Don't Think of a Sick Child
George Lakoff and Glenn W. Smith write that President Bush wants to leave American families to the mercy of profit-run healthcare -- a practical and moral failure.
This piece originally appeared at Salon.
George W. Bush doesn't want you to think of a sick child. Not Graeme Frost. Not Gemma Frost. Not Bethany Wilkerson. Not any of the real children affected.
He wants you straining your eyes on the fine print of policies, puzzling over the nuances of coverage -- whether you can afford premiums for basic, catastrophic, comprehensive or limited health insurance. Last week on "Real Time With Bill Maher," even Tucker Carlson kind of got it right, saying, "No one child is a metaphor -- he's a kid!" That's the point. They're all kids, each one, one by one. The question is, do you care?
The actuaries don't. And can't. Health insurance companies make their money by denying care. They maximize profit by authorizing as little care as they can get away with. That's what all those administrative costs -- as high as 30 percent -- and all that paperwork are mostly about. It takes a lot of people to justify denying care.
It's the opposite of the way the market is supposed to work: Make more money by delivering more product. The health insurance industry makes more money by delivering less product. It maximizes profits by minimizing care.
Profit-run medicine is not, and cannot be, full care. What is needed is patient- and doctor-run medicine. The State Children's Health Insurance Program (SCHIP) is just that. Our children need care. Our doctors provide it. The government handles the transactions, period. And we pay a lot less and get a lot more, because there are virtually no administrative costs and no profits being taken by outsiders.
Profit-maximizing insurance, as opposed to doctor-provided care, forces the nation to choose among its children: who will get care and who won't, who will suffer and who won't, who will live and who will die.
Bush and his conservative allies don't want us to see sick children, just as they don't want us to see those bodies in bags coming back from Iraq. They're in the habit of sweeping our human casualties under the rug.
But Americans are a compassionate people. We do care about sick children. We do care about our dead and wounded vets and their families. We do care about victims of Hurricane Katrina. Empathy and compassion are what this country is about. America is about caring for one another, about being in the same boat, about being a national family. It is not about profiting from someone else's suffering, especially if that someone else is a child.
Government in America has a sacred moral mission to protect us, its citizens. Protection means more than the military and the police. It means worker protection, consumer protection, environmental protection and Social Security. And it means health security.
President Bush warns us against "government-run" healthcare, which is anything but government run. In SCHIP, the government doesn't deliver care, it enables it. It directs payments. Bush wants to leave the nation's children -- and the rest of us -- to the mercy of profit-run healthcare. The reason we need SCHIP is that profit-run healthcare has failed.
When children in your family fall sick, you don't look away. You make sure they are cared for and get better. That's the way the American family should also work.
Video, a report, and more resources are available at Rockridge's health care campaign site.
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SCHIP is 77% privatized in the states
While I like the languaging of this article, and agree that the discussion of values is what we are after, I need to point out one discrepancy. SCHIP is not simply government financed health care access. In most states it is administered by private entities, with their administrative costs and profits included in the costs, so taxpayers are once again funding corporate profits unnecessarily. The high administrative burden imposed by private entities is to a large entent what makes health insurance unaffordable in the US.
77% of SCHIP is privatized- and private insurance companies now regard the privatization of government programs (such as Medicare and Medicaid) as a primary new growth market. Capturing government programs has provided them with windfall profits, piling on extra costs that render government programs unaffordable and unsustainable over time. We cannot afford the additional 20-31% increase in costs that these companies exact.
If their claims about their efficiency were true privatization would be a benign process, but every instance of privatization of government programs in health care has resulted in increased costs and poorer, depleted services, with beneficiaries encountering new difficulties and restricted access to needed services as the former "straight" Medicare and Medicaid programs are being replaced by HMO's, etc. This has snowballed, driving greater and greater public and health care provider dissatisfaction with government programs, and stiff resistance to any ideas that would create new programs, such as a single payer program. The waste, inefficiency, and the perverse incentives that cause these profit seeking companies to create new barriers to access contributes to overall diminished public trust or regard for government, and unwillingness to place even more control of health care in government's hands.
The increased cost of privatization of government health care programs- Medicare, Medicaid, SCHIP, etc., is a trojan horse that ultimately will cause a backlash- benefit cutbacks, or possibly the economic demise of those programs, while serving only the short term political goals of minimizing private insurance company assault on extending governemnt coverage of the uninsured. The windfall profits these companies accrue are then plowed back into further enhancing their lobbying and marketing campaigns, so they are further entrenched in their position of power to derail meaningful health care reform policy in the US. It is a spiral toward destruction of health care access for the middle class.
Those who believe that there can be successful regulation of these financial powerhouses to force them to provide appropriate health care security to beneficiaries and reign in their control of the health care debate do not have history on their side. The economic resources to skillfully and powerfully market their point of view virtually ensures the continuation of their dominance.
In an electoral system where money equals access and power, the public financing of these industry behemoths incrementally increases the corruption of our democracy, and makes the advance of meaningful health care reform even less politically feasible than it is today.
I believe our languaging must reflect a coherent system of values that places the public good over private profit in the life and death arena of health care. Language that vigorously supports the spirit of SCHIP, and it's continuation and expansion as a government (not privately) administered program is invaluable.
Privatization
Excellent comments! This is why it's such a bd idea to privatize ESSENTIAL services such as health care, water, energy, fire and police protection, courts (as in mandatory arbitration), and the like. People can choose whether or not to buy a car or a TV or cell phone service. We can't choose to go without health care if we're in an accident or get cancer. We can't live without access to clean, affordable water, and we'd be hard pressed to exist without the means of cooking our food, heating and lighting our homes.
Insurance company priority
I like the term "health security." It's what we all want. I do think the article sort of skipped over the issue of corporate motivation. Insurance companies are NOT in business to provide health care, nor are they in business to provide insurance coverage for health care. Insurance companies are in business to MAKE A PROFIT! The article takes it from there very nicely, pointing out that insurance companies maximize profits by denying care – but that's basic in the corporate mentality. PROFIT is the goal, no matter how, no matter what.
Healthcare
- I love what Rockridge is doing. I've read "Elephant" and "Thinking Points," and sent financial support. However, we need a more concise framing for healthcare (and other issues) than what is presented in "Don't Think of a Sick Child." It makes perfect sense, but it's too hard to communicate. (And the TV spot is fine, but awfully oblique
- how can we follow-up with more direct messages?) My daughter is on the field staff of a U.S. Senator who supports progressive views. I believe she needs healthcare framed in one or two sentences. An elevator speech. And it can't be something cute like "no sick child left behind."
Also, the distinction between individual patients and actuarial averages seems a good focus. But do we really want to make "profit-run healthcare" the enemy?
Don't think of a Sick Child
One of the frames that we are missing is to reconnect taxes as a method of responsible payment and the care of a sick child, or school lunches for children, or disaster recovery, etc. What the conservatives and neoliberals have done is to successfully disconnect American's sense of compassion and responsibility from the contract that government is paid for through taxes in order to protect us and care for us. Until we reconnect that link, we will continue to lose the argument.
The disconnect is wide and deep, and we need to come up with the emotional links to repeat ad nauseam to overcome it.
You deserve all it.
We in Spain got all that public and universal healthcare (except for extended dental care) you are claiming for; I have lived under it during all my life (and I´m forty) But our right party (do you remember Aznar?) is trying to break the system from the discourse and framed language imported from the US conservatives (and remember that we are talking about a utopian or broken system: we have it working fine and the citizens consider it essential as the highways and so... and we got superavit, by the way)
Of course our conservative vultures wouldn´t dare to air anything against our public health . They are just ruining it in a sneaky way where they can . Luckily only in towns and regions where they rule.
My point is : you really need to work hard that framing. For sake you deserve reach something so basic!
Cheers from Spain and congrats on the good work there.
New! Leave Every Child Behind
I am very excited by Rockridge's healthcare initiative. The case study over at Rockridge Institute, the video, the post at Salon; and the blogs are buzzing...
http://www.openleft.com/showDiary.do?diaryId=1992
http://www.dailykos.com/storyonly/2007/10/19/7127/3475
I wanted to add my 2 framing cents. Now is the time to get strategic. We can go after the conservatives' failed healthcare position and their failed education policy at the same time:
Leave Every Child Behind: No Healthcare and Poor Education Results
This then snowballs into family values. Do you care for your children and their future?
Then surely you care about their education and their healthcare.. then surely you support progressive family values.
This is obviously a condensed version of how the argument would go-- but my point is I think it is time to take the gloves off and go on the the offensive.