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Preface & Reader Response

I am grateful to pay my share of taxes. It is a privilege. I think it is the greatest bargain for the cost in human history.



Comprehensive Health-System Reform Now


What Conservatives Did Not Think To Do During 12 Years of Squandered Leadership

by Jerry Murley

Conservatives who now counsel a go-slow, incremental approach to health-system reform cannot be fully trusted on the subject. They were in legislative power for twelve years and never addressed reform in any significant way – and that was in the day of economic boom. Their game is obvious and consistent – delay, do little and hide – block, obfuscate and stop health reform while at the same time they disable a reformist administration in its infancy.

I am going to speak from the heart and from common-sense experience. I'll not speak as the town-hall criers have with their prodigious lack of civility and their preposterous pose of articulate and persuasive argument based upon an in-depth reading, knowledge, and understanding of the genuine health-system reform movement. Nonetheless, I might just muster a slightly different point of view that a few others can share and that also happens to be in the best self interest of most of us.

The convenient, let-me-alone libertarian posture and rant is certainly permissible under our Bill of Rights (which we principled pragmatists do extra duty to preserve), but its authenticity, to say nothing of its wisdom and conduciveness to liberty, is supremely suspect. Observe the most rundown cars on the road. They are plastered with angry and crude don't-tread-on-me bumper stickers. Particularly, I refer to the cars with sticker slogans that rail about excessive taxation. I frequently saw such signs even back in the economic boom days – the days of excessive financial swindles fueled by pandering, self-serving, and lax regulatory and tax policies – during conservative reign. Why the bumper-sticker street rage back then? How much are low-budget drivers contributing in actual taxes anyway? I have to hand it to conservative strategists; they certainly have sold the bill of goods to the down-and-out crowd, convincing it to not only vote against its own best interests but to commit acts of incivility that are counterproductive for positions that will hurt the economic standing and well-being of its members.

Yes, the conservative con has worked all too well to convince working stiffs to not only march counter to their own economic needs but to behave disgracefully and incomprehensibly in the public forum before their children and the world. Congratulations to nominal conservatism, for you have now begun to scrape the bottom along with the potheads of the 1960s, except where they were motivated to end an interminable war, you are ruled solely by your pocketbook and your what-you-looking-at insular tendencies. Another difference between then and now is that many of those from the 1960s era expected to be and were beaten and jailed for their antics.

We will always have our ungrateful and forgetful well-to-do, our tin-hearted middle-of-the-road armchair nitpickers, our inveterate slackers, our penny-ante flimflammers, and our fiscal-responsibility hucksters – between whom only God knows the difference. We will not rid ourselves of them in part because bottom-dwellers abhor a vacuum and there will always be someone to slide into any vacancies. But we cannot let the repetitiveness and insistence of the don't-touch-me bunch and their ilk impede the common-sense sixty percent from doing the things that are right to do. We can't permit a forty-percent minority (of which, I estimate, twenty percent represent a die-hard fringe, ten on the right and ten on the left) to drag down the rest of us and the future with their third-grade scams and phobias. Here's a notion: take the con out of conserve and then we are left with an idea and guiding principle that most of us can believe in and live by – a principle that will preserve and improve our institutions and our way of life – and a practical approach to citizenship that retains the right to choose how, when, and whether we contribute to a common cause. However, that right to choose does not grant to a few the privilege to block everyone else from serving in ways that are necessary, balanced, way past due, and practically, humanely and constitutionally sound.

At base, all arguments against health-system reform come down to this: The government is excessively taking and wasting the hard-earned money of the average citizen. Thus by implication, either the government should play no major role in many shared functions critical to the daily life of most citizens, or it is incapable of managing anything of value. And there is the dread debt-onator – huge debt following eight boisterous years with a supposed conservative at the helm, full of bitterness and wars, culminating in near financial collapse.

I'm an average citizen who does not squawk constantly about taxes. I am grateful to pay my share of taxes. It is a privilege. I take my fair standard deduction and I am thankful for roads and education; and scientific research, including space exploration; and care for the indigent, unprotected children, and the elderly; and police, fire, and military protections; and transportation services and safety regulations; and disease control and sanitation services; and emergency response services; and foreign policy services; and power utilities; and the judiciary system; and monetary, financial services and securities oversight; and consumer, environmental, and constitutional-rights protections that I get for my tax money. I think it is without doubt the greatest bargain for the personal cost in human history.

As with almost every other human relationship and endeavor, with government, one receives in direct proportion to what one gives – and in proportion to how evenhandedly, diligently and respectfully one continues to evaluate the relationship or endeavor. In other words, one's government performs in direct proportion to what one expects and the level of respect and involvement one contributes to the principles and practice of governing – to its institutions and to the people who work in government and for whom government works. Sure government throughout history disappoints. But the creed and guiding light of our nation is that it can improve because of the very principles upon which our nation and governance are built. This is why our allegiance is given to the Constitution and not to a party or to a person or to a religion or to a symbol. If one does not see governance this way and one insists that government and the fellow citizens who serve it are inherently corrupt and inept, one has completely missed or lost the love of and faith in the principles upon which this country is founded. Our government is as good as its people – no more and no less. We don't want to better government because we are helpless softies and adore government with blinded eyes, but rather we want better government because we see ourselves as a better people.

That noble notion that the best government is that which governs least is a bit too facile and short of the mark for modern realities. That bucket just doesn't carry the water we need for sustenance today. Rather, that government is best which manages constitutionally, respectfully, and with superior effectiveness, despite occasional stumbles and re-adjustments. Ancient wisdom and virtue are not at war with modernity, but rather fantasy is at war with reality. The government can govern less when people govern themselves. What has been heard and seen of late from nominal conservatism does not indicate that self-discipline is on the rise or even valued in public life.

I cannot understand how a single American taxpayer who has ever suffered a real medical emergency and been saved by government safety nets or employer-provided health coverage has the impudence to object to others receiving similar benefits, especially those who can't get it for reasons not totally in their control. I would gladly spend a second time each year what I spend annually on the health care of my family for equal health coverage for another family, if it would guarantee universal and transportable health care in this country. I don't even draw the line for an illegal immigrant having a medical emergency. What the heck happens to humanity once it has a little coin purse and an under-the-mattress nest egg – or once it starts to covet (or dream to emulate) the fat wallet and wall safe of its celebrities and masters of commerce?

Here's a good-faith offering to fiscal responsibility and voluntary participation in an immediate health-system overhaul. At a very minimum, we could add one extra check-off line to the federal income tax form so that a portion of an individual's standard deduction could be voluntarily forfeited and dedicated to an insurance pool for the uninsured. That simple arithmetical adjustment could also be counted as a charitable deduction, if one is into that sort of thing. And perhaps some civic-minded magnates and forward-thinking corporations might match such contributions to magnify the impact. Now if that is not a personal sacrifice at the altar of civility and freedom of choice, and a leap of faith in the goodness of the American people, I don't know what those fine words mean.

Health-system reform at this moment is a just and practical cause which is worth risking re-election for. Every member of Congress should be willing to fall on his or her sword to enact reform now. And those legislators who impede it should be turned out so that the reforms made now can continue to be improved. This is a defining moral issue, not some sham trumped up to win votes and retain seats in the halls of power – or to increase gab-TV viewer ratings. This reform is not just another giveaway to poor-people and middle-class workers in transition: in capable legislative and administrative hands, it could in short order be a boon to businesses and the U.S. economy, which is a reason why genuine bipartisan participation in crafting legislation could be particularly useful.

My health provider is BlueCross BlueShield of Tennessee (BCBST). BCBST has saved my bacon so many times that I would be a complete and utter ingrate to complain about the personal costs of my health care and not wish and work to spread similar prudent protection to others. Sure BCBST and I have had to haggle over a procedure now and then, but they were eventually reasonable. During my last major health difficulty, with complications following triple by-pass surgery, I believe my health insurance consultant cared as much about precautionary tests and additional procedures as did anyone else on my health-care team.

Let's lay our cards out on the table big talkers: I had thoracic surgery and cobalt radiation for Hodgkin's disease at 21 that was paid for by my mother's BCBST policy at work. I had seven months of chemotherapy and a hospitalization at 47 for Hodgkin's. My wife had years of successful treatment for leukemia, which included spending over a month in the hospital. And I had heart surgery two years ago and follow-up treatment for respiratory complications. All was paid for by my BlueCross BlueShield of Tennessee.

Today we are healthy and grateful. And we are compassionate and frugal. We read, we listen, and we think. And we are not deluded by cute sleights of hand, bumper stickers, inconsistent political chicanery, and appeals to unadulterated selfishness.

I clearly see how a family under our present system could be ruined by inadequate coverage through little or no fault of its own. Every honest participant in this discussion knows that we can create and should create a better system. It is in our own self interest to do so. Portability alone will change our economy for the better, giving workers the opportunity to seek better employment unfettered by health insurance worries. Why should caring grandparents go bankrupt out of compassion for ailing grandchildren because the children's daddy lost his job or can't or won't find one that provides complete family health coverage? The current system is a bust: it uses emergency rooms for primary care that has gone bad because preventive care was skipped altogether, resulting in unnecessary longer-term treatment and perhaps disability. Are we stark raving mad? Yes, we are! We are emphatically bonkers. Town-hall whining and penny-wise-but-dollar-foolish fiscal fixations do not translate into community or personal good. They do not do one thing to help what all (but the mental hermits of our land) know is an inadequate, broken yet improvable health system. Public yelling and miserliness only prolong the suffering and the loss to our economy and to our common decency. Yes, the change will cost something. But the benefits to our nation could be enormous – and they could be gratifying to those willing to contribute something to the task of caring for our own best interest in others – even those outside of one's own extended family – in a nationally shared effort.


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