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“We Give People Light, and They Will Find The Way.”

Posted on | October 26, 2020 | No Comments

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Mike Magee

In the Jennifer Hudson/Black Eyed Peas campaign video remixing “Where is the Love?”, Joe Biden mirrors the famous words of Civil Rights legend Ella Baker, “Give people light and they will find the way.” Health care reform in America is now the path we must travel to uncover our own “exceptionalism.” And Biden asks aloud, “Are we ready?”

Health care, fundamental to rebuilding a nation and its culture from scrap, was what drove the military’s decision under the Marshall Plan. In the re-build of Germany and Japan, we elected to start with a health plan – in part because we recognized that all other social determinants – housing, nutrition, education, clean air and water, safety and security – would be enhanced in the process leading to a tradition that could support stable democracies.

This is essentially the same challenge we as a country (having wandered so far off course as to elect Trump) are faced with today. Changing culture, as health professionals know, is a tall order. It is about compassion, understanding and partnerships. It is about healing, providing health, and keeping individuals, families and communities whole. And – most importantly – it is about managing population-wide fear, worry and anxiety.

What we are asking of the people, and the people caring for the people, is to change their historic culture (one built on self-interest, hyper-competitiveness, and distrust of good government). This is a tall order – something that parents, pastors, politicians and physicians equally recognize. Things evolve, and difficult things take time. But what happens if you run out of time, if the threats of delay or incrementalism create risks that outweigh or negate rewards. If global warming reaches a point of no return or a pandemic spirals out of control? What then?

“What then” usually involves some middle path, one that emphasizes self-determination but not self-destruction. In the case of health reform, this is the argument for provision of a public plan (similar to Medicare) as a voluntary option that is available to all comers. In the response will be revealed next steps in health reform.

If we choose to go this route however, the mischief makers who spent a decade undermining the Affordable Care Act must be effectively sidelined from the start. The essentials? The public plan must be open to all. Insurance must be a requirement and mandated as such with penalties. Medicaid expansion (in combination with the new public offering) must be required in all states without exception (including the 12 current hold-outs). And a complete benefit package as delineated in the ACA must be required (no skimpy substitutes). In other words, the public offering must be muscular, nationwide, and easily accessible to all comers.

At the same time, we must disabuse ourselves of any notion that a cultural shift with health care as the leading edge will be simple or easy. We need only recall those post-WWII Marshall Plan years to remember that, as we were building out national health systems for our vanquished enemies, the AMA, Pharmaceutical Manufacturers Association, and allies simultaneously branded Truman a “socialist” and dispatched his plan for national health care as “socialized medicine.” Power, profit, and persistence prevailed. It took nearly two more decades to move the dial on Medicare and Medicaid.

What we witnessed this past week during the final debate, the “60 Minute” Leslie Stahl interview, and Jake Tapper’s skillful extraction from Mark Meadows that “We are not going to control the pandemic”, was a grim reminder of how far protectors of the status quo are willing to go. All this while the Covid-19 infected camps of Trump and Pence continued to unleash fear and worry, and fuel hatred and resentment. It is not a pretty picture.

But putting that aside, it is useful to acknowledge what our former military leaders stated as Germany and Japan sought to rise from the ashes in 1945. “We start with health care because it is an anecdote to fear, worry, and hatred.” Using the same logic, our distressed American culture will benefit greatly from universal health care. We start anew. And given a bit of patience, and some wiggle room to choose a better future, we might be surprised to learn that we are a bit more “exceptional” than we might at first appear.

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