Tuesday, July 14, 2009

La Quatorze Juillet Comes for Health Care

Power never concedes without a fight

Bastille Day is the French national holiday commemorating the 1789 storming of the Bastille, an armory and prison belonging to the King of France. The French Revolution, which began as a primarily bourgeois struggle against the power of the monarchy and the Catholic church, had barely begun at the time. But severe and widespread famine throughout France, as well as extreme autocracy and indifference to the suffering of ordinary working people, and finally the armed intervention of foreign powers, would move the revolution through a remarkable variety of stages. The by turns democratic, repressive, bloody, chaotic, creative and empowering developments during 10 years of revolution has made the French Revolution a metaphor for the use of all comers, a conservative cautionary tale, a story of heroic resistance to the mob, a nightmare of counter-revolution and a dream of liberty.

History is always subject to debate and challenge. In the end, we are all revisionists and ideologues; the best of us likely are those who are able to speak about the personal biases that bring them to prefer one version over another. The Wikipedia entry about the French Revolution here is a great opportunity to contemplate the many ways that a little knowledge might be a dangerous thing.

In the meantime, Bastille Day has also functioned as a personal mnemonic, helping me to remember my first official day at the University of Michigan. I took the train to Ann Arbor (back when Amtrak was a nightmare of the future) on July 14, 1965, heading for three days residence at East Quad and orientation for incoming freshmen. The debacle that was my educational career at UM needs acknowledging (and perhaps detailing at some later time), but that memory today led me (by a somewhat tortuous route) to this question: What contemporary Bastille most needs taking (and liberating)?

I asked my new friend, M, a related sort of question the other day. We must first of all move on health care, she responded. Had we been using the Bastille Day metaphor at the time, I'm quite sure she would have said that we need to liberate the health care system and make it ours. But how?

M believes that we can't do a thorough job of reforming health care or accomplishing other substantial progressive change without an accompanying change in the consciousness of privileged elites who must, she says, come to recognize that great wealth and excessive materialism are not a right and are an obstacle to a more just society.

Though M and I see eye-to-eye on many things, it was collective action--street heat--that opened the doors of the Bastille and reinforced Louis XVI's understanding that he must make compromise with the revolutionary impulse that would eventually doom the ancien regime. The reasons why Louis later lost his head need exploring, too, but the lesson of Bastille Day and (a myriad of other moments of dramatic political change) is, as Frederick Douglass put it:

"Power concedes nothing without a demand. It never did and it never will. Find out just what any people will quietly submit to and you have found out the exact measure of injustice and wrong which will be imposed upon them, and these will continue till they are resisted with either words or blows, or both. The limits of tyrants are prescribed by the endurance of those whom they oppress."

Though Douglass here is talking tyrants, the point works even in a democracy, which in every instance still calls for a struggle with entrenched power. How, then, do we go about winning a struggle for substantial reform of the health care system against the entrenched power of insurance companies, corporate health care providers and those who are most highly rewarded for their work in the current system?

We begin by taking, as my friend Perry Hall says, "the language and the argument away from the reactionaries." A favorite argument of the congressional defenders (and others) of the current system is that government intervention in health care would end the rights of patients to choose their own doctors and to agree with their doctors on the medical care that would be appropriate for them. This argument comes from the same members of Congress who have passed laws to keep women and their doctors from arriving at conclusions of their own about abortion and, even, birth control. It boggles the mind that they might actually believe their own rhetoric, but that is not what matters.

We hear also and repeatedly about the staggering new costs that health care reform will impose. This argument comes from those who are quite happy with the staggering costs the status quo imposes and, as Dean Baker discusses in The Global Warming Lie Detector, do nothing about the staggering costs that war and weapons systems impose on taxpayers.

If the "limits of tyrants," and, by implication the possibilities for progressive change, are defined by the action of the people, then it follows that the people must trust their own understanding that our current health care system is too flawed, too expensive, too inefficient and too inaccessible to be maintained. Having trusted in the process by which we each arrived at such conclusions, we ought to be ignoring the propaganda deployed against us, and making our voices heard.

There must be a thousand ways for ordinary people to affect the direction of health care reform, but here's a few:

Go here for a list of "10+ things you can do." Number one on this list, unfortunately, is participate in a march on May 30, but even without that one, there are lots of possibilities here.

Send congress a copy of your medical bill. This site will help you do it.

Go to this site for a list of national health care campaigns and state connections you can make to focus your activism locally.

The important point, ultimately, is that the ancien regime will not fall without the action of ordinary people. There is a real opportunity here to make democracy work a little bit better. Even young, healthy people get old and get sick. Real health care reform will pay universal benefits.

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