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    Columns

    Healthcare Practitioner Corner: Us & Them

    Reading the subtext of the healthcare reform debacle.

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    Erik Goldman03.01.10
    “Us and them, and after all we’re only ordinary men,”—Roger Waters, “Us & Them,” Dark Side of the Moon, 1973
     
    There is something terribly disturbing about the derailment of the Obama administration’s healthcare reform attempt. I say this not as a fan of the plan. Anyone who has read my columns over the last two years knows that I am a strong critic of insurance-based medicine and any reform that makes mandated “universal” insurance the central goal.
     
    I say it as a citizen deeply troubled by the ugly nature of the debate, by our collective unwillingness to face the magnitude of the healthcare crisis, and by our inability to muster up the will and the vision to do anything but vilify those we perceive as “other.” There’s something sinister and corrosive at work in our national psyche, and it showed itself in the healthcare fracas.
     
    A few days after the historic and, for some, unsettling Massachusetts election of Scott Brown to Ted Kennedy’s Senate seat, the New York Times ran a post-game analysis entitled, “The Democrats’ Day After.” What put the chills down my spine was not the article itself—a critique of Democrats’ misreading of public sentiment—but two reader comments.
     
    One was from a gentleman named Neil Underwood White from Natick, MA, who stated:
     
    “I am an independent voter in Massachusetts, the moment I heard that Scott drives a used truck with 200,000 miles on it and Scott's mother is on Welfare. I immediately decided to vote for Scott. He is one of us, a working poor Caucasian, and he will work for us: millions working poor Caucasians in Massachusetts.”
     
    The other, from “Rick” in New York City, explains that:
     
    “The reason the Democrats are constantly in disarray is because they always have a socialist agenda that they demand to push in a nation that is not socialist. The American founding fathers would get up from their graves if they realized that the nation they founded is becoming more and more European than ever. That is not what they created this nation for—to be European. Obama campaigned for American leadership, however, all we get is a replication of European agendas. Obama wants to lead the world by doing what the world wants America to do. There is a socialist party in the USA its called the Democrats.”
     
    Both comments fairly bristle with anger and indignation, but more than that, they hint at a fear and hatred of anything that’s not White and “Real” American, as if the problems in this nation are primarily caused by “others,”—non-Caucasians, foreigners—bent on pillaging, destroying and corrupting the great good of the USA. Historically, that sort of thinking leads to some pretty nasty places.
     
    What’s interesting about the first comment is that Mr. White is from Massachusetts, which underwent a state level universal health insurance reform four years ago, led by Republican governor Mitt Romney, and voted for by none other than Scott Brown himself!
     
    The Massachusetts plan mandates that every citizen of the state buy insurance, and it provides subsidies for those who cannot afford it on their own. In its first years, the Romney plan has racked up costs well beyond projections, and while it has expanded the number of citizens with insurance, there’s no indication it has substantially improved access to healthcare givers, or that it has actually improved public health in Massachusetts.
     
    Mr. Brown has, of course, vowed to align with Senate Republicans to block national healthcare reform. If he were a Democrat, we might accuse him of flip-flopping. But Republicans don’t flip-flop, right? And besides, he has his reasons for changing his stance.
     
    On Fox News, Mr. Brown defended his state-level vote for Romney-Care, explaining that it was an entirely different kettle of chowder than the sort of socialist soup that Obama & Co. want to force-feed the nation. The Mass. plan, Mr. Brown states, is based on “free market” principles rather than socialism. Did Fox ask him to clarify the difference? Of course not.
     
    Mr. Brown, and Mr. Romney, who may yet be a GOP presidential nominee in 2012, contends that cost over-runs in Massachusetts are not due to any inherent problems with Romney-Care per se, but rather are the fault of (non-Caucasian and) Democratic Gov. Deval Patrick, who eliminated a “cost and quality commission” that would have reined in spending. Mr. Brown also tapped into regional rage, arguing that Massachusetts’ citizens have already paid for their own universal coverage. Why should they have to pay for everyone else’s?
     
    So, let’s get this straight: if it’s a state level insurance-based reform spearheaded by and voted for by Caucasian Republicans, it’s OK, but if it’s a national level insurance-based reform spearheaded by a Democratic (and non-Caucasian) President, it’s Communism?
     
    Mr. Brown’s healthcare doublethink does not seem to bother Mr. White, who in a few short but loaded lines expresses the tangle of vicious contradictions poisoning debates about healthcare reform and pretty much any domestic policy.
     
    Mr. White is impressed that Mr. Brown’s mother was on welfare. So I guess receiving welfare—aka “socialist” public assistance—is OK for Caucasian people, especially if their offspring go on to become politicians in a party with a long-standing ideological stance against “the welfare state.” Surely, it’s not Mr. Brown’s mother that South Carolina’s gubernatorial hopeful Andre Bauer had in mind when he likened welfare to feeding stray animals!
     
    Mr. White’s comment goes on to predict that in the Senate Mr. Brown will “work for us: millions of poor working Caucasians.” Is the plight of poor working Caucasians somehow different, and more deserving of public assistance, than the plight of the millions of poor, working non-Caucasians? Is there something in the Obama domestic agenda or in Ted Kennedy’s healthcare advocacy that somehow unfairly disfavors poor Caucasians to the advantage of poor non-Caucasians?
     
    Or is Mr. White implying—without overtly stating it—that any significant advancement of non-Caucasians in this country, symbolized by the election of Barack Obama, is inherently at the expense of Caucasians? If Mr. Obama’s mother had been on welfare, I wonder if Mr. White would have seen that as a reason to “immediately decide to vote” for him. Somehow, I kinda doubt it.
     
    While Mr. White worries about the enemy within, Rick’s Europhobia gives voice to a long-standing American anxiety that “foreigners” are going to destroy all that’s good in this country. The foreigners are, in this case, those limp-wristed socialist Europeans whose asses we saved during WWII, whose cities we rebuilt, but who thanklessly criticize us when we invade Middle Eastern countries, who refuse to plant our corporations’ GMO seed on their farms, and who smugly consider their healthcare systems (to say nothing of their auto designs) superior to ours.
     
    I always get a little nervous when commentators like Rick invoke the Founding Fathers, bearing in mind that many of the gentlemen who signed on to “All Men Are Created Equal” were slave holders. Those who weren’t didn’t seem to have much of an issue with their compatriots denying dark-skinned people their basic human rights, to say nothing of dispossessing the native non-Europeans of their lands. And let’s remember that the “Fathers” were quite literal when they referred to “all men.” Women didn’t win the right to vote until the 1920s!
     
    Perhaps that’s the secret fantasy of “Real Americans” like Rick: to go back to an America where white guys ruled with impunity and could do and say whatever they wanted, blacks did all the heavy lifting for no pay, women (Sarah Palin not withstanding) kept quiet and knew their places, and all those immigrants with funny names and dangerous ideas stayed over in Europe.
     
    But as long as we are on the subject of the Founders, I’m sure they would have quite a bout of heartburn if they saw what’s happening in the nation they started. Somehow, though, I think they’d be much more disturbed by the way entrenched industrial interests have co-opted the democratic process than by President Obama’s allegedly socialist health reform agenda.
     
    Far more profound than the shift in public sentiment signaled by Mr. Brown’s election was the Federal Supreme Court’s historic overruling of earlier laws limiting corporate campaign influence. The Supreme Court’s conservative majority claim they are protecting First Amendment freedom of speech by granting corporate entities the same rights to free political expression—and campaign contributions—as are safeguarded for individuals.
     
    The Supreme Court’s move is precedent-setting, with far-reaching implications. In essence, it disables any limitations on the corporate ability to influence elections. To be fair, the ruling also applies to labor unions. But as powerful as they may be, unions are not likely to outspend Big Oil, Big Pharma, Big Insurance, Big Finance or Big Food anytime soon.
     
    I’d love to know how Messrs. Washington, Jefferson, Franklin, et al would view this move. If the Tea Party crowd really had any sense, they’d be paying much closer attention to that, and sending pink slips to the Bush-appointed justices who supported the reversal. 
     
    But they won’t. Because it’s somehow easier and more comforting to accuse Mr. Obama of being Un-American.
     
    Please don’t misconstrue this as a defense of Obama & Co. They’ve squandered the goodwill of millions of Americans like myself who wanted to believe they represented a fresh approach to governance. They quickly proved that anyone—regardless of race, creed, gender or place of origin—can and will play the functionary for corporate interests. Despite the Right’s insistent blather, there’s little the Obama administration has done in its first year that could even qualify as slightly progressive, let alone revolutionary!
     
    It wouldn’t surprise me in the least if, after obstructing the Obama administration’s domestic agendas and portraying him as some sort of alien “other” for political gain, the Republicans re-take the White House in 2012 on a wave of populist anger…and then proceed to ram through a healthcare reform package that looks like Romney-Care on steroids. (Just out of curiosity, where was all the outcry about “ramming through” when it came to the Homeland Security Act, which truly was rammed through the legislative process?)
     
    My point here is not about the merits or drawbacks of Obama’s or anyone else’s health reform plan. It is about the nasty, veiled racism and xenophobia—the Us vs. Them dynamic—that has tainted the debates. Frankly, it scares me.
     
    What does all this have to do with nutraceuticals or healthcare practitioners? Well, call me idealistic, but I believe our industry—our movement, really—is an example of what’s best about our country. Few industries encompass such a broad range of lifestyles and viewpoints. When I first came into this field 10 years ago, I was astounded by the diversity of people who could come together around key issues of health and wellness. Where else do straight-laced Mormons and dreadlocked neo-pagans find common ground?
     
    The natural/holistic medicine movement represents youth and elders, the religious and the non-believers, the athletic and the ascetic. It somehow embraces people from a dizzying array of traditions, races, ethnic backgrounds, countries of origin and political affiliations, all united in a common if not fully articulated set of values linked to the idea that there’s healing power in nature, and that health is to be found through balance. I believe there’s tremendous power in that…and genuine hope.                                   
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