For years my passion had been the struggle for health care reform in Tennessee. I thought everyone who had to go to the doctor ought to be able to. It was really that simple. It seemed like the most obvious justice. I never understood (still don’t) the idea that any legitimate rules would say poor people should die for being poor. I never understood (still don’t) the idea that some people hadn’t earned health care and that they were somehow acceptable casualties. I never understood (still don’t) the idea that a decent people could as a matter of policy and choice leave the more vulnerable of their number behind.
At the beginning it was really I suppose very self centered for us. Gov Bredesen’s rules are going to take away Linda’s health care and I wrote him a letter asking him not to kill my wife. And then we started to meet the people who were to die, the people who could do nothing, the people who had no way to get any help for their suffering. We found a world we didn’t even know existed.
The moment I realized that the state of Tennessee could and would continue to commit health care violence on thousands and thousands of innocent people in the service of some kind of barbaric political agenda was the moment Linda and I both became radicalized in this struggle.
When the battle for expansion started long before there even was an Insure Tennessee we were told that there was no path forward. Tennessee would never cover the uninsured. And then Insure Tennessee happened and what would have been a silly dream not long before seemed to be a real possibility. The impossible seemed possible.
Two crushing years and I don’t know. I have never seen facts be so irrelevant to a political debate and have never seen public opinion so ignored. And now at best maybe the whole thing is on life support. I don’t know.
Speaker Harwell has convened a task force to find an answer based on “conservative principles” (the governor thought he had already done that). Right now it is the only train leaving the station and if it is simply political theater perhaps we are all screwed. People are still dying. Thousands who can no longer wait will possibly be left behind. It sure seems that way.
A lot of people are cautiously optimistic right now. There have been two task force hearings and they have listened to the same people who told them the things people were told about why Insure Tennessee was a good idea. But at least they asked. And I hoped they listened.
One friend told me he thought it was a good idea. He said it gave the Republicans control over something they had lost control of and if there was a way to make it look like their idea maybe they would rush to take credit and something good will happen. A lot of people I know share that hope.
Another friend saw it very differently. He said they were folding the issue of Insure Tennessee into what they saw as the larger issue of Tenn Care. The Republicans never really bought the idea of the urgency of 280,000 uninsured Tennesseans he thought. Their urgency was about a program they thought too big and they never really felt okay about doing one new big thing (Insure Tennessee) while an existing big thing (Tenn Care) was too big to manage effectively. The “pilot programs” the task force has talked about so much are in his eyes about finding a way to bring down Tenn Care costs and not insuring the uninsured. I dont know the answer and at this time don’t know if anyone knows. I think the intent of advocates will be to define the issue as those stuck in the coverage gap in the most intense way possible as the task force meets throughout the state.
One thing does seem to be clear. Whatever their plan it seems apparent it will be small, a pilot program that might take a long time to become statewide. That seems to be a core part of their agenda.
It raises, if it does turn out to be true, a real fundamental issue. If it is seemingly the only political path forward and if, as seems true now, even in the best of circumstances, to focus on far less than everyone in the gap – – if people will be left behind – – how do we respond? Right now every single person I regards the coverage of all 280,000 people as a non negotiable expectation. But the simple truth is that it never made a difference with Insure Tennessee and who is to say the task force will really care what we think. If political reality and moral urgency collide where do we draw the line or should it be redrawn at all? I hope not but I think it might easily be a choice we face.
I hope this train really is leaving the station and I hope it is large enough to take everyone on board. Large enough no one is left behind. Long past time.