After receiving its latest invitation, I told AARP why I wouldn’t join up: It doesn’t support single-payer health care. AARP responded with its argument against single-payer (HR 676), and I responded to their points. Here is a summary of the exchange:
AARP: HR 676 does not address the problem of increasing health care costs …
Thomas Dickinson: HR 676 does not need to address increasing health care costs. We need care now for everyone, rich and poor — everyone in the same pool. That needs to be addressed first. No need to conflate all the parts of a complicated problem. Solve the most egregious inequities first.
AARP: HR 676 essentially eliminates Medicare, Medicaid, and the SCHIP programs that have served the American public well for many years. …
TD: The only reason these three programs exist is to repair shortcomings ever since Frances Perkins had to give up on single-payer back in the ’30s so that President Roosevelt could get other New Deal programs passed. She wasn’t wrong then. In fact, history has proven the gross inadequacies of what we got instead or we wouldn’t be having this discussion now. Saving these is only “if it ain’t broke don’t fix it” applied to a very flawed system cobbled together more than 70 years ago.
AARP: HR 676 does not promote shared responsibility for health care coverage among employers, employees and the government — a basic principle of AARP policy. … Taxes will need to be increased. This means that the bill simply shifts the burden of the rising costs of health care onto the taxpayer alone, with no motivation built in its structure for cost-containment.
TD: Why is health care tied to the workplace at all? Only because “that’s the way we’ve always done it.” It became the responsibility of employers after the failure, noted above, to pass single-payer in the ’30s. It was a novelty, a perk to attract employees by holding back income that presumably would’ve been spent on health insurance by the individual — and thereby possibly putting the employee in a lower tax bracket — and then spending a portion of what was held back on health insurance for them, allowing the employer to negotiate better rates so their employees cost them less. A complicated “win-win” for employee and employer, but all just fancy machinations covering the failure back then to enact single-payer.
Also, the taxpayer is not “alone.” We taxpayers are together helping each other and especially those too poor to pay taxes. One of my greatest roles as a citizen is “taxpayer.” Isn’t it yours? Why do you go along with the very mean-spirited spin that taxes are bad and raising taxes for something as altruistic and life-affirming as health care for all, by all — which is what a single-payer is — is somehow bad?
Government regulates, and cost-containment is clearly a function of regulation. Right now, cost-containment is for bigger profits, not better health. That will remain true as long as the profit motive remains in the system.
AARP: In addition HR 676 has not gathered bipartisan support, which is important to enacting and implementing any reform.
TD: And it won’t as long as organizations like AARP aren’t advocating for it. The health care lobbies are the most powerful, and AARP has thrown in with them. How is it that while the public, the doctors and the nurses all consistently prefer a single-payer solution, our “representatives” don’t? How is it that single-payer is “off the table” according to the politicians in charge of the discussion? No representation there. (If it were “on the table” as a voter referendum, it would win, wouldn’t it?) Who benefits when single-payer is not an option? Certainly not the sick and the lame, the youngest and oldest, the poor, the public. No, the beneficiaries are the businesses built upon people’s misery, and the politicians and others they reward for not representing the wishes of the public.
So, I’m curious what the relationships are between AARP and the health care lobbies. I want to know all details — the previous employment of AARP officials, their Washington friends, the donations, the meetings, etc. I want to understand why AARP would advocate against what its constituency wants.
I don’t care if businesses fail, not even a whole sector of the insurance world; the economy changes all the time. This is America, after all. I do care if a citizen dies because his neighbors — you and me and the rest of our society — said, “Tough luck, fella, the business of health care is more important than you.”
We can handle overhauls and upheavals; we’re handling an economic one now. We can handle one in health care.
AARP: “All Americans should have access to affordable health care …”
TD: No. All Americans should have health care. The society affords it, not the individual. Do we put that “affordability” criterium on national defense? Fire safety? Police? Education? Of course not. All of us pay for those things together, yet you think health care should be paid for individually?
AARP: “… these costs should not burden future generations.” … “Wellness and prevention efforts, including changes in personal behavior such as diet and exercise, should be top national priorities.”
TD: You measure in dollars only? There are far greater costs to future generations when citizens’ lives are destroyed by disease and avoidable death ruining them economically, keeping them underemployed, undereducated, unable to contribute to civil society because all they can be concerned with is covering costs — let alone the pain and suffering from ill health that could have been avoided had our society accepted its responsibility.
The first change in personal and national behavior is for those who have to help those who don’t. When did that notion depart the national psyche? We are our neighbors’ keepers. Helping others is not a burden, it is a responsibility according to all the major religions and our Constitution. We formed the government for exactly that, and the health of the citizenry is one of society’s most basic collective needs.
Burden? We haven’t come close to accepting the “burden” bestowed upon us by our Founding Fathers. The only people who have the luxury of future money woes are the ones who’ve already got some. We are charged with caring for everyone now, especially those without. A society is only as good as the way it treats the least among it. We’ve got a long way to go, and AARP should direct its considerable clout at the real solutions, not the half measures designed to keep business in business.
Thomas Dickinson is a pianist and piano teacher in the Powderhorn neighborhood of Minneapolis.