A RECENT DISCUSSION OF INCREMENTALISM
Part Four - discussion in one state among activists who have been working as a Defend Health Care Committee
At a recent meeting of activists in this state a discussion of incrementalism was initiated. Briefly, the question was posed whether incrementalism was (1) to be excluded by this group and (2) one of the possible approaches that would fit under principles of a Committee to Defend Health Care. It was given only partial discussion at that time.
Subsequently one activist thought:
Incremental reforms cannot add up to a universal health care system ever. Adopted incrementally they will be financially unworkable and will be seen as requiring enormous expenditures for ADDITIONAL PROGRAMS. The largest cost savings lies in cutting insurance bureaucracy and excessive profits (as our principles advocate) and will never come into play by adding new programs to our existing system.
This activist also mentioned that there is a brief statement about which state efforts are to be included on the Defend Health Care web site. This statement (www.EverybodyInNobodyOut.org/AboutInclude.html) currently includes a statement about incremental approaches which reads:
"We DO NOT include incremental approaches, even though these are often termed "universal health care" by the media and the major political parties. In practice, incremental advocates stepwise reform, without any plan or date by which they would be reaching the final goal of universal health care. This is essentially advocating for the status quo of continuous piecemeal reforms. Such reforms may go on for decades, possibly even while the numbers of uninsured grow. The fact that such reforms might be of some benefit, over the alternative of laissez-faire growth in the number of uninsured does not mean that our efforts should be going in that direction. We would include such work if it had the publicly stated goal and a determined time line for the achievement of universal health care."
A second activist responded: I don't disagree that the best way to get universal care is to cut the insurance bureaucracy and profits but I'm not sure it is the only way. This position has certainly been presented by individuals at our meetings, but I don't remember this as a principle endorsed by our state group. If this is to be our position and we all agree the solution has to include these cuts, then in the future we should be upfront about it in our presentations.
A third activist then pointed out that within this state committee's principles the following was already included:
Pursuit of corporate profit and personal fortune have no place in our care giving. Potent financial incentives that reward over care or under care weaken patient-clinician bonds and should be prohibited. Similarly, business arrangements that allow corporations and employers to control the care of patients should be proscribed.
And Activist 3 added: Our first intention with our current legislative effort is to make sure that health care is affordable and available to everyone. Once that is achieved we can then join others in focusing on the specifics of a plan. If the insurance companies could include all the uninsured without discriminating due to risk then fine, but right now they find it financially necessary to avoid paying for parts of patient care even for those who pay premiums by putting riders on contracts and having pre-existing condition clauses. So even if you have insurance you are not fully covered.
EINO Webmaster: So then, there seem to be conditions under which insurance companies could participate in a solution and we could still consider this an adequate option under our principles. We cannot state categorically that all participation of insurance companies and their bureaucracies would have to be cut out. But their power would have to be regulated within certain bounds and they could not be the primary agents designing our health care system according to their needs.
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