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Sunday, June 14, 2009

Washington D.C., Eventually, Got Baseball Back -- So Maybe There’s Hope for Universal Healthcare, Too

The healthcare reform issue reminds me a bit of the extended saga of efforts to bring major-league baseball back to Washington D.C. after the Senators left in the early 1970s.

The acquisition of the Montreal Expos to become the Washington Nationals came together rather quickly. But before that, fans in the Washington Metro area waited decades to once again have their own team, suffering through several episodes of having their hopes built up only to be dashed, through such failures as attempts to move the San Diego Padres to D.C. During these years many fans gave up hope of ever having a true home team to root for.

And as the lines between the Washington and Baltimore metropolitan areas began to blur, with many residents having come to think of the two regions as one combined metropolis, the Orioles became so much of an adopted home team among Washingtonians that many fans and sports commentators came to feel that there was no longer a need for D.C. to have its own franchise.

The quest for universal healthcare in the United States is similar in many ways, in terms of its chronology and of a series of raised and dashed hopes. Washington lost the Senators in the 1970s, the same decade that Sen. Edward Kennedy (D-MA) emerged as the highest-profile advocate for national health insurance. But Kennedy’s efforts in the 70s came to naught, as did the efforts during the same decade get the Padres.

During the Reagan 80s, with the ascendancy of HMOs and other managed care models, the nation seemed to collectively buy into the notion that the private sector was best equipped to provide healthcare. Meanwhile the Orioles during the 80s succeeded in adding more and more Washingtonians to their fan base, and baseball fans in the D.C. area became increasingly complacent about the issue.

And as Washington dragged on through the next decade without a baseball team, a Democratic administration suffered perhaps its second biggest political embarrassment, with the failure of the healthcare reform effort delegated to Hillary Clinton by her husband. I don’t think I need to mention what the first biggest embarrassment of that administration was, but I’ll offer a hint for the clueless that it had something to do with a sartorial item, blue in color, and cigars.

Yet just when so many Washingtonians had become comfortable thinking of the Orioles as their team, and had come to view Waiting for Baseball in Washington as being just as absurd as Waiting for Godot, suddenly the Montreal Expos were the Washington Nationals. And just as the solution to the D.C. baseball problem came from north of the border, President Obama has suggested that, if we were starting a healthcare system from scratch, the best solution just might look like the kind of government operated, single-payer system we see in Canada and most other modern, industrialized nations.

But the practical reality is that we’re not starting from scratch. With a system, flawed as it may be, of private insurers and managed care organizations so firmly entrenched, it’s hard not to be just as much of a cynic about universal healthcare as one might once have been about Washington baseball, especially when confronted with indications of just how much money and power seem to be weighing the political and legislative processes toward the status quo.

President Obama has already said that the single-payer option is not on the table, and if one is to believe a caller to NPR’s Diane Rehm show on June 12, Sen. Max Baucus (D-MT), who chairs the Senate Finance Committee, has been making every effort to keep the voice of the single-payer advocate out of the dialogue.

Identifying himself as a physician, the caller claimed to be among the single-payer advocates whose requests to participate in the Finance Committee’s roundtable sessions on healthcare reform were refused, and who were arrested on order of Sen. Baucus for disrupting two of the sessions. The caller also claimed that the effort to silence the voice of single-payer advocates stems from a heavy influence on Baucus and other lawmakers of powerful and well-funded lobbies in the healthcare industry with an interest in thwarting efforts to establish a government-operated program.

Baucus’s side of the story is represented in a report from NPR’s Julie Rovner, aired May 22 on Morning Edition. In Rovner’s report, Baucus comes across very much as a realist and pragmatist, making an effort to get something passed that will be at least a step toward positive change.

"It just can't pass, not today," Baucus said of the single-payer issue, adding that "we can't squander this opportunity. We can't waste capital on something that's impossible."

Regardless of the veracity of the caller’s allegations about Baucus’s ties to the industry, Baucus, in practical terms, is probably correct. For those of us who accept the premise that corporations such as GM and AIG were too big to fail, it would seem difficult to argue that the private healthcare industry is not too big to demolish for the sake of starting from scratch.

And, as has been pointed out frequently in the ongoing dialogue on healthcare reform, it is true that a significant proportion of Americans do have coverage that they are satisfied with. So it would be unfair to pull that coverage out from under them.

This argument almost certainly still holds true even though the number of Americans in that category has probably diminished somewhat over the past year. For example, 55-year-olds who, after having successfully clawed their way into what they thought were comfortable and secure middle management gigs with good benefits, only to now find themselves with neither jobs nor healthcare, may be far less inclined to display “Have You Hugged Your HMO Today?” bumper stickers than they would have 25 years ago as thirtysomething yuppies during the Reagan 80s.

Nevertheless, it does seem, for now, that even though Washington D.C. was ready for the Expos to swoop down from Canada and become the Nationals, it looks like political Washington -- arguably for good reason -- isn’t yet ready to bring the Canadian “Medicare for All” model down to be the national healthcare solution.

But there appears to be hope that we are no longer going through the exercise in absurdity of Waiting for Godot. We can’t afford to go back to the drawing board, but it looks like there’s a good chance of getting a decent level of coverage for the uninsured and creating some viable and affordable alternatives for those who lack or are not satisfied with coverage at work.

And accomplishing that, sports fans, might not be a home run, but it would be at least a solid base hit. Sphere: Related Content

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