Democracy and Health Care

  A commentator on an earlier post asked the very good question:

the question then becomes what the heck do we do?

I cannot claim to have a prescription "for what ails" the United States. I am not a politician* and even if I was I hope I would have the wisdom to recognize the limitations of my knowledge and my expertise.


What follows are a few tentative suggestions.


First, become involved in politics at a local level. Running for office in the United States even at the state level, is ruinously expensive for anyone not personally wealthy or who does not have the support of the monied. That fact makes it difficult for anyone who does not support laws and regulations (or the repeal of laws and regulations) that favour the wealthy to run for most political offices. However it costs little to run for office in local elections.+ And fortunately it costs nothing to volunteer to work in local elections since one does not need to worry about travel or lodging expenses.


Take the time to observe the way in which "Tea Party" supporters have managed to insert themselves into the political life of the country through seats on local boards of eduction and other "lesser" organs of representative democracy. Americans elect individuals to jobs that have a wide range of responsibility and oversight including judges, sheriffs, members of the library board, members of the parole board and regents of the state universities. It is at this level of political involvement that it is easiest and perhaps most important to get involved.


Second, narrow the things you are going to fight for. By this I don't mean that you should give up caring about all but a few issues but rather than you should pick a few key places to make your stand. I personally would suggest two areas focus: health care and unions.

Why? Because my overwhelming concern right now now is for the large and growing number of marginalized Americans. The list includes (but is not limited to) the poor, women and QUILTBAGS.ǂ Strengthening health care and unions would do much to protecting their rights.

Unions:

The most marginalized and those who are the most at risk are those who are least able to protect existing rights or gain additional rights through the process of negotiations. Those who are in power, the kyriarchy, have all the cards. The marginalized have few or none. The powerful can 'wait out' those without power. The poor parent who has children to feed at home will take a job cut rather than lose hir job. The QUILTBAG will hesitate to "make noise" in the workplace since they are the least likely to have solid support from those around them. And women, living in a political and cultural environment that is threatening rights so recently won are unlikely= to "make noise" for fear that the kyriarchy will set one group of women against another while suggesting to men that all the rights women have won have come at the cost of their own.

Health care:
Because health care is generally in the United States tied to employment someone who has "preexisting conditions" or who has children (with or without preexisting conditions) is little more than an indentured servant. They could leave their place of work but only at great risk to their family's economic and physical health. Parents would not be forced to stay at bad jobs for the sake of the health of their children. And more employees would be willing to face down bad employers if losing a job did not mean losing affordable access to the health care system.


The health care paradox:
Unfortunately achieving universal and affordable health care in the United States is almost impossible if the country does not first achieve universal and affordable health care. By that I mean that universal health care is not just an end it is also a means. When one lives in a country with universal health care then, in some sense, every person in that country is a member of one's own tribe. Preventive care becomes doubly important: one wants all the members of one's tribe to be maximally healthy and it is cost-efficient to prevent disease and ill health.


If one grows up with the idea that paying for the health of the child who lives down the block is little different that paying for the health of one's nephew -- then one also tends to feel that wrongs done to the adult who lives down the block are wrongs done to a member of one's family. Unless one sees one's fellow citizens as members of the same tribe one tends to resent paying for their well being. Universal health care is not the only way to achieve "national tribalism" but once one has achieved "national tribalism" universal health care is both logical and necessary.


So my suggestion to Americans who want to "make a difference" is to begin small and to work at achieving those things that lower the barriers between Americans.


*Unfortunately all too many politicians are not aware of their own limitations. It is unreasonable to expect any human being to be well versed in all areas of knowledge. It is not unreasonable to expect other human beings to be cognizant of their own limitations. 

+There are obviously exceptions to this general rule. Running for election as a congressional representative in New York City or in Los Angeles can be extremely expensive. 

 

ǂThe named groups are neither mutually exclusive nor exhaustive.