How Democrats Need To Frame The Healthcare Debate

[ Posted Tuesday, June 9th, 2009 – 15:52 UTC ]

The debate over what, exactly, "healthcare reform" means is about to hit fever pitch (so to speak), and instead of diving into the legislative details of what seems to be emerging from congressional Democrats, I would like to make a broad suggestion in how they should be framing the issue correctly. Some may call this approach naive, but I truly believe that rather than fighting for one species of reform over the other, Democrats need to first adequately define the core principle they are fighting for. Their "values" on healthcare reform, to put it another way. And while it may not be achievable this time around, I think the goal Democrats should loudly proclaim they are attempting is a very simple one: nobody should ever go bankrupt because they get sick.

Like I said, this is a simple idea. Which leads to the naysayers who may call it naive, or even simplistic. But I think it is powerful because it is so simple. It's easily understood by all. And I think it would resonate strongly with all members of the public, no matter what their political stripe. As a bonus, it forces opponents into defending the current system, where medical bankruptcies happen every day in America -- which is a pretty tough position to defend.

Not everyone, and not even every family, has a personal story of bankruptcy due to medical problems. But everyone -- whether it has happened to a member of their family or not -- is terrified of one day losing everything they have saved over a lifetime, just to pay a doctor's bill.

The statistics on this are staggering, and are a national embarrassment. A recent study showed that 62 percent of all personal bankruptcies in America are due to medical reasons. The majority of which were people who had health insurance. Which makes it even more embarrassing. There are thousands of stories out there of people who thought they were doing the right thing and thought they were covered, but tragically found out (too late to do anything about it) that they were not covered when medical disaster struck.

So why not hold some very public congressional hearings and showcase a few of these stories? Why not traipse out for the television cameras sob story after sob story of people who had insurance -- and yet lost everything anyway? This would focus the media's (and the public's) attention where it should be in this debate: the real scope of the problem we face. Rather than some high-flown debate over political philosophy, why aren't the Democrats staking out their position as trying to solve the worst problem that exists, and the worst fears Americans have in the healthcare debate?

I'm waiting, personally, for some Democrat to stand up and say the following on a national news broadcast:

"Our goal as Democrats in the healthcare debate is simple -- we think that no American should have to declare bankruptcy to pay their medical bills. We think this is a horrendous problem which affects millions of people in this country, and we think it needs to end. Hardworking Americans are -- on a daily basis -- being forced to give everything they have worked their entire lives for just because they got sick. We think that is wrong. We think that is the core problem which needs to change in the healthcare industry in this country. Now, we have a few different ideas about how to go about guaranteeing that no American ever again should have to face bankruptcy because of illness, but we all agree on this same goal. There needs to be some sort of safety net to keep this from happening to people -- even people who thought they had good health insurance before they got sick. We think it is unfair, and we are trying to fix it. Our Republican opponents think it is much more important to guarantee that insurance companies and doctors and drug companies rake in obscene profits, than to guarantee that those profits will not come at the expense of someone's retirement savings. They keep using words such as 'freedom' in this debate, so let me be crystal clear -- what they really mean by this is 'the freedom to go broke when you get sick.' That is unacceptable to me, and unacceptable to the Democratic Party. And that's why we are trying to change our broken system. We invite Republicans to join us in this fight, so that never again in this great country will anyone have to face a bankruptcy judge from their hospital bed."

Is that really such a hard concept? Or do you think it would resonate with the public at large? So why hasn't a Democratic spokesman stood up and defined the debate in these stark moral terms? What is holding them back?

Healthcare reform is not merely a matter of corralling the necessary votes in Congress -- it also means getting the public on your side. And, so far, Democrats have been all but absent in this public debate. This needs to change, or else we're going to wind up not with a monumental "New Deal" or "Great Society" sweeping change, but instead with some incremental window-dressing which is not going to fix the system at all. Which will mean, ultimately, that we are just going to have to have this whole fight again in a few years. And that would be a tragedy indeed.


[Grammatical Note: I am finally bowing to what is becoming the conventional usage of "healthcare" instead of "health care," and will be using this standard from now on. I don't know why, since I am usually at the forefront of making one compound word where others still use two, but "healthcare" has always just looked wrong to me. But with the debate heating up, I think it best to now lay this issue aside and get on the etymological bandwagon, as it were.]


-- Chris Weigant


3 Comments on “How Democrats Need To Frame The Healthcare Debate”

  1. [1] 
    fstanley wrote:

    I keep hoping that President Obama and Congress will do the right thing but when I hear that single payer is off the table I am upset. I am also not very happy to hear that there is talk about taxing benefits for those who have them and forcing those that don't have healthcare to buy the existing flawed and costly plans.

    The insurance industry will never self-regulate and they are already going back on some of their earlier promises.

    We need real "Change" now!


  2. [2] 
    Osborne Ink wrote:

    Chris, I think you've nailed together the perfect frame. This is the nightmare for the GOP: that Americans come to see health care reform as key to their family's security.

    There's been a backlash against the bankruptcy study in the wacknut blogosphere; they're so scared of this framing that they're bending themselves over backwards to explain away the data. That's why it is vital for the proponents of reform to build the frame with the stories of real Americans.

    For me, health care reform became an issue the day I lost a sale. The family was middle-class and had insurance; they liked my product and they wanted it. But their daughter had just been diagnosed with cancer and the surgeon wanted $10,000 in cash before she would pick up the scalpel. Altogether, they spent their entire savings account keeping their child alive -- around $85,000. And again, this was WITH insurance.

  3. [3] 
    Moderate wrote:

    It's an excellent framing. The problem is, I don't think it achieves too much as I'm not sure too many moderate Republicans could possible oppose that. The issue is less that healthcare needs reform, but rather the best way to do it.

    For example I think that's a laudable principle. People shouldn't go bankrupt to get treatment. But I'm not a fan of too much centralisation in the hands of the government because of just how broken our NHS is here in the UK.

    Sure, people don't go bankrupt to get treatment; largely as many of them die before they get the treatment they need. Is that really any better? Not for me.

    Rationing is a serious problem. People wait months for surgery that they need now, or simply get refused treatment for assorted reasons (none of which are to do with need, and have everything to do with the cost of the treatment).

    The more I read about Germany and The Netherlands, the more I think public healthcare must be workable. But the UK stands as an example that it's not a certainty that it will be, or that it will be any better than what you have now.

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