Are we like the People of Panem?

For those of you with a PR day job, you must understand this sentiment: I come home from a long day at work and bask in the freedom to browse the internet for the fluffy stuff. I spend my 9-5 day staying up to date on hospital policy, clinical care, and research studies. In the evening, I ride the social wave. Interestingly, more often than not, my evening reads connect back directly to my day job. Several weeks ago, the hot topics on the internet were: the #HungerGames and #HealthCareReform.

Ever since then, I've been itching to dig into the on-going health care debate, especially after listening to a very compelling piece that NPR did several weeks ago on the second day of Obamacare hearings for the US Supreme Court. So for a moment, let's talk universal health care reform and then maybe we can get to the Hunger Games. 

I understand the reason for all of the hype. It's a big deal for the government to try to mandate something like health care, passing a law like this would set an impressive legal precedent. Even if one argues that the mandate would not infringe upon the constitutional rights of American citizens (which it could, the Supreme Court Justices have yet to determine this), it could also open the door to future legislation that crosses farther over this line. But here lies the problem: health care is essential to life and not everyone can afford it. Does everyone deserve it? I think most would agree that the answer is yes, but there are so many other factors at play here that add to the complexity of the issue.  The largest of which, I think, is freedom of choice. 

What's more interesting to me at the moment, is how the American public is reacting to the Supreme Court Hearings. So my thought is, let's take it to the people and see what they have to say via Twitter: 

@Vision365 @darbus69 it is your RIGHT to work and pursue thosethings you want, such as healthcare. I choose not to buy insurance.

Good point. RT “@BorowitzReport: Americans should not be forcedto spend money on healthcare that they could be spending onguns.”

RT @KateClinton: Shouldn't Supreme Court judges who havehealthcare recuse themselves from this case?

Dumb tweet of the day MT @Jimi_We If SCOTUS kills ACA allAmericans should refuse to provide healthcare for congressmenand SCOTUS.

Hands off my Healthcare! We need #Obamacare!

Why don't we apply successful principles of Internet (transparency, choice) to health care? http://bit.ly/GZ7GoR 

Healthcare going down? Back 2 millions being uninsured. RSupremes makg that the American way? Canucks think we're nuts! 


So single-payer healthcare not only would have been cheaper & more equitable, but it also would have been more legally resilient.

Read the above (just a small sampling of one night's discussion on Twitter). To sum it all up: people are uneasy about change. That's old news, but, is it just the element of change that poses a threat? No, people are concerned about putting their own health in jeopardy. For this reason, we have been teetering on the edge of health care reform. We want to take the plunge, but we are scared of the consequences.

The fight over health care reform is just like the Hunger Games. The government has nurtured a society that promotes the Games (universal health care) and encourages tributes to fight to the death (provokes citizens to a place where they feel trapped); without freedom of choice. Each tribute, just like each American citizen, wants the chance to choose life (or medical care), without having to take it from their friends and peers. Therein lies the problem: when the government takes away their choice, they feel forced to protect themselves and they become animals - caring only for their personal well-being. It's survival of the fittest. They no longer trust the men and women in power.

Americans are caught between a rock and a hard place. Altruism is a strong force within democracy and they want to provide medical care for everyone, but they do not trust #Obamacare. People are too afraid that, like the Hunger Games,  the system is rigged; that when they really do get very sick, they won't get the timely, high standard of care that they need and feel that they deserve. And it may be a matter of life or death. Acts of kindness and universal health care may risk the loss of their own quality care. Like so many things in life, it all boils down to self preservation, as the Tweets above show. People are suspicious. Just like in Panem, they do not trust the government to make these decisions; this can cause a great deal of unrest and unhappiness in the nation. 

In MA, we pay a high percentage of our annual salary to healthcare benefits, as the result of the Massachusetts Health Care Reform Law (2006), implemented by Mitt Romney during his time as governor. For many single workers, like myself, this translates to 1/3 of my monthly pay check - a high price to pay. I am rarely sick enough to need medical attention, so this number does feels unjust.

I understand the resentment towards #Obamacare. However, this is no excuse for neglecting those who need medical attention. So what do we do? What if Americans want both free choice and universal health care? Can we have our cake and eat it too, or is this one big Catch 22?

"Obama-Care"

BOSTON, MA (9/14/2009) -- Is health care a question of legality or morality? Are we, as American citizens, entitled to health care that allows us to live worry-free, knowing that we will never leave a hospital untreated due to the price of the medical treatment? I think almost every American would agree that this is the case. But Why?

Because health care is a necessity in life- it is one of the key components in ensuring the American dream of "life, liberty, and the pursuit of happiness." Therefore, it is not simply a question of policy and legislation that Washington finds itself carving out of the oak tree of history, it is a moral standard that lawmakers are choosing to either adhere to or disregard.

When Obama presented his health care plan to the American people on September 9, 2009, he was might have thought he was delivering a marketing speech to a panel of the toughest critics in the world. He was, in a way. But his audience was not the elite businessmen who were sitting in their Brooks Brothers' suit coats standing and sitting in agreement as the president spoke before their very eyes. The REAL audience assessing Obama's plan was driving home from work on I-95, setting the table for dinner in Waltham, MA, and sifting through bills at their desks as they contemplated taking out a second mortgage on their homes, in order to pay their outstanding medical bills. These were the men and women that listened to Obama's words, careful to take every statement with a grain of salt.

Here, I am going to take a liberty that, as a journalist, I am told never to take. It may feel a bit naughty (in truth, it DOES, why else would I be apologizing?), but I am going to switch into first-person narrative. Because, in reality, I can speak for these people I have described- the real audience for Obama's health care argument- because I am an average American citizen and this topic concerns me. It is my health at stake.

As a college senior in my final year of undergraduate work, I often think about the future and the possibility that in one year, I may be paying my own medical bills. So when Obama spoke, I listened, sitting in my sweats on the couch in my boyfriend's college apartment.

President Barack Obama is one of the most ideological presidents that I have seen in my mere 21 years of existence. He always has his chin up, his eyes twinkling, and his head held high. I don't believe half of what he says, even though most of the time, I want to. I really do!

Obama's plan deals with three brackets of people: the insured, the uninsured, and the irresponsibly uninsured.

For the insured, Obama plans to make insurance better; there will be more stability for job insurance, people will have the freedom to choose the doctor they desire, routine/preventative check-ups will be covered, and you will not be denied coverage due to a pre-existing condition. Bravo! Obama also condemned insurance companies that force people to pay for prescriptions "out-of-pocket," saying "No One should go broke because they got sick."

For the uninsured, Obama is determined to provide insurance through an Insurance Exchange that allows insurance companies to compete for clients on a level playing field. Despite accusations from right-wing Republicans, Obama says that a new government insurance option will only be added to the pool of other insurers, one of many fish in the sea. The cheap, government option will be totally self-sufficient and non-profit, entirely independent of tax payer dollars. The exchange would not go into effect for four years, however, tax credits and a low cost plan would be offered in the meantime.

And for the irresponsible American citizen, Obama has a message, "No gaming the system!" The president spoke directly to the minority of Americans who can afford health care, but choose not to pay for it. These are the people who think they will never get sick and then, inevitably, end up being rushed to the emergency room and the rest of us end up paying their bills. These are the people that rack up health care costs and these are the people that are going to prevent reform plans from successfully coming to fruition. But no longer. From now on, Obama wants to make it mandatory to carry health care insurance- just as it is mandatory for every driver to carry some sort of auto-insurance. End of story.

First, let me tell you what I did like about his plan. He acknowledged, as the late Ted Kennedy said, that this is not a bi-partisan issue. The matter of health care is one of "large heartedness" and the moral character of our country. Obama also said that he will protect Medicare and the future of the elderly population, he will offer the American people a choice in affordable health coverage- a choice that does not have to be government funded, and he "will not accept the status quo as a solution."

Along with this optimistic attitude, Obama made several compromises. He is willing to use ideas from across the aisle- including elements of health care reform proposed by former President Bush and Obama's political opponent in the 2008 elections, Senator John McCain.

The problem is that the health care plan is going to cost a grand total of $900 billion over a ten year period. Where is all of this money coming from? Obama says that it is coming from within the health care system, from harvesting all of the expenditure that is wasted on executive bonuses and elsewhere. Obama says that by making the system more efficient and by holding people accountable, we can fund the new subsidized health care plans without "adding one dime to the deficit." Any additional costs will be paid for by the added money entering the system by way of the newly insured (formerly uninsured).

Ok, this is all fine and good, but I am not convinced. I want to see the numbers. I agree, (admitting to my own ignorance of the health care field) retrieved wasted money could provide the system with a significant figure, however, can it really fund all $900 billion? Break it down for me...where exactly is each sum coming from? Show me the numbers.

Obama showed some true backbone towards the end of his speech, however, after getting dubbed a "liar" by Rep. Wilson in reference to illegal immigrants' exclusion from the health care plan. Obama said that he will not waste time listening to people who want to try to kill his plan. He will only listen to those who are willing to work to improve it. The use of fear and antistatic values to hinder progress will not be tolerated. That being said, Obama would not let a few sour grapes ruin the monumental moment in US history.

Promising to "pull this economy back from the brink," Obama told Americans, "I am not the first president to take up this cause, but I am determined to be the last."

See: Obama's Health Care Speech to Congress

By Catherine Moore, camoore@bu.edu