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Posts Tagged ‘health-care reform’

A long time ago, when my first child was born, I found to my surprise and consternation that my employer-provided Blue Cross Blue Shield policy did not cover normal childbirth expenses in a hospital. I guess they rationalized that by thinking that normal childbirth wasn’t a disease, so why should health insurance  pay for it? Fortunately, credit cards had just been invented. I put the balance due on my BankAmericard.  When I returned to work, a couple of days later, I complained to my coworkers about our lousy health care insurance. One of the older men, probably only a year or two away from retirement, spoke up and said, “Who cares? I don’t want to pay for your babies.”

I was taken aback by the his total and complete lack of concern about my plight, but somehow I was able to quickly retort, “Yes, and I don’t want to pay for your heart attack either!” The old man stood there speechless for a minute and slowly turned and walked back into his office without saying another word.

Today, as Congress struggles with the question of just slightly improving the U.S. health care system – certainly they’re not considering anything close to the health care that is provided in the civilized world – we find that we have become a polarized population. The Republicans are uniformly against the proposals at hand while the Democrats, true to form, are disunited but bumbling forward,kicking and screaming – not to mention dealing secretly.  It looks like the House Dems might actually vote “yes” at this time – but who knows, it’s not like all of our members of Congress are motivated by what is best for the country.

If one just steps back for a moment it’s easy to see what divides us. There are three groups of people, generally speaking, in this country. One group has no health care or very little health care and basically no voice in our government because they are the poor disenfranchised.  A second group has health care but is concerned about the people who don’t have it. The third group also has health care but doesn’t care about the first group in the least.  If they had their way the first group would just go away. The third group, of course, is the Republican Party. It is the party of “every man for himself” or “you’re on your own”.  It’s the party of “I’ve got mine and I don’t care about your problems. Take care of yourself.” They are the Party that aligns itself with the ” Christians” of America.

OK. Fair enough. The Democrats basically represent the method of living that mankind adopted a very long time ago in order to survive. It used to be called tribalism. Everyone was a member of the tribe and everyone contributed to the welfare of the tribe.  In turn the tribe took care of its members because every member was important. The Republicans, on the other hand, represent a newer, more modern point of view. They are the rugged individualists, the go it alone types. The can take care of themselves.  They are the philosophical descendants of the Calvinists who founded our original colonies  – people like the Pilgrims.  It was the early “pioneers” in this country who struck out on their own, with guns of course, and took the land from the Native Americans.  It was relatively easy to be on your own, living off the land, when you had all the firepower you needed and the American landscape lay there, ripe for the taking. And they took it.

Today, 95% of America’s wealth belongs to 1% of the population.  You can bet most of that 1% is Republican and Calvinist.  The question is this: why are so many other Americans also Republican when they have virtually no chance in sharing in the immense fortunes of the Elect?  Sadly, a big part of the answer lies in history.  When President Lyndon Johnson signed the Civil Rights Act of 1964 he predicted what would happen: the “Solid South” that had always been the most dependable segment of the Democratic Party would turn Republican. And they did. The old Confederacy just couldn’t accept racial equality for blacks. That was half a century ago and much progress has been made in the old Confederate states, yet they are still the heart of Republican sentiment. Of course we shouldn’t ignore the cowboy states of the West – they are the rest of the Republican Party.

If one looks at the demographic of those poor people who have no health care there is one thing that stands out: they are mostly minorities.  They are largely blacks and Hispanics.  The message of the Republicans is clear: they already have theirs – and they have no interest in helping anyone else, and certainly not the blacks and Hispanics.  In the end, the health care debate in America is actually a debate about Civil Rights and ironically the Republican Party, the Party of Abraham Lincoln, is against the right of all the American people to have health care.

The right to health care is now recognized throughout the civilized world. It is only America that does not recognize this right.  The time has come for America to grant its people the same rights that are granted to the citizens of France and Ireland and Canada and Russia and Malaysia and England and Norway and Denmark and Germany and pretty much anywhere else you can name.  It is only the Republican Party that is united in denying this right to the American people because,  after all, they’ve already got theirs, and they certainly don’t want to pay for yours.

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Emotions have run high on both sides of the issue.  Is access to health care a right, a privilege, or a commodity?  The answer, it seems, depends upon where you stand.  Today, as the U.S. Congress continues to thrash through the process of considering the health care bill, accusations fly from both sides, with Senator Joe Lieberman caught in no man’s land, trying to please both sides but pleasing no one – an army of one.  The left-most side of the debate has already turned on their leader, President Obama, declaring that he has misled, misdirected, and misfired.  Dire predictions abound about 2010 and 2012.  On the extreme right, Republicans chortle with glee, knowing they have stymied a process that might have led to low cost health care for most Americans.  It’s hard not to be emotional about this whether one is on the left or the right. Health, after all, can be an emotional issue. But, then again, so is money.

There can be little doubt that we are a nation divided on this issue. There may be a majority of people who want to change the present health care system. There may be a majority who favor a public option or expanded Medicare or some other version of a government supervised health plan. But it apparently isn’t a two-thirds majority or a three-quarters majority. And that is the problem for this Bill.  Our Constitution was written to ensure that the majority rules, but not the simple majority.  The way the system is supposed to work is that 60% of the people (i.e. 60% of the Senators who represent the people) can make laws – but 51% just isn’t enough. There are not 60 Senators who want this health care bill.  It is that simple. It also seems that there are not 60% of the people who want it either – maybe 55%, maybe 59%, but it doesn’t look like 60%. So, it’s not going to happen – at least not in its present form.  That is the way our government works – that is who we are.

The question we need to ask is this: what does this say about the American people? Somewhere around 30% of the people don’t have and can’t afford health insurance.  Many people go without critical medical care because they can’t pay for it.  Many people die because they can’t pay for the medical care they need. We all know that. It also seems that pretty close to half of us are OK with that too.

It’s just who we are.

We Americans like to say that we believe in freedom – in many ways that belief defines the essence of America: freedom to be what you want, do what you want, say what you want. It is also the freedom to not do things, to not help someone, to not pay someone else’s bills, to not take care of strangers. It is the freedom to look the other way.  We do that all the time.  Many people may have forgotten by now, but there  was a tragic case of murder that occurred in New York City in 1964. A young woman named Kitty Genovese was stabbed to death at the entrance to her apartment building. She screamed that she was dying. A lot of people watched. No one helped.  A few years ago New Orleans was inundated by Hurricane Katrina.  President Bush flew over the city and looked out the window of his airplane at the drowning city as he flew by. He didn’t help. The U.S. government didn’t help. The people drowned.

It’s just who we are.

It is indeed ironic that it is the Republican Party that has led the fight against health care. It’s ironic because so many Republicans are staunch “Christians”. Yet, standing by and watching people suffer and die is the opposite of Christianity, isn’t it? Isn’t that a value more to be attributed to the Roman Empire where people were thrown to the lions just for fun? I must admit, I don’t understand the mental gymnastics that people have to go through in order to call themselves Christian and at the same time vehemently and violently oppose health care for the sick and dying people of America.

It’s just who we are.

In the end though, we have to recognize one truth.  Regardless of how strongly we feel about this issue, we as a people, have an agreed upon method for creating rules. We have an organization we call Congress that makes the rules on our behalf. The process is complex and involves a lot of horsetrading, money changing hands, posturing, threatening, and cajoling. Money counts in our system. Money buys influence in our system.  The average citizen’s only voice is his single vote in the elections. We voted. There is now a majority of Democrats in the Senate, but not an overwhelming majority. We made it that way.  We could change the system. We could eliminate lobbyists and payoffs.  We could eliminate the deal-making and the lying. But we don’t.

It’s just who we are.

In the end, whether a watered-down health care bill passes or it doesn’t, it is because this is what we, as a people, voted for.  We have this form of government because we want it and we don’t want to change it.  If we don’t choose to provide health care for the poor and unfortunate people of America it is simply because we don’t want to do so. That’s what this all means.  It isn’t President Obama’s fault. It isn’t Joe Lieberman’s fault.

It’s just who we are.

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As the Senate prepares to take up the issue of health care reform, the Republican Party is gearing up for a fight to the finish, a fight to defeat any attempt at improving our health care system.  It is a desperate struggle the Republicans are waging, desperate because it is about money – lots of money.  It’s also a sad struggle because it shows so clearly how corrupt our government is. Granted, our government has been corrupt for a long time. Slipping a wad of money into a Congressman’s pocket is an old tradition on Capitol Hill. It’s the best way to assure that you can either get the legislation you want or to prevent legislation you don’t want from being passed.  Today, this “passing of bucks” is accomplished by middlemen, called lobbyists. It seems that just about every Congressman and Senator has his price. There are precious few who cannot be bought.

Money is where the health industry comes in. It is, of course where Republicans come in as well.  After all, they are the Party of business, of Capitalism, of profit. That is their constituency.  One is tempted to say, “OK, that’s alright. Let the Republicans represent the sellers of goods and the Democrats represent the buyers of goods.” Of course, it’s not that simple because the Democrats also represent the ordinary workers, while the Republicans represent the employers.  But one would hope at least that there could be an honest debate.  One could hope that there would be a rational discussion of the facts – all in the national interest.  It would be a debate about what is best for the American people – after all, isn’t that ultimately the purpose of Congress – to do what is best for Americans?

Unfortunately, the Republican Party has chosen not to have a debate on the merits of health care reform.  Instead they have launched campaigns of outright lies about reform. They have tried mightily to steer the debate into discussions about Death Panels and Nazi medical experiments and the rationing of health care.  Any reasonable person can tell that these Republican tactics are nothing but lies and because they are lies and not real issues that should be discussed, the Republican Party has done a disservice to America – in brief, they have become un-American in their zeal to protect the profitability of medicine.

There is a danger here in all of this distortion, in all of these attempts to steer the discussion away from the real issues and to focus on trumped-up concerns that have no basis in reality.  The danger is that we will fail to ever discuss the actual dangers that are inherent in our current way of going about the health business.  Here is one excellent example that, as far as I can tell, is being completely ignored: we have a vastly insufficient supply of H1N1 vaccine because we have a for-profit health system.

The simple fact is that not everyone gets a flu shot every year. Most people do not get routine flu shots and because of this our vaccine industry, ever intent on making a profit, has sized itself according to the yearly demand for flu shots.  Our commercial vaccine production industry simply does not have the capability of making enough H1N1 vaccine to protect everyone man, woman, and child in this country. It simply cannot be done.

So, I would ask our imaginative friends in the Republican Party, the ones whose vivid imaginations can conjure up images of Death Panels and Nazi medicine being practiced on Americans, and the limiting of health care to only those who are connected with someone in government, to think about something else. Consider this: suppose the H1N1 flu strain that is making the rounds this year was different. Suppose instead that it was the same H1N1 strain that made the rounds in 1918. How many people would die in America? One hundred million? Two hundred million? How many would die in the entire world? A billion? Two billion? What could be done stop that strain of flu?  Nothing. Nothing could be done in 1918 and nothing could be done now.

The question I would put to the Republican members of Congress is this: is there any way you could think of that we might be able to make enough vaccine for everyone in a case like this?  There is only one answer: the government has to create this capability in advance – it’s not a last-minute sort of thing.  Why? Because it’s a money loser. Big business would hate it – it’s a gigantic capacity that would only be used once in a lifetime.  You can’t make money from that. Which is why there is a natural role for government in health care. The government spends about half of our national budget on defense – i.e. defending us from other people in other countries. How long will it take until we understand that it is also the role of government to defend us from other foreign attackers, things like viruses and bacteria. It might seem strange at first to look at it that way, but think about this: suppose – just suppose – that there really were aliens from Mars attacking us – would it be the role of government to defend us? What if instead of the Martians being little green men they were little green bugs?  What if these little green bugs were actually microscopic invaders? How is that different from deadly Earth-based viruses attacking us?

The simple fact is that the government has a duty to protect its citizens. This duty extends to protecting the citizen’s health. Health care should not be a profit-making business.  It should be more like a utility, available to everyone and dispensed by the government. That doesn’t mean that businesses can’t play. People are certainly free to purchase health related things, but the government has to understand that it has a responsibility for the health of its citizens – a responsibility that cannot be dodged and delegated to the profit-making business community.  We missed a bullet this time with the H1N1 flu; however, it is virtually certain that a time will come in the future when a very deadly viral pandemic will sweep over the Earth.  The steps our Congress takes in the next couple of months may well determine whether America survives that inevitable pandemic; it may well determine whether the population of our country is obliterated or if it survives.  It would be a shame if hundreds of millions of Americans died in the future all because the Republicans wanted to help their friends in the health business make a buck.

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As the health care reform legislation wends its way through Congress, it appears that some sort of Public Option may be included in the bill.  The latest talk is that it will only be available to those who have no health insurance. If you already have health insurance through your employer you won’t be able to get it.  It also seems that individual states will be able to opt out of the program, thus denying residents of those state the opportunity to purchase the Public Option.  Meanwhile it appears that the vast majority of the American public are in favor of the Public Option – an option that most of them won’t be able to exercise.

Is there a message here? You bet there is. The American people are fed up with private health insurance.  It costs too much and provides too little.  The American people have seen the excellent quality of health care in Canada and much of Europe- all provided by national health care systems and most of the people seem to be saying that they would rather have something like that. The primary opposition to some sort of national health care comes from the hard core Republicans who are held in thrall to the insurance companies and the banks of America.  The thing to remember is that while the Republicans are a very loud voice they are at the same time a very small voice. Only 20% of Americans now consider themselves to be Republicans. That is a pretty small minority and it shouldn’t have the power to dictate national priorities. Actually the previous election that booted them out of office sort of says the same thing.

So, is there a solution for this upside down manner of thinking? Is there some sort of compromise that can worked out with the party of the politically flirtatious Olympia Snow that would make the majority of Americans happy and yet satisfy the cravings of Republicans to pay a lot of money for very little insurance? You betcha!

The solution is really remarkably simple. Create a national health care system and use Canada or another country that has a very successful national health care system as a model.  We don’t have to just make it an expanded version of Medicare. Make the national health care system such that it covers everyone by default.  You don’t have to be employed or live in a certain state or have no preexisting conditions. If you are alive, you are covered. However, knowing the extreme disappointment the Republicans are sure to feel about being covered by the government, we should provide them with the option of buying expensive insurance that doesn’t necessarily cover all possible ailments and might be revoked at any time for any reason. We will call that the Private Option.

If you ask me that is a compromise worthy of Solomon himself.  Everybody will be happy, everybody will get their way and we will all be healthier in the process.  I would bet even Sarah Palin and Rush Limbaugh would go for it.  I mean they would run right out and buy the Private Option. Right? Wouldn’t they?

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In Part 1 of this series, I wrote about the role of the banking industry in our government and how, via the lobbying industry, they were able to influence our government to create or remove laws regarding the banking industry.  You might call it a buyout of our government.  One of the rather unique features of the banking business is that it doesn’t create a tangible product, like washing machines or automobiles.  It just loans money to you and then its meter starts running, and you have to pay back the money plus an additional amount – and that additional amount can be enormous.  For example, if you take out a $100,000 mortgage on a house at 5% interest for 30 years, by the time you have paid back the bank you will have paid $193,255, almost twice the purchase price of the house. If you have the misfortune of having an adjustable rate mortgage you might find your total repayment to be a lot more. Which is one of the reasons we are now in a worldwide recession.

There is another financial industry that is a close cousin to the banking industry.  It also produces no tangible product, but unlike the banking industry, where if all goes well you eventually wind up owning your own house, in this other financial industry, if all goes well you wind up with no return on your investment at all, i.e. you get nothing.  I am, of course, talking about the insurance industry.  Little more than legalized gambling on the probability of personal disasters, the insurance industry is one of the big money-making businesses in our country, and if we care to recall the activities of AIG and credit default swaps, it is also one of the leading causes of the worldwide recession too.

Like the banks, the insurance industry is in the business of taking more money in than it gives out.  Today we have insurance for life, health, accidents, fire, hurricanes, you name it.  You can get insurance for just about anything.  If you are an average American you will never collect as much money in claims as you pay in premiums.  It has to be that way, otherwise the insurance companies would lose money – and that isn’t going to happen.  Like the state lottery, your chances of winning when you buy insurance are small – and the insurance companies want to make your chances ever smaller.

Which brings us to the topic of health insurance.  Until Barack Obama became president the insurance companies were pretty content with their system of health insurance, i.e. don’t insure high risk people and set the cost of insurance high enough so that even when the expected number of people have legitimate claims there will still be enough money left over for a fat profit.

Enter President Obama.  Without waiting to hear the details of his plans for health care reform the insurance companies began their anti-reform campaign.  Why? Were they worried that the American consumer would be hurt by reform?  Were they concerned that it wouldn’t be fair to some citizens?  Were they worried that some people might be left out?  Were they worried that our medical system would be inundated with millions of new patients when everyone had insurance and therefore the quality of healthcare would deteriorate? No.  They were worried about losing money, that’s all.  They had a good thing going by only selling insurance to people who would probably never use it.  That last thing they want to do is to sell insurance to someone who is going to run up a big medical bill.  So, they had to take action.

The health insurance, and entire health care industry, began a massive spending campaign on lobbying Congress – much larger than their usual massive campaigns. In the first quarter of 2009 this group of businesses spent over $35, 000,000 lobbying members of Congress. Ummm, let’s see now… there are 100 Senators and 435 Representatives…so 35 million divided by 535 is, uh, $65,420.56 per person.  Not bad. Of course that’s just in the first quarter too.  Who knows what the total amount will be by the time the voting is done.  And, naturally, the money is not spread around evenly.  You can bet there is strategy involved. There are certain key Senators and Congressmen whose votes might make the difference.  It’s a great system we have. If you own a business, you send your money in to Congress and then you tell them how to vote so that your business makes a fat profit. The fact that by so voting a Congressman might actually harm rather than help his/her constituents is just not part of the equation for many members of Congress.

The direct link from wealthy owners of major companies to our government representatives via lobbyists is well known.  The remarkable thing is that the American people do not seem to be very upset about our system.  Of course, when things don’t turn out good in the end the people always vote out the bad Congressmen and even Presidents, but these people are just replaced by a new and eager crop of recruits, eager to participate in the same process – i.e. pocketing money from lobbyists. We have the best government that money can buy.

That of course is the problem.  It is the wealthy who have the money to spend in this way, and it is the wealthy who hire the lobbyists, and it is the wealthy who then tell our elected representatives how to vote.  In Part 1 of this series I showed how this invisible hand of the wealthy directly led to the failure of our banking system and the worldwide economic meltdown. Now we have the same process occurring in one part of our insurance industry – namely the health insurance industry – and the result could well be as catastrophic, because if health insurance reform doesn’t happen the cost of insurance will continue to escalate while the insurance companies continue to find reasons to disqualify treatment for certain diseases, even for people who have paid their premiums.  This is what the insurance companies want – maximum profits and minimum losses.  Our government should be protecting us from these vultures, but how can that happen when the elected members of our government are receiving millions and millions of dollars from them?

The invisible hand of the wealthy isn’t really all that invisible, but it is very powerful because it pervades the entire economy and budget of the country.  We have already seen how the banking and the insurance industry exerts its control over our government.  However, the wealthy are involved in other industries too.  We’ll look at that in Part 3 of this series.

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According to the Centers for Disease Control (CDC), the swine flu is now “widespread” in the majority of states in the U.S. In those states where it is not officially “widespread” it is mostly categorized as either “regional” or “local”.  In other words, its pretty much everywhere – right now.  Today, the very first swine flu doses of vaccine are being distributed to health workers. This is only a very small batch of vaccine, the amount of vaccine that could be used to inoculate most of the U.S. population is still far off, and it is unlikely that the huge amounts of the vaccine will be available before the flu is officially “widespread” in just about all parts of the country.  At which point one might wonder if it makes sense to get vaccinated at all.

Here’s something to think about: what if this disease were more deadly? Or, what if it just left lasting effects that didn’t kill quickly but just made your life miserable as long as you lived?  Would we all still be sitting on our couches, still changing the channels to see what else is on TV?  Could it be that this flu pandemic teaching us something that we aren’t learning? You bet it is.  The thing is this, however, the lesson has already been taught to us before – on more than one occasion – but it is one we don’t want to learn.  That’s because it’s about money.

It was almost 100 years ago that the Titanic set sail from its last stop at Cobh harbor in Ireland on its way to New York.   It already had a reputation as being unsinkable, even though this was its maiden voyage, due to its construction, which included a number of water-tight compartments.  Tragically, it turned out that the watertight compartments could not prevent it from sinking.  Even more tragic was the fact that there were not enough lifeboats on the ship.  Perhaps less well known is the fact that a sufficient number of lifeboats had actually been provided for the Titanic, but the ships management company, White Star Line, decided to offload almost half of the lifeboats because they felt the decks of Titanic were too cluttered.  And besides, the existing regulations didn’t require all those lifeboats anyway.  The result, of course, was the most famous maritime disaster of all time.  The lesson was that all ships in the future had to have sufficient lifeboat capacity no matter what anyone says.

There is, however, a further lesson we can learn from both the Titanic and the swine flu – but it is one we are unlikely to learn until it is too late.  The lesson is this: when we entrust our safety to profit-making corporations we have given the option to these corporations of choosing between profits and safety – and they will always choose profits.  The simple fact is that safety doesn’t make money and therefore only an entity that has the safety of the people in mind, and not profit, will make the correct decisions concerning public safety.  That entity is, and can only be, the government.

The simple fact is this: we don’t have enough swine flu vaccine.  We will not have enough swine flu vaccine in time to help prevent that vast majority of cases.  More people will get swine flu that will be protected from it by a vaccine.  The reason for this is simple: we don’t have the capability to make enough a vaccine fast enough.   Of course, when I say “we”, I mean the vaccine industry because there is no government vaccine production capability.  So why is this? Why isn’t there enough commercial vaccine capability to produce a vaccine for everyone in time? It’s because it doesn’t make sense from a profit-making perspective.  How often would these companies use this prodigious capability?  No too often. How would it pay for itself? It wouldn’t.  It would sit idle most of the time.  The Capitalist equation works for the business owner, not the general population.  It is the government (i.e. the people) that has to intervene when the for-profit system fails to provide for the safety of the people.  After the Titanic disaster strict lifeboat regulations were passed – by governments, not by the ocean liner industry.

We are in the process of learning a lesson similar to the Titanic lesson again.  However, it is one I believe we won’t learn well.  That’s because the swine flu is not deadly enough. A lot of us will get sick and a lot of us will die – but not enough, not enough to galvanize the public into demanding action. The result will be that our government won’t create a capability that could immunize all of us at some future time when we are confronted by a truly deadly killer. And then of course, it will be too late.

One can only wonder at a government that designs and builds enough nuclear weapons to kill every man, woman, and child on the planet many times over, all in the name of defense.  Yet, when it comes to defending its own people from disease, our government turns a blind eye to the possibility and its own responsibility, and leaves our lives at the tender mercies of the for-profit medical industry.

Capitalism at its best.

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In less than a week President Obama will address a joint session of Congress. He will speak to our elected representatives about health care and the sorry lack of it in America.  He will undoubtedly talk about Senator Kennedy and the cause of his life: health care for all and Kennedy’s belief that health care is a right and not a privilege.  He will mention the needless suffering and deaths of those who can neither afford to buy health insurance nor pay for their own medical needs.  We have heard it all before.

Over the past several months, the President and his team have tried mightily to work with members of the Republican Party to craft some sort of health care legislation, but it is all too apparent that the vast majority of Republicans have negotiated in bad faith.  They don’t want universal health care – at least not at the expense of the insurance companies and pharmaceutical companies.  Today, in the United States, health care is a for-profit business.  Health care is a commodity that people buy and sell. You either can afford it or you can’t. In the cold world of Republicans you live or die by your own resources. I doubt that you would get any sympathy from most Republican members of Congress if you fell down and died in the street.  For them, the main concern would be that you were blocking traffic.

We’ve been here before – this issue of human rights.  Years ago it was the right to vote for everyone. It was often denied to non-white Americans in certain parts of the country.  Years ago it was the right to equal access and equal opportunity.  Equality was a right often denied to non-white people in America. It was the Democrats, John Kennedy and Lyndon Johnson who struggled to gain these rights for all Americans.  Many people died in the cause.  Many “Americans” were violently opposed to the concept of equality.  It seems strange now, but that is the way it was.

Despite the years of negotiations before the Civil Rights Act was passed, it was only after President Kennedy was assassinated and the American people marched en masse in Washington that President Johnson found the overwhelming support in Congress to finally pass that landmark legislation. America and the world are better for it.  It was a leap for many Americans (including Blue Dog Democrats) to accept that equality and equal opportunity was a right that all Americans are entitled to.  We take it for granted now.  The same thing must happen with health care.

President Obama has tried mightily to work with Congressional Republicans and Blue Dog Democrats, but it is clear that these people are intransigent in their beliefs.  They simply do not recognize that Americans have a fundamental right to health care.  They do not care that millions of Americans still suffer from a built-in discriminatory system that still favors the “elect” in this and in many other areas.  The battle lines are formed, the positions are hardened.  There will be no negotiations.  It’s 1964 all over again.

President Obama has only one option: next week he must declare before Congress that health care is a fundamental right of all Americans.  He must be unequivocal; there can be no room to misinterpret or negotiate this right away.  He must not flag or fail.  He knows this.  There can be no room for Congress to water down the legislation.  The American people have already spoken at the ballot box.  The Democrats have the votes.  The only choice for the Republicans and the Blue Dogs is to either get out of the way or to truly be constructive (something that seems highly unlikely).

The feeling is in the air.  America is about to change again.  For the first time in nearly fifty years we will have a new right – a right to health care.  And fifty years from now people will wonder what all the fuss was about.  Of course it’s a fundamental right, just like the right to live.  It’ll be obvious in fifty years – but next week President Obama has to declare it to Congress now, and in no uncertain terms.  It’s show time.  He has no other option.

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