Health Care Reform Update: Is This The Week That Is?




[by Karen Metcalf]

When I last posted on health care reform, I likened being a health activist this past January to riding a roller coaster, with lots of ups, downs, bends, and vertigo-inducing twists, all very akin to the sensations I was experiencing.  But there’s another key feature of a roller coaster, one that I hope is not similar to the reform process: it always brings you back to the same point.  Over the last month, I’ve often had the feeling that our chances of reform were getting so slim that we would end our roller coaster ride in the same place we started when President Obama took office a year and more ago—although, of course, we would really be taking multiple steps backward, each one measured by one more bankruptcy or death among the ranks of the uninsured.

But now, suddenly, as this week begins to unfold, I feel a bit more hopeful.  Many years ago, I remember there was a television program called, That Was The Week That Was;  this week, February 22-26, seems to be shaping up as This is The Week That Is (Decisive).  After what seems like forever, we do seem to be seeing movement.  The trigger is the actions of the President.

Yesterday the White House posted its own attempt to reconcile the separate health care reform bills that were passed by the House and Senate in 2009.  As I write this, the detailed analyses of this synthesized bill are just starting to emerge, with, in so many instances, all the spin attached to everything in Washington.  To understand this new version, it’s probably best to start with what’s on the White House website:

And if you want a preliminary summary of the contents, this early posting seems to provide some fairly solid reporting on the proposal and the politics surrounding it:

So far, I haven’t found anything in the proposal that I can’t support—given all that has transpired over the last year.  Would I like to see a public option?  Of course.  Would I like the ceiling for Medicaid to be 150%, not 133%?  Yes, although I worry about whether there are enough providers who will accept all these new Medicaid patients (with poor reimbursement rates), and I’m very happy to see the expansion of Medicaid to far more adults.  Am I excited about the possibility of reining in the unreasonable rate increases of insurance companies when they merely serve to maintain the company profits of the shareholders?  Yes!

So, I’m holding my breath and crossing my fingers that the Democrats in both the House and the Senate feel the same way.  If they do, then just maybe there is some hope that they’ll present something resembling a united front at the summit on Thursday with the Republicans, which of course is the climax of the week.  And again, it is only through presidential leadership that this summit is taking place.

Of course, there isn’t always a direct causal relationship between the President’s actions and what is happening on the ground.  Take, for example,  the recent letters on health care reform in our local newspaper, the Quad-City Times; almost all of the letters recently have been supportive of reform.  Finally, people seem prepared to speak out publicly on this issue.  Perhaps it’s because they are actually worried that nothing will happen.  But perhaps, perhaps, they see a glimmer of hope that the President is willing and able to break through the apparent impasse in Congress.

And now we have people literally on the move to get the job done.  If you don’t know about it already, read about the march from Philadelphia to Washington that will finish the day before the summit:  It honors Melanie Shouse, who lost her life to breast cancer because she could not find affordable health insurance.  From what I understand, this is exactly what our representatives in D.C. have been asking for—people taking to the streets.  (Oh, I wish I could go and join them!)  Clearly people were ready to act, but the President’s idea of a summit was the necessary catalyst to spur them to action.

So, at least pre-summit, the prospect for good reform does seem a bit more hopeful.  If it should happen (and the common wisdom is that the Congressional break that begins March 29 is the new internal deadline), we’ll all be applauding President Obama’s clever leadership—as we should.

But I do want to  move off on a bit of a tangent to remind everyone of what I consider the effective starting point of the current push for significant health care reform.  It came back in 2007, when the now taboo figure of John Edwards first pushed the envelope and brought out a plan to cover everyone in this country.  Until then, no candidate in the 2008 campaign had been willing to go so far, and his plan forced the other candidates to think large and come out with their own versions.  If health care reform does pass this year, let’s by all means stand and cheer Obama, but let’s also take a quiet moment and raise a glass to Edwards.

Right now the move for health care reform reminds me of one of those worm-like creatures that I remember being part of in grade school.  We would all form a line, nice and straight, and carefully place our hands on the waist of the person in front of us.  Then the lucky person at the front of the line would start moving, and we would all try to follow, while not losing our grip on the person in front of us.  It was easy, at first, nice and slow and straight, but as we moved a bit faster, and the leader moved to the right and the left, it was harder and harder to stay connected.  Sometimes we didn’t succeed, but when we did, what an exhilarating feeling!  And the object was never, ever, to return to the starting point. This week I feel as though we just might have a leader who will get us a long way down the field.  And at least I feel like we’re moving again—and in the right general direction.

native of St. Louis and a graduate of Cornell College in Mt. Vernon,
Karen Metcalf has been working on health care reform since 2003,
when she learned that an estimated 18,000 people die every year in this
country because they lack health insurance.  Although her background is
non-medical, she is married to a pediatrician who trained in Britain
and Canada and practiced in Canada for many years before they moved to
the Quad Cities in 1994.  Since their move, they have been studying,
discussing, and writing about the American health care “system,”
drawing upon their experience in all three countries where they have


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