Words Matter in Health Reform: Part III – Voters And Health Reform.

Posted on | October 31, 2018 | 6 Comments

Mike Magee

Republican’s decade long attempt to torpedo the Affordable Care Act has largely failed, except in serving as a teaching tool for the American public which in majorities now supports universal access to health care and greater government oversight and planning.

But to advance to the next step as a nation, we need to agree on nomenclature and be accurate in our terminology. As we have seen over the past two segments of this 3-part series, “words matter.”

In Part I, we learned that the Canadian system is not technically a “single payer” system, in that provision of insurance (set to national standards) and the delivery of the care is the responsibility of individual provinces, not the national government. A more accurate label for their system would be “Single Oversight Authority/Multi Plan”.

In Part II, we took a look at America’s status-quo, and examined our performance as a health care system, and the role that profiteering, complexity and inequality play in undermining health and productivity in this nation.

In our final segment, let’s explore reasons for optimism – what are our assets, what do we have to work with as we move to transform our system?

These formidable assets include the following:

1. Nearly $4 trillion already committed, even if misallocated, to the nation’s health.

2. A remarkable array of educational institutions devoted to the creation of a highly skilled health-professional workforce.

3. An incredibly dedicated network of public health schools and practitioners, and a well-distributed but underutilized group of pharmacists anxious to contribute at their full potential.

4. A rapidly expanding primary-care army bolstered by nurse practitioners and physician assistants.

5. A testing ground of 50 different states offering the ability to customize various approaches to care within parameters set by the national government.

6. A majority of the population that now supports health care as a right, and a move toward a single-payer authority/multi-plan model in national polls.

7. A first-class and highly profitable scientific research and discovery community that could well stand on its own without diverting resources from health planning or patient care.

8. An enormous number of health system middlemen currently involved in non-real work who could be redirected toward strengthening services that would contribute positively to the social determinants of health—including improvements in nutrition, education, environment, housing, transportation, and safety.

In a polarized society like ours, though, trying to drive change solely through a communitarian ideal that prioritizes social cohesion is probably not a winning proposition on its own. The winning argument at the end of the day is economic.

The true impact of spiraling health care costs and their secondary effects—including stagnant wages, income inequality, a lack of job mobility, high rates of medical bankruptcy, the closure of rural hospitals, an inability to invest in infrastructure repairs, and our growing national debt – is staggering.

Warren Buffett, a man who knows something about sustainable growth, said recently: “The health care problem is the number-one problem of America and of American business. . . . Medical costs are the tapeworm of American economic competitiveness .”

On a percentage basis, the U.S. is now the fifth highest debtor nation (as a percentage of GDP) in the world after Japan, Greece, Italy, and Portugal.

Republicans are currently resurfacing the notion of cutting health services for the elderly, the poor, the marginalized and discriminated against – to “save Medicare” and address budget deficits that they themselves have exacerbated through recent tax cuts for the wealthy.

But let us be clear – there is another way. We could have the courage and the will to reapply our more than ample health care assets and reject the status quo. We could vote in change. We could elect leaders willing to honestly address a simple, long overdue question: “How do we make Americans healthy?”

Comments

6 Responses to “Words Matter in Health Reform: Part III – Voters And Health Reform.”

Art Ulene
November 1st, 2018 @ 11:00 am

Thank you for that thoughtful analysis, and for pointing out all of the assets of our current system. I agree with everything you say, except this statement: “We could vote in change.” No, we can’t, because our uninformed voters have no meaningful understanding of the issues… because the politician currently in power have no interest in telling the truth…. because there are NO politicians–on either side–with the courage to say what needs to be said…. and because the big-money interests will (again) block what needs to be done. If voters could solve this problem, then the Democrat politicians they elected years ago would have done what really was needed…. and the Republican politicians who succeeded them — and who had 8 years to come up with something better than Obamacare — have delivered nothing. “Vote in change?” I don’t think so.
Mike Magee
November 1st, 2018 @ 3:51 pm

Just one more mountain to climb, Art! The summit is in sight, but agree the weather is iffy. We’ll see if it clears up next week. Best, Mike
Denise G. Link
November 2nd, 2018 @ 12:57 pm

To respond to the notion that people are uninformed, perhaps the answer is in the mirror. Healthcare professionals, like yourselves, Mike and Art, and me, must move beyond the “knowledge deficit” framework for our messages. There is practically zero correlation between knowing what needs to be done and doing it. Persuasion and providing information are not the same. We need to find out who our audience identifies with, who they think they are, and then talk about shared values. The issues must become personal, as Mike says, and the personal must be linked to a personal cost in ways that may mean financial, but also include other “costs”. I made some traction in my recent campaign using that approach and will continue to refine and apply it going forward in my next campaign. As I have mentioned in the past, your columns have contributed significantly to my thinking. Thank you
Mike Magee
November 2nd, 2018 @ 2:20 pm

Thanks, Denise. As usual, your comment is insightful – most especially that “Persuasion and providing information are not the same.” At the same time, populations do evolve especially and occasionally when severely tested. Trump is testing our democracy – Nov. 6, 2018 will be a single snapshot of how we’re doing in response. Best, Mike
Art Ulene
November 2nd, 2018 @ 2:39 pm

Denise is right…. up to a point. We used to say that “Knowing is half the battle.” If that were true, we’d be the thinnest people in the world…. no one would smoke… everyone would exercise regularly. However–when it comes to voting—knowing SOME things (especially facts) plays a huge role in determining the outcome. Only one-third of Americans today can name ANY branch of the government… and 74 percent of the population can name only one branch. Do you really think that “values” matter when the level of civic ignorance (that’s not a perjorative term–it refers only to lack on knowledge) is so high? I don’t think so… and I don’t think voters can/will change anything when it comes to the healthcare problems facing this country.
Mike Magee
November 2nd, 2018 @ 3:38 pm

I see this as a 3-stage pragmatic challenge – motivation (knowledge enabled or not), access (problematic if you are poor and/non-white in many red states), and action (follow-thru: good intentions don’t count). None of this assures that you are an enlightened voter. In fact, many studies clearly demonstrate that large portions of Americans vote against their own self-interests (educational, financial, and reproductive). The labor to educate I suppose holds out the hope that we humans can learn and be responsible and improve life here on Earth (for us, other living species, and our planet.) Religion and national pride at best should encourage this effort. But as we have seen can easily default to “God’s will be done”, “hopes and prayers”, and outright tribalism when we are mislead, afraid, distracted, or indifferent.