“Keep your government hands off my Medicare!” It’s such a great line. So sparse and economical. Something that Hemingway or Shakespeare could have been proud of. It captures perfectly the sense of desperation that’s driven otherwise sensible suburban tea-partyites to throw bricks through office windows and threaten the lives of congresspeople. In its unassuming simplicity is revealed the extent of misinformation, ignorance and sheer inanity that have fueled the past year’s most rancorous debate.
Not that debate is the right word; debate requires an element of rational discourse with the occasional and judicious application of fact. What we just saw was more like Spartacus than Roman Senators. From death panels to armed protesters to “you lie,” the health care reform fracas has been nothing short of a no-holds-barred assault on civility in public discourse and the presumed intelligence of the American populous.
So, when last summer an angry constituent commanded Representative Robert Inglis of South Carolina to keep his “government hands” off of the government-run health insurance otherwise known as Medicare, it was in keeping with the general spirit of national lunacy. But what this unnamed citizen was remarkable for was his ability to, in seven words, summarize better than any other the assumptions, anxieties and inconsistencies of the entire anti-reform movement.
There are two possible lessons to draw from his outburst. The first goes something like this: The whole political circus that is the reform debate has nothing whatsoever to do with health care. In this view, the sheer ignorance exhibited by Rep. Inglis’s constituent, while perhaps an extreme example, demonstrates that reform opponents don’t actually care about health care per se, they simply oppose liberal ideas.
People, this view goes, are angry about the direction the country is taking. They are angry about having a non-white president. They are fearful of what the nation will look like in 20 years when whites of European descent are a minority group. They are a mindless mob, manipulated by right wing hacks into a frenzied rabid morass that will attack anything perceived as a threat to the status quo. For this they blame, in large part, the scaremongering and constant flow of misinformation disseminated by Limbaugh, Fox News and other conservative mouthpieces.
It’s a compelling argument, and factually there’s little to disagree with. However, the link between racist anxieties and a willingness to accept Fox-style misinformation, while not entirely imaginary, is a myopic and incomplete explanation for the depth and vehemence of opposition to the law.
Which brings us to a second understanding of Rep. Inglis’ constituent. There is a powerful ambivalence toward health care in the United States stemming from a national failure to adequately or clearly answer a fundamental question — is equal access to medicine an American right? Answering in the affirmative would be an invitation for the government, as guarantor of our rights, to take a far more active role in paying for, if not providing national medical care — yet this has certainly not been the outcome of debate thus far. But it’s not exactly not a right either. After all, if any of us showed up at a hospital with a life threatening injury we would expect to be taken care of without having to demonstrate an ability to pay for treatment.
The “keep your government hands off my Medicare” crowd play out this ambivalence, on the one hand demanding a continued entitlement to free health care while in the same breath denying a roll for the government in providing to others that same service. Less than selfishness though, this inconsistency exposes anxieties over the implications of a government guaranteed right to medicine.
Recognizing equality of care for all as a right would also require us to confront directly the fact that resources are finite. Providing for everyone will mean that some people get less than they otherwise might. There is also a fear that a claim to health care services is less strong if it is not ‘earned’ in some way. Anti-reform activists played heavily on these anxieties in their warnings of rationing, limited choices and government takeovers.
Resolving this ambivalence will require a difficult national conversation that will make the debate of the last year seem amicable. That we have made it this far without directly addressing the issue is remarkable, but cannot go on forever. The passage of the health care reform law is a first step. But it will remain only a theoretical guarantee unless a convincing case can be made to Rep. Inglis’ constituent, and all who share his ambivalence, that health care really is an American right. Making that case will not be easy or pretty, but it is the only way forward.
Geoff Jara-Almonte ([email protected]) is a third year medical student.
