The Battle for Healthcare Begins

By Katrina vanden Heuvel, The Nation. Posted May 7, 2009.

"If there is no public insurance option…then this is not reform at all."

That's what Governor Howard Dean said last night in a conference call with thousands of activists -- and he's absolutely right.

As Dr. Dean noted, the battle for real reform begins Tuesday morning, when Senator Max Baucus chairs a Senate Finance Committee hearing that will look into the public plan option. Activists are writing messages on why such a plan is critical and Senator John Kerry will read some of them into the record at the hearing.

The conference call -- organized by MoveOn and Democracy For America-- began with a story similar to that of too many citizens across the nation. MoveOn member Lisa Hall said she was in a car accident -- hit by a drunk driver -- and was laid off in the aftermath when she couldn't work. She lost her insurance, COBRA ran out, and the bills mounted as no insurance company would cover her due to pre-existing conditions. "Ultimately," Small said, "[I went into] bankruptcy, like so many others…. The healthcare in this country has to be accessible to everyone. Not just the healthy people or the rich. We're just working folks, trying to keep our jobs and what we've earned."

Dean said the outcome of this fight will be determined by activists. We know what's coming -- charges of "socialized medicine", "you won't be able to choose your doctor", "a bureaucrat in Washington will make your healthcare decisions," etc. It will be up to the people to write letters to the editor, call your congressman, talk to neighbors. Myths will need to be debunked, front groups exposed, and money trails followed. Already, special interest groups are making robocalls and devoting millions of dollars to an anti-choice campaign.

"What we want to do is give people a choice," Dean said. "And stop saying you've got to be in the private insurance market or have no insurance whatsoever if you're under 65." (People over 65 are already in a single-payer system -- Medicare.)

As Dean pointed out, the facts are on our side in this battle. For starters, the proposal of a public plan option allows people to keep their private insurance if they want to and even subsidizes it. It's also cheaper than private insurance since a greater percentage of premiums goes towards healthcare instead of CEO salaries, shareholder dividends, swank offices, etc. (In Vermont, Governor Dean was able to cut administrative costs by 1/3 when the state ran Medicaid instead of a private company.)

But in Washington -- facts be damned -- real reform that benefits ordinary citizens doesn't come without a tough fight. "We're going to have an all out fight about this… and we're not going to go down again," Dean said. "If members of Congress know how strongly people feel about this they're going to think twice about voting against it."

Dean said that Senator Baucus is the legislator who most needs convincing since his committee is one of the two in the Senate that will deal with the bill -- and he especially needs to hear from people from his home state.

"He is nominally in favor of [the public option] but has also said that he might trade it away," Dean said. "I don't think it's necessary to trade it away -- we have a Democratic President, a Democratic Senate, and a Democratic House, there's no reason to trade it away…. I think we're going to get a good bill out of the House, the problem is in the Senate."

Indeed, the Senate is a place that resists change and all too often kills needed reform. This time around, we can't let that happen. Tell your representatives now that it's time to give people the option of a public plan.

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Katrina vanden Heuvel is editor of The Nation.

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