by Ted Manna
AR Political Correspondent
Sept. 25, 2011
THE DEBUT OF CITIZEN CAIN
DUMMERSTON, Vt. -- At last week's "Tea Party" Republican presidential debate, CNN's Wolf Blitzer asked Texas Congresssman Ron Paul this hypothetical question: a 30-year-old man in good health elects not to purchase health insurance. He then has a major medical crisis that requires expensive care. Who should pay for his care?
Paul's response: "That's what freedom is all about, taking your own risks. This whole idea that you have to prepare and take care of everybody..."
Blitzer interrrupted. "But Congressman, are you saying that society should just let him die?"
Before Paul could answer, there were cheers and shouts of "Yeah!" and "Yes!" from the crowd.
While Paul, who is a physician, went on to say that someone without insurance should not be allowed to die, he made it clear that "our neighbors, our friends, our churches" would choose to assume the man's care. He just doesn't believe that government has a role.
An estimated 45,000 Americans a year die because they lack health care. The lack of empathy for people who met, and may soon meet this fate, is to be expected. The Republican candidates for president reject the idea that we have a collective obligation to one another, and that the vehicle we use to deliver on that obligation is government.
So much for the concept of "We, The People."
So much for "compassionate conservatism" and the social safety net. In the Tea Party's world, if you are poor, homeless, unemployed, sick, or suffering, too bad. Society has no obligation to take care of you.
So much for all the so-called Christians that are running for the Republican nomination. Proverbs 14:31 says it all: "He who oppresses the poor shows contempt for their Maker, but whoever is kind to the needy honors God."
That Ron Paul was so cavalier about the plight of the uninsured can be explained by what happened to the man who convinced Paul to run for president in 2008.
Kent Snyder, who was Paul's campaign manager, died in June 2008 of pneumonia at age 49. Snyder could not obtain health insurance due to a pre-existing medical condition, and racked up $400,000 in medical bills before his death. His family and friends resorted to fundraising to try to save his life, but only came up with about $34,000.
Flawed as President Obama's health insurance plan, the Affordable Care Act, may be, one important element it contains is that it bans insurance companies from cherry-picking healthy customers while denying coverage to people with pre-existing conditions.
Paul calls Obama's tepid attempts at health care reform "monsterous" (sic) and "bad for your health," even though that law could have saved his friend's life, a friend that raised $19 million for Paul's presidential campaign but couldn't afford to buy health insurance.
That's almost as disgusting as the Tea Partiers that cheered the prospect of an early, painful and unnecessary death of any other human being.
It speaks volumes about where today's Republican Party is at. They say that neighbors, friends and churches can do the job that government does when it comes to helping those in need. They cry "freedom" when they really are saying "I got mine, too bad for you."
And then there is my brave little state of Vermont, which is in the process of establishing a single-payer health insurance system for its residents.
I had the chance a few days ago to hear a talk by Dr. William C. Hsiao, an economics professor at the Harvard School of Public Health who is advising Vermont as it designs its new health care system.
Hsiao has been a health care consultant in many different countries, and he said that about 40 nations are trying to overhaul their health care systems, including India, China, Indonesia, Egypt, South Africa and Nigeria. This group accounts for nearly half of the world's population.
Why are so many countries looking at fundamental reforms to their health care systems? Hsiao said it is because people are "dissatisfied, unhappy, and demand that their political leaders do something," adding that people are choosing the "political market, where everyone has an equal vote" to pursue reforms, rather than the "economic market, where the more money you have, the more votes you have."
Whether it is an authoritarian state like China, or a democracy like India, Hsiao said leaders have come to the same conclusion: a dysfunctional, unequal health care system can lead to political unrest.
Hsaio argued that these countries look at the United States, and see what happens when a country decides not to deal with the problem of access to health care.
"We let the problem go on for so long, and we created such powerful stakeholders in America, that when President Obama tried to push through his plan, you see what kind of emotions he aroused, how much money got pumped into the campaigns, and the political situation we have now. Other countries are learning from this, and they don't want to let it go that far."
Despite many U.S. public opinion polls that show that health care, mainly cost and access to health care, ranks No. 2, behind the current state of the economy among the top public issues, Hsiao sees little hope for changes to the U.S. health care system.
"I've given up on the United States," he said. "I do not think that any research I can do can contribute to the policy debate because the process has gotten so politicized. That's why I've turned my attention to other countries. Except for Vermont."
Hsiao is working with the state to develop a single-payer system, which he defines as providing everyone with a common benefit package, and which channels payments through what he calls "a single pipe," with uniform payment rates for providers, a commons claims process, and a common adjudication process.
He stressed that "single-payer" doesn't mean having a government-run program. He said he left that out of his definition because he believes that single-payer does not necessarily involve government. It does involve cutting down on fraud, waste and needless bureaucracy and using the savings to extend coverage to all.
Over the past few months, Hsiao has warned that the process of reforming health care in Vermont will take years, and it is subject to the same political forces that stymied health care reform on a national level. But he thinks Vermont has a better chance at achieving something that the rest of the nation is scoffing at: universal health care.
"Vermont has high ambitions," he said. "I think you have a noble vision, and I don't find that among many other states, or among the people. It is really a pleasure, and an honor, to be engaged in this exercise.
"You want universal coverage that's equitably funded. This reflects your social ethics. You worry about equity, and most American states don't worry about equity, or consider fairness. They don't worry about their neighbor and if they have health insurance, and [they don't say] 'I will help pay for part of it, if I am wealthy.'
"These simple statements reflect the social values of society, and you have it."
Too bad it seems to be lacking in much of America right now.
Chief of AR Correspondents Randolph T. Holhut has been a journalist in New England for more than 30 years. He edited "The George Seldes Reader" (Barricade Books). He can be reached at firstname.lastname@example.org.