How was it possible for the Republican machine to derail health care as a major issue of the election campaign? They blamed the health care crisis on 'frivolous malpractice law suits.' Bush demagogically called for health care to be 'personal' with 'personal ownership' in opposition to the 'evil' of government bureaucracy.

They substituted their anti-abortion and backward gender ideas for the real health care issues of a rising infant mortality rate and the 45 million people without any health insurance and another 60 million with very little.

Exit polls are highly suspect, but a willing media made the Bush claims and proposals seem legitimate choices for too many working-class voters.
As a result of the election, progressive forces will not be debating the best kinds of national health legislation in the upcoming Congress. We will be fighting against the corporate ruse of individual medical saving accounts and privatization of social security. We will be fighting to overturn the worst parts of Bush’s Medicare legislation and for the extension of federally financed community health and mental health centers. And, yes, we will be fighting for continuation of a 'women’s right to choose.' In addition we will be exposing the racist edge to all of Bush’s backward health policies.

One thing is for sure: the election of Bush and his corporate allies will not solve the health crisis. Their phony Medical Savings Accounts and the disastrous Medicare legislation will not solve the problem of 45 million uninsured and the increase in death and disease amongst our people. Hell, even the AARP has turned its back on the Bush Medicare program.

Aside from the questionable election results, there is a clear disconnect among voters between people’s personal health problems, community health issues, labor-negotiated health benefit plans and similar on-the-ground, basic life and death issues and the clear need for a national health legislative program. Many of us are engaged in jargon-laden discussions on which national health program is best for our country.

There are many options: 'Medicare for All,' 'Single Payer,' 'National Health Service,' 'Universal Health Care.' Extension of the Federal Employee Benefit Program became the centerpiece of the presidential debate. The differences among these proposals are lost on most people, especially when anti-people, Republican politicians openly lie about the value of their proposals.

Most importantly, these options seemed to go well over the heads of the very people for whom these national health legislative programs are intended. They became the subject of high level, often esoteric, 'policy wonk' debates. How a person’s everyday health problems can be taken care of is the main point often missed.

How to Clarify

When a person’s eyes glaze over is a sure sign that you’ve lost them on the topic of health care. The disconnect happens because that person’s direct experience is not part of the discussion for national health legislation.

Activists who are aligned with any or all of the national health legislative options must become more connected to the everyday struggles of people who are in desperate need of health services. Starting 'where people are' will bring us back in touch with people who may have a different viewpoint on issues. Some of the people we are trying to reach have very different ideas on parenting and gender rights and who voted the wrong way last November. So how do we talk with them and clarify the national health crisis?

The connection between self-interest and the system may be a starting point. There is a dialectical relationship between the everyday health needs of people and the city, state and national policies that affect their lives. Corporate interests understand this, and they are up late at night thinking up schemes to derail a common sense understanding of how this system works. The common sense link between self-interest and social policy is something progressives will have to struggle to make visible for everyday people.

It is the same kind of campaign that convinces fearful workers to side with a labor union in an organizing drive even though the employer uses union busters and lies to break up the drive. If done correctly, it should enable deeply religious people to either modify their strongly held beliefs or put them aside and seek a national health program that truly fits their needs. It will enable them to break with the policies of greed of for-profit hospitals such as Senator Frist’s Hospital Corporation of America and their ilk.

Corporate is Not Personal

In the 1980s, the World Bank and international corporate interests stated that the way to better, high quality and accessible health care would be via market forces and privatization of government programs. In the 1990s, the US medical industrial complex, lead by the insurance and drug companies, agreed with that direction and cleverly hijacked the term 'managed care,' a term that had described pre-paid group health practices that actually took care of people. Under corporate control, managed care became a method of cutting services and increasing corporate profits. Activists and professionals soon labeled this system 'managed profits.'

Now, the World Health Organization, meeting in Mexico, just released a report showing that the market force and privatization strategy has actually widened the gap between those people with good health care and those with poor health care. The WHO labeled these activities as a disaster.

Following the IMF and World Bank direction, the 1990s 'managed care' strategy of the insurance carriers was a disaster and mostly discarded, although the drive for profits wasn’t. A new corporate strategy was needed. The Bush people unveiled that strategy and its Madison Avenue slogan in the election campaign. They are harping on the terms 'personal' and 'taking ownership of health care.'

It is all a smoke screen to allow the health industry corporations to maximize their profits and stop the drive for a public national health program. They use the same phrasing in their call to privatize social security.

Well, corporations are not personal; they are the antithesis of personal. The 'ownership' they are talking about is corporate ownership and not a person’s control of their own life. We must make our national health proposals 'personal' to people.

I’m not a calling for an end to the efforts by think tanks for developing the most effective national health program or to criticize those activists who are involved in local struggles. The goal is to unite these efforts.

The grim reality is that few members of Congress, state or local governments are actively putting their political lives on the line for any national health program. That should tell us something.

We have to light the fires under every elected official to make it clear that the everyday struggles for health services means that our government has to take responsibility for the health status of our people. This may require activists to get state and city legislators to enact health coverage for people. Enlisting state governments to fight for a national health program would significantly help in this struggle.

Dr. George Silver writing in the Washington Post suggested the following coalition points: 'Congress could take steps to restore the state capability for innovation and initiative through a program that appropriates funds and asks for a few basic things in return: (1) universal coverage, (2) a single source of payment, (3) global budgeting, (4) quality-control measures and (5) guarantee of service. These ground rules, along with the power on the part of states to overcome federal preemption of their authority to meet these goals, would go far, in my view, toward giving us the models we need to move forward as a nation.'

Progressive activists for local and national health struggles are not going to win everyone. The damage done by the ultra-right ideologues in terrorizing many people will take time to correct. Reproductive rights will continue to be discussed. But, by focusing on local rural and urban health issues and the necessity of government responsibility, we can start the process to gain the political base and support for the most progressive national health program that our country needs and wants.



--Phil E. Benjamin is a contributing editor of Political Affairs and can be reached at