Ailing America: Unhealthy Debate, Sick System

Good Fences

By J.J. Goldberg

Published August 12, 2009, issue of August 21, 2009.

One of the first things children are taught in our society, once they’re old enough to speak, is to listen to others and respond appropriately. The lesson is usually imparted these days in some variation of the phrase “Use words.” What we really mean is, don’t use your fists. Don’t cry or shout or throw yourself on the ground. Say what you have to say and then listen to what the other kid wants to say. That’s how we resolve our disagreements. We call this “communication.”

Some of our fellow citizens seem to have missed kindergarten that day. Right now, while the rest of us are trying urgently to hash out our national values and priorities, they’re busily working to make a hash of the whole thing.

Yes, there are many excellent reasons to lament the way Americans are sorting out their disagreements over health care this summer. But there are many more reasons to lament the way America delivers health care year-round. It would be a shame to lose sight of that. The fuss over town hall chaos simply diverts us from the essential issues. Which, of course, is the point of the disruptions.

Why get worked up about health care delivery, when so many of us like our plans? One reason is the number of Americans who die every year because they lack proper insurance and can’t get decent health care. Back in 2000, that number was 18,000, according to a study published by the federally chartered Institute of Medicine in 2002. More recent studies, using the institute’s math and factoring in the rise in the uninsured, show that annual deaths now top 22,000. Cancer victims and diabetics rank high on the list, according the institute.

Another reason is the number of families driven into bankruptcy by medical expenses that aren’t covered by insurance. In 2001 that figure was about 750,000, or half of all the nation’s personal bankruptcies that year, according to a study by Harvard’s medical and law schools. The number of persons affected, counting dependents, was more than two million. About three-quarters had insurance when the illness began. Half of that group lost their insurance when the illness forced them to stop working. The other half incurred expenses that weren’t covered under their policies. More than half of the total were college-educated and owned their own homes. An update in 2008 found the percentage of personal bankruptcies stemming from health coverage had topped 60%.

Here’s another reason to care: The United States ranked 45th in the world in life expectancy in 2008, according to CIA figures. We lagged behind nearly every other industrialized nation, every one of which had some sort of universal national health plan — and none of which, it’s worth noting, has shown any inclination to switch to our system.

Simply put, our current system does a worse job of keeping people alive than any of those other systems. It’s not hard to figure out why. The other systems begin with medical care as a human right and universal coverage as an entitlement. In our system, medical care is a commodity that is bought and sold. If you want to be crude about it, human life is for sale in America. And here, unlike Humphrey Bogart’s Casablanca, life isn’t cheap.

Astonishingly, the reform that President Obama is trying to pass, in all of its congressional permutations, doesn’t actually offer a reasonable, morally sound system. It’s far more watered down than the universal health plans proposed over the years by Theodore Roosevelt, Harry Truman and Richard Nixon. It leaves the main burden on private businesses, driving up labor costs and hurting American competitiveness. The notion that Obama is pressing for some radical reordering of American society is just plain silly. It’s a wonder anybody buys it.

Indeed, it’s a wonder that Americans, with all their religious faith, remain so resistant to guaranteed health care. You might think that people who take religion so seriously would be the first to place human life beyond barter.

As a matter of fact, America’s churches actually take life and health quite seriously, whatever their parishioners might think. The Catholic Church has favored guaranteed health coverage for years. The nation’s biggest Jewish organizations and denominations, working together under what’s now called the Jewish Council for Public Affairs, have unanimously endorsed universal health coverage since the 1950s.

This summer, several dozen of the country’s main religious denominations, including some of the biggest Protestant synods along with Catholics, Jews and Muslims, are mounting a national campaign to bring the moral urgency of health reform home to their congregants. Called “40 Days for Health Reform,” it kicks off August 19 in a conference call with President Obama.

The Jewish community will be represented by the Jewish Council for Public Affairs, speaking for the major organizations and denominations, United Jewish Communities representing the Jewish charitable federations, plus the National Council of Jewish Women and the Religious Action Center of Reform Judaism acting on their own.

Cynics might argue that the Jewish involvement is just another case of soggy liberalism. That’s short-sighted. The Jewish community owns scores of hospitals and nursing homes across the country, with combined budgets in the billions of dollars. Simple community self-interest dictates that Jews get involved in getting this thing under control.

But there’s one more good reason. When the summer is over and Labor Day is behind us, the kids will return to school and Congress will reconvene. When we gather in synagogue that Saturday, we’ll read a biblical portion that concludes, in Deuteronomy 30, with the commandment that the sages considered the final and overriding dictate: Choose life.

Contact J.J. Goldberg at goldberg@forward.com



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