The past year the two things that have been on our minds as Americans has been the economy and health care. And, while BPs fireworks in the Gulf have been a distraction of late, I think a reflection on national health care reform is in order.
But before we get there, I’d like to reflect on how we, as progressives, interacted with that process. I think the health care reform debate is a perfect example of progressive-myopia.
Social change is glacial. It is evolutionary. It moves ahead in fits and starts. It is difficult and uncomfortable. And it is ongoing, constant, and never ending.
Throughout my graduate school career, I studied social change. And I think this is the part that hung me up. I was looking for a discrete moment in time in which 'social change' happened. But, social change is a process. And there are many actors who take the lead during different parts, but it is this process that is the key to real social change.
This is what I think we have been missing in the health care debate.
As I am prone to do, let’s look at an example here… Let's take a minute to review the time line of the Civil Rights Movement. It was ten years between Brown v Board of Education of Topeka (which required schools to desegregate) and the 1964 Civil Rights Act. It wasn't until 1971 that the Supreme Court argued that the Constitution's guarantee of' 'equal protection of the laws' supported the busing plans established across the nation (Swann v Charlotte Mecklenburg Board of Education). So we have 20 years of an ongoing, agitated, and very public social movement seeking long term social change, and I would deign to argue that not one of us believes we live in a post-Civil Rights (or at least a post-racist) society.
Does that mean each of these milestones was a failure? Should the Civil Rights Movement have splintered after Brown II when they saw that schools weren't desegregating as required by the United States Supreme Court? (fill in your own series of examples where CRM stumbled or was blocked, but did not fall to illustrate this point)
So why is it then that have been so unwilling to bend when it comes to health care? Do we REALLY believe that we are going to change the delivery system of American health care in one fell swoop? Are we really willing to call this effort a failure because we didn’t get a single payer system out of the gate? I have been stunned by the number of progressives I have spoken to of late that consider this health care reform effort a failure because we didn’t get a public option this time around. To me that is shocking, disappointing and short-sighted.
This is something we Progressives are far too prone to. We are policy driven – we believe the ‘facts will set you free’ – when really, what we are trying to do is NOT change a policy. We are trying to change the fundamental way we, as a society, value health care. We need to start a discussion about WHY health care matters – not provide a fact sheet describing what the change will look like. This is the real battle.
If you believe, like I do, that health care is a right, then you are a part of this social movement. What we are seeking is not health care POLICY, we are seeking social change (read: value-based politics). The policy (i.e. the legislation) is just one tool we will use to create this social change.
The core of this social movement is changing how we, as Americans, understand our relationship to health care.
Before we have meaningful policy, we have to have meaningful support. Before we have meaningful support, we have to have a social movement. Before we have a social movement, we must recognize what it is we are wanting to change and why we want to change it.
In other words, we need to shift the conversation, not just the health care paradigm.
One thing the Right has right is its focus on value-based politics. They appeal to the heart and then to the head. Now that we have the first step in health care reform at the national level (insurance reform), it is imperative that we begin (or continue) the value based discussions about what it means to provide access to basic health care services and what values that access supports.
Call it a social movement, or value-based politics, or whatever you want to. But it is my belief that this is the discussion we need to be having.