Health Care Reform: Why We Need To Speak Up & Support

I am not even sure if I should post about health care because I find the situation infuriating. But I believe it is important that those in favor of health care change show support. There are a myriad of things to say....

To begin with, I heard that in my formerly historically democratic state of Minnesota, our Republican governor, who is rumored to be a potential presidential candidate in 2012, is arguing that Obama's health care plan is a violation of state's rights based on the constitution. Per the news this morning, other politicians are getting behind this idea, but oddly enough, the news reported this was a political tactic. I am glad Obama was in Minneapolis this weekend for a rally with the Target center full of supporters.

Let us look at the state of Minnesota first before discussing some other issues. Minnesota has historically been a state that provides for its citizens. We have one of the highest insured rates in the nation and we are one of the healthiest states (despite all the fried fair food and hotdishes!). We have the program MN Care that provides insurance for the uninsured, even adults, though there are income and asset restrictions. Yet, our governor decided to cut MN Care affecting adults with no children.

My first thought after hearing that states want to be able to not participate in a federal insurance plan was this is ridiculous and unfair to the citizens of these states. What would be the effects of this? Would people move to states where they could access it? Will this whole thing about states' rights even play out?

But it also a bit frightening that when I attended the "state get-together" (i.e. the MN State Fair) I saw numerous people wearing buttons against health care reform. The slogans were something to the effect of "keep your hands off my health care." And I did not see many people wearing buttons who supported the health care reform, including myself.

Thus many of us who are for health care reform end up "preaching to the choir" when we discuss this. And I also wonder if we have become complacent in that Obama is president and the control of the Democrats (though wondering what happens in relation to Senator Kennedy's passing). Taking lessons from social movement research, this makes sense in some ways. Yet, the research on other political debates and social movements, such as the highly controversial abortion one, both sides must remain energetic even if they gain something because the other side is always there. But even activists aim for the middle ground with their framing knowing it is near impossible to "convert" those on the extreme end.

So, what do we do with health care? What kind of arguments need to be made to show this country is not moving in a direction that is beneficial in regards to health care? And how can anyone think that "death panels" are a reality? (thanks Senator Backman... your analogies are so eloquent). And if they believe that , how can they ignore that many minorities in this country, racially, ethnically, and economically, probably face a "death panel" because of the inequity in this country as it is?

Some of this has to do with American Exceptionalism and our deep rooted beliefs in individualism. I am sure people were not happy with the creation of the welfare state because of the Great Depression, but doesn't the Great Depression and our current economic crisis, the worst since then, show that there are structural factors? In addition, I ask how can people be so sure of things, particularly their own jobs and health care, in these horrendous economic times? Seriously, who has security?

I could go on about opinion pieces I have read that resonate with the sociological literature explaining our American Exceptiona ism and limited welfare state, but I'll save that for another time. But I will say this. As I teach my students when we learn about welfare states, welfare is not just the means tested support given to mothers. Welfare as a word means a condition of well being and having your needs met. And most people benefit from the welfare state. Such as if you have kids and get a tax credit. Or there is the idea of corporate welfare. And the welfare state as a term is about how the state provides when capitalism or the economy does not function as it should. So, yes in some countries beyond the US, the idea is that the families and church are to provide before the government steps in to help. And in other countries, i.e. the ones people like to label as "socialist", every citizen is provided for because they are a citizen. And people are saying now that we should look to our families now, but again, this misses at least two points. One, not all families can provide because there is so much inequity in our society. And two, again back to my earlier point, who is secure? What happens if the family we get help from cannot provide anymore?

But I have strayed a bit from the direct discussion of health care, though this is in other countries is part of the "welfare state." And part of this is about points I think people are either mis-informed or in general lack complete information on that should be brought out in this discussion. And I do not claim I am the first to mention these. Yet, I have done my own research about these in relation to meeting my family's insurance needs and have discussed this issue with others who have provided more information.

First, do people read their insurance plans? I mean in-depth to know what is covered, what is not covered, and to know the maximum their insurance will pay. If people did, I think they would be surprised and not in a pleasant way. And if something does happen, the person may not have the coverage they think.

Second, if you loose your job and your health care (or in other words a group plan), can you get insurance? Do you have something that health care is imperative for that might be considered a pre-existing condition? Most people assume that major illnesses are included in this. But we also have to consider other things. Pregnancy is a pre-existing condition, as is a new-born child. Mental health, including things such as depression or anxiety, is a pre-existing condition. I also have heard victims of domestic violence are considered a pre-exiting condition. And having a pre-existing condition precludes a person from obtaining private health insurance.

Why does this matter? I do not even think we should have to answer this question, but it seems necessary in this debate. First, if we keep people healthy, this is more cost effective than to let a condition go untreated and then have to deal with a larger, costlier treatment. And not to cover a new born when ensuring the child has vaccinations and needed treatment would probably have a huge effect on improving their life chances and I would imagine our mortality statistics in this area. Second, and very much related to the first, if people do not have insurance for these or who do not have insurance in general, studies have shown they end up going to the ER, which costs much more. Third, I know in the state of MN, there is a plan that those who are un-insurable can apply for, but I do not know if this exists in other states. But you have to go through much paperwork and red tape to even apply for this. In having read the materials, with a PhD, I had a difficult time understanding. And though I might be making a jump here, I think in some ways these policies are discriminatory. Gender comes to mind in that pregnancy affects women and I believe women tend to be diagnosed more (or seek help) for mental health concerns. But moreover, are we not discriminating against those with mental health concerns, that I do believe to an extent have a biological basis, by denying them coverage? The late senator Paul Wellstone did a lot of work on this and some insurance companies were in hot water for how they treated mental health.

Third, people believe that Obama's health care plan would take away from their coverage. As he has noted, this will not happen. But, how can people think their coverage is staying the same? Who's co-pays have not gone up?

And lastly, for now, people are making the argument that Medicare and Medicaid are a mess, so why should we trust the government with insurance. This seems to be misguided logic to me. First of all, is the current president and administration the one to blame for this if it is a mess? It doesn't seem so and it seems like the same logic of blaming Obama for the economy, which was already in bad shape before he came into office. Thus, if there issues with these, can we not research what they are and use these lessons to generate a health care plan and revise the Medicare and Medicaid?

This has been a long post. And in conclusion, I will restate a point that many sociologists probably make. A healthier society and a more equalized society is by far more cost effective. And my own personal thought here is that no one is secure in these times. And this is not a thought that we want to believe, but we have to look at the reality around us.

Hence, as sociologists we often face the dilemma of if we should advocate for an issue. And I think we have to because of the information we have that shows the benefits to individuals and society in relation to equality and health care. How can we not care about these issues?