A moral imperative

Cable news has been saturated with images of what appear to be ordinary Americans at recent town hall meetings, many angry, some vitriolic, chanting over and over again, "Just say no. Just say no." What are they saying no to? Health care reform. Of any kind. Period. When pressed, they mention "death panels," "government rationing and control" and "treatment for illegal aliens." Outside are men and women, standing shoulder to shoulder, a few strapped with handguns, holding photos of Obama portrayed as Hitler, a narrow black mustache added, and the words socialism and Nazi writ large and small. A man stands to address Sen. Arlen Specter and renders himself all but speechless, so overwhelming is his rage. A woman breaks down and sobs, insisting that America is no longer the America of our founding fathers.

"Just say no," they insist. No to families facing health care bankruptcies (over 60 percent of all filed bankruptcies are due to the exigencies of health care). No to 47 million citizens facing each day without health care. No to those who are underinsured. It's an emphatic "No!" and it echoes the Republican leadership.

Of course, ask the Republicans about those 47 million and their fallback argument is that every American has health care if needed: All they have to do is walk into an emergency clinic for treatment. No one can be turned away. It's a bankrupt, mendacious statement, chilling in its callousness. Emergency clinics do not represent primary care medical treatment. They are not prophylactic, nor do they deal with long-term health concerns such as prenatal care.

Contrast the "Just say no," "Go to the emergency room" rebuttals to what took place recently in Inglewood, Calif. A non-profit, Tennessee-based organization, Remote Area Medical, originally established to serve third-world communities, offered free medical care for those in need in the South Los Angeles area, covering dental, physicals, mammograms, eye exams and even acupuncture. It was set up on the floor of the Forum, a massive arena, filled with waiting areas, examining rooms, dental chairs and x-ray machines.

The response was overwhelming, the need exceeding anything Remote Area Medical anticipated. With the clinic scheduled for eight days of care, some 1,500 showed up the first day. Of those who arrived (some drove for hours and slept in their cars), many were without health care insurance and desperate for care. Those who did have medical coverage could not afford the high deductible; in effect, they had catastrophic insurance and nothing more. Untold numbers had not seen a doctor or a dentist for years. Eight thousand patients were seen, receiving tooth extractions, fillings, pap smears, breast exams, physicals and eyeglasses. And we know that this is but the tip of a very large iceberg.

The Inglewood response puts the lie to the Republicans "Just go to the emergency room" response. It also begs the question as to how we, as a nation, can allow an absence of health care to define the lives of so many of our citizens. It is morally wrong. It is a civil rights issue, one of discrimination against those among us who are sick. We can change this. We need only the political will.

This is the time for the Democrats to summon that will and step forward. This is worth fighting for. It is a seminal moment that will not come again. We need to break what amounts to an insurance company monopoly on health care and offer, at the very least, a public option (single payer would be far more efficacious). To do less will not be health care reform. It will be a kind of insurance reform, leaving in tact a system that will ultimately bring us to fiscal ruin. And nothing will have really changed.

Chris Honoré writes for Revels. His reviews appear weekly.

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