success of Michele Bachmann et al in Iowa presages more national giddiness.
Before the nation descends into an infectious giddy-mania, its time for a time-out to espy the glorious No Government future for health care in the United States. Imagine the Tea Partiers prevail, and that Congress repeals health reform legislation. The Tea Partiers victory will by Pyrrhic.
A large chunk of Americans will have no health insurance. Today the number stands at 50 million: in this recession, many firms have dropped insurance, or dropped employees. But even during prosperity, the number of uninsured reached 44 million.
The employer-based system was not designed to cover every American. Wherever citizens routinely have health insurance, Big Government has acted.
Imagine no Medicare, or a privatized Medicare. We could return to 1965, before BG entered that private insurance arena. When Congress passed Medicare, few retirees had health insurance. Health care costs were lower, but most retirees could not afford it anyway. Today retirees take Medicare for granted. They grumble that it is not extensive enough, costs too much, is too complicated. They dont grumble that Medicare denied them coverage.
Post-repeal, the private insurers will be cheering: Well see a resurgence of policy incentives to keep costs down and profits up; exclusions for pre-existing conditions; caps on coverage; high deductibles; not covered procedures; limited networks of physicians.
The heath reform legislation corrected some of these imbalances; with repeal, insurers will have free rein to say no. Some of us who have insurance will find we are under-insured. Even the Tea Partiers will grow somber when a managed-care bureaucrat caps payments for chemotherapy.
The Americans who are uninsured and underinsured, moreover, will suffer. A decade of cuts has made the safety net of publicly funded clinics and hospitals porous. Are the voters screaming Repeal prepared to see people with diabetes lose limbs? To watch people with cataracts grow blind? We have medications to lower cholesterol, to control hypertension; are the people screaming Less Government prepared for more heart attacks? More strokes? Does every pregnant woman need prenatal care? Will they accept more cases of tetanus, diphtheria, even polio if we cut back on immunizations?
Perhaps the ranters, those with insurance, can accept that future, particularly if saying no to health reform will jump-start the economy.
But the ranters should recognize: a sick workforce is not a productive engine of prosperity. The diseases that make us sick make us poor workers, and unlikely entrepreneurs. Conservatives praise Texas as an economic paragon: the state ranks high in job creation, but last in health insurance (26% of Texans are uninsured), low in education, low in income. Hardly an economic utopia. (Ironically, Massachusetts legislation has insured most Massachusetts residents; but former Gov. Romney, in his zeal to woo the voters he thinks he must woo, has backed away, as though the law was a bad first date).
For tea partiers, though, the final indictment of BG is not that it is a controlling Big Brother, but that it is a rapacious one. They campaign on a familiar plaint: We pay too much in taxes.
Rugged individuals, independent of Uncle Sam, built this country.
To move the country forward, we must let citizens keep more of their money. Or so the rhetoric holds.
Yet the ordinary Joes throughout our history have been bolstered by the collective will of a populace willing to spend to improve the nations lot.
We all have benefited from publicly financed schools, roads, housing, education, food production. We pay taxes to better our lives. Health insurance belongs in that list.
In a moment of quiet reflection, let the Tea Partiers put down their placards to acknowledge Big Government as, potentially, an ally.
Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email firstname.lastname@example.org.
From The Progressive Populist, October 1, 2011
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