I really wanted to be useful in a health care reform movement here in Colorado. I am still holding out for some effective effort. Right now, nothing is shaking.
I’ve been to meetings and am on email lists. But mindsets are stuck in designed-to-fail mode. One, they are focused on health “insurance” rather than health “care.” Secondly, they presume that the road to success is through the electoral and legislative process.
The second notion is easily set aside. ACA, or Obamacare, was nothing more than jujutsu, taking all of the great energy for reform and channeling it for benefit of AHIP*. Even if, with herculean effort, they elect one or two members to the legislature, they’ll never begin to mount the force that insurance companies bring to bear. Even assuming that the person elected is honest and sincere, he or she can only introduce legislation that cannot pass or would be subject to veto
The veto can easily kill any movement, as it did in California under Governor Schwarzenegger. Jerry Brown would do no better. Our governor, John Hickenlooper, is a D-Republican. That’s how it shakes out everywhere, from here to Bullock in Montana to Brown in California. D-Republican governors serve as gatekeepers.
AHIP seeks to minimize access to health care. Premiums, co-pays, deductibles and coinsurance are effective tools in preventing people from entering the system except when in dire need. Even with insurance, poor people can be bankrupted.
Ergo, the concept of “insurance” does not fit in health care except in a catastrophic sense. Rather, all of us need to access to health care. The insurance companies have effectively encircled the system so they can charge their 20% fee. It’s a classic leeching, or “rent seeking” activity.
I suggest part of the answer is small, local and free clinics where people can go for basic triage. Most health care issues are treatable in early stages. Too many people fear going for basic care due to the added burden of medical costs on top of existing premiums. (Anyone needing more intensive care would have to enter the insurance-corrupted system, and I have no answer for that other than our current highly inefficient free care system via public charity administered through hospitals.)
But we start at ground elevel. Free clinics would be busy and cash-strapped, so that the “reform” movement would be focused on funding and staffing. All work would have to be voluntary, and funding as well. Public-spirited citizens could then put their good energy into effective activities with a payoff: seeking contributions from individuals, businesses and foundations for the clinics. Volinteers could actually see a psychic reward.
If successful, it would be imitated and would spread. Insurance companies would see it as a threat to their business model. The real fight would then begin, reformers defending a successful model which would be under attack by insurers. They might succeed, as public perceptions would favor David over Goliath.**
It beats the hell out of quixotic legislative campaigns and battles that, even if successful, result in a veto.
Working in a corrupt system to fight corruption is futile. All who enter that system perish. Only reform from the outside is possible.
*America’s Health Insurance Providers, the industry lobby group.
**The Democrat Party would then join the fray in their usual role as false friends, working inside the reform movement to kill it. They are a deadly enemy of reform.