President-elect Barack Obama has renewed our hope as Americans that the promise of opportunity is revitalized, alive and well. But in order to secure his own legacy as the first great president of the 21st Century, and one of the greats in American history, he will need a grand undertaking equivalent to Abraham Lincoln’s saving of the Union or Franklin D. Roosevelt’s New Deal. Amidst the current economic downturn, it would appear clear what the momentous challenge and chance for long-lived admiration will be for an Obama Administration, and it is health care. Not small bore reforms of existing programs or expansions around the margins of the popular State Children’s Health Insurance Program (SCHIP) or Medicare, but a truly revolutionary sea change in the compact that the American government and their people share in relation to the health of the populace.
As Steve Coll of The New Yorker comments:
The next Presidency has within its reach at least two generation-spanning causes: the need to jump-start a new energy economy, and, in so doing, help to contain climate change; and the need to enact a plan to provide quality health care to all Americans, and, in so doing, complete the project of social insurance that Roosevelt described in 1935. Each of these projects is urgent, but it is health-care reform that speaks more directly to the economic and human dimensions of the present downturn.
The accumulating failures in the country’s health-care system are a cause of profound weakness in the American economy; unaddressed, this weakness will exacerbate the coming recession and crimp its aftermath. A large number of the country’s housing foreclosures in recent years appear to be related to medical problems and health-care expenses. American businesses often can’t afford to hire as many employees as they would like because of rising health-insurance costs; employees often can’t afford to quit to chase their better-mousetrap dreams because they can’t risk going without coverage. Add to this the system’s moral failings: about twenty-two thousand people die in this country annually because they lack health insurance. That is more than the number of Americans who are murdered in a year.
As my health law professor once said, it is inaccurate to call what we have in the United States currently a “health care system,” as there is nothing systematic or logically organized about it; it is, rather, more accurate to call what we have the “health care industry.” And therein lies a core, fundamental problem with the way that many Americans are pushed into thinking and talking about their health care; it is common in the advocacy, policy, and newsmaker worlds to hear about “health care consumers.” Health care, as one participant in the presidential town hall debate commented, is often thought of as a commodity in this country. But this is not a cheeseburger or a new raincoat that we are talking about; this is our health, the key to our economic security and ability to access the American Dream of boundless opportunity that President-elect Obama represents. Health, as President-elect Obama and the great lion of the Senate, Ted Kennedy, have both stated, is a fundamental right of Americans.
Without a guarantee to our right to health care, and the opportunity for good health that follows, many Americans are in danger of losing their jobs, and as Coll points out and as I have pointed out here before, their homes (up to 7 out of 10 foreclosures are caused in part by medical crises). Surely, if human rights apply as much here in the United States as much as it does abroad, the human right to the opportunity to meet the most basic needs for ourselves and our families–housing, feeding, and clothing ourselves–must be guaranteed. This is not only about 46 million uninsured Americans who cannot afford to purchase health care as “consumers,” or about the 25 million underinsured Americans who, despite paying premiums, are at constant risk of bankruptcy should catastrophe or tragedy strike. This is about health writ large: the health of our American community, the health of the American economy, and, not the least of all, the health of the American Dream.
And, as it turns out, this is also about the health of the Obama legacy, and whether in that pantheon of the great American presidents, his name and memory will join the likes of Washington, Jefferson, Lincoln, and Roosevelt.
Cross-posted at The State of Opportunity Blog.
