The discussion in Don's "Quotes of the Day" on the
impact of PBOR on the struggle towards genuine universal health care in the U.S.
is worthwhile reading for those interested in that struggle. Many of the most important
points have already been eloquently made by one or several of the contributors.
However, some
equally important elements have yet to be touched upon.
Before I address those I first want to emphasize whole-hearted support of the
contribution from Pollner, Wooten and McCanne. Unity in our struggle will decide whether we are to succeed in leading
this country towards a civilized
health care system serving all its residents (like every other industrialized
nation). We need a broad and wide-ranging dialogue within the bounds that
can be agreed to at the onset by the interested parties.
First, it needs to be pointed out that the most
likely allies of those struggling towards universal health care in this society
are precisely those individuals currently concerned or politically active about
issues of health care reform and pursuing these ends through incremental
reforms. If we can't work respectfully with these folks then we may as
well not waste any further effort. This is a separate issue from what
results and influences the PBOR campaign will achieve (these are already
adequately discussed by other contributors). Like activists busy with
other incremental health reforms the activists in PBOR are either already aware,
or can easily be made aware of the importance of achieving these rights for
everyone, not just those who have managed to arrange adequate insurance at the
moment that illness strikes.
In state UHC work the group in North Carolina (see
www.NCdefendhealthcare.org) has developed respectful and useful alliances with incremental
reform activists and activist groups. The concerns of these activists are almost always our
concerns also, the difference is one of strategy. We relentlessly and respectfully remind and
explain how
the achievement of UHC could rationally and finally resolve their individual
issues, but always without demeaning more limited concerns and the committed
efforts in achieving those concerns. Any other attitude would cut us off from our best allies.
It would also display a lack of the concern for what people are NOW suffering. If some of that suffering can begin to be alleviated by
small reforms as we continue to fight for UHC, why would any UHC activist be unhappy about
that? [We join every other contributor besides Uwe Reinhardt in rejecting
the notion of diversion of movement energy].
At the same time that UHC activists unify with those working for
incremental reform, it makes enormous sense for UHC activists to work specificly and
explicitly towards NON-INCREMENTAL UHC themselves.
The reasons for this are plentiful (see www.EverybodyInNobodyOut.org/FAQ/fqStratConsid.htm
). That is we would like to see the more limited struggles succeed in the
meantime while we harness all available interest in the struggle for UHC which
we believe is necessary to resolution of each of these incremental struggles:
child health, mental health, substance abuse, senior prescription coverage etc.
etc. . along with the problems of un- and underinsurance.
Briefly the main reasons recommending a focus on UHC are:
1) that progress overall will be
elusive with budget cutting phases taking away previous gains, or rolling back
health access in new ways even while transient successes are achieved in other
incremental health reforms, and
2) instead of begging for additional funds from the legislature or congress,
program by program, UHC activists can argue for overall savings and efficiency to
cover all needed programs once the whole system is reformed to include all residents
and all medical needs without recourse to 3 to 8 levels of insurance bureaucracy
(not to mention several other possible areas of savings).
It was surprising that these two strategic reason recommending
explicit work for UHC were overlooked by the previous contributors. These two reasons will tend to convince activists pursuing
incremental goals, over time, making our concern for implementing a health care
system wherein every resident has all their needs met their concern as well.
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