I have been doing a lot of thinking about the incongruity of supporting MassACT’s health care ballot initiative, and my personal distaste for ballot initiatives in general. I know there’s lots of people who would like to call me hypocritical, especially in light of my opposition to Reilly’s decision to certify the anti-gay ballot initiative, a round-about way to ignore normal amendment procedures and use much lower standards to engender discrimination into the state constitution.
I still stand by my albeit-non-lawyer assertion that Reilly could have chosen either way on the anti gay initiative - certification or rejection - based on different but legal interpretations of the law, and that he chose wrong. Someone pointed out to me that not certifying the anti-gay amendment would set a precident that may in the future affect a ballot initiative I support. Since generally I hate ballot initiatives, that’s not really the issue, anyway.
But back to this health care initiative, and why I generally hate them but support this one. I remember back when I first moved here and registered to vote, on the ballot that year was the English-immersion inititive, a binding law that changed the way our schools taught non-English-speaking students.
I felt at the time, that even with the voter education packet sent to us by the state, with arguments for and against in the news and in that packet, I was not qualified to decide this issue. I was not a teacher, or educator, or non-English-speaker and would not even be affected personally by this law. Moreover, I thought that most voters in the state were equally unqualified. And in any given election, there seems to be more and more ballot initiatives. How am I supposed to get myself educated on each one, and feel I made the right choice for this state? We are all busy people, and this is the reason we have a representative democracy - in theory, we vote in someone who will look out for our interests and the interests of the state. They form committees and become highly educated about a particular aspect of governance. If they do a bad job, we vote them out. It’s not my job as a voter to know the nuances or understand every consequence of every law the Commonwealth passes. It would be an impossible job anyway!
I ended up skipping that line on the ballot, believing then as I do now that I’d rather not feel responsible for consequences when I don’t understand the underlying issue.
Now we come to the health care ballot. Sorta. Hang with me here.
When California Governor Gray Davis was recalled, the rest of the country found the process pretty ridiculous. If people were unhappy with him, they had an election coming up where they could vote him out of office. Instead, a man whose agenda was pretty well-known spent millions pulling the recall in the forefront, and millions were spent opposing the recall. Then millions again were spent by the people running to replace Davis. There’s already a process in place to recall politicians - it’s called an election, and for really bad eggs, impeachment. California’s rather loose recall laws are just silly.
However, they are the law. Everything that was done against Davis was, ostensibly, legal. These were the tools in the Republican arsenal - but they are also available to Democrats should they want to play the same game. Schwarzenegger, too, could face a recall (not that anyone’s pushing one) instead of an uphill battle to be replaced at the next election (which I hope he is).
Just because a legal tool is silly and prone to abuse, doesn’t mean the other side shouldn’t consider using it when the needs warrant. I’d like to see stricter rules on ballot initiatives - for instance, closing this loophole allowing a constitutional amendment a lower bar for passage, or these binding initiatives that change the laws of the Commonwealth whether or not their consequences have been studied.
But this health care crisis, something that was a crisis over ten years ago when the federal government refused to do anything about it, which has gotten worse every year, is killing people. That’s right, people are dying because our health care system (if you can even call it that - Charlie mentioned it’s more like patchwork) is not adequate. We have the richest country in the world (or so I am told) and yet we can’t even deliver half-assed quality medicine to our own underprivileged - or even middle class. And not one politician currently in office seems to be brave enough to cry out, “Stop! We have to do something, something courageous and bold and substantial!”
This ballot initiative might fix some of the problems on its own - it has some pretty sensible things in it. But the real purpose of this tool, this initiative, is to give the citizens of Massachusetts the chance to engage their politicians directly. To tell them to stop, and do something courageous and bold…and substantial.
That is why I’m supporting this MassACT ballot initiative.
September 21st, 2005 at 7:34 am
Hey lynn, excellent analysis. I’m a member of Workman’s Circle, one of the groups that will be supporting this Mass Act ballot initiative and collecting signatures. I agree with you completely on all points. I also look on this as an occasion to do grass roots organizing–to talk to lots and lots of people about health care and how they understand their situation, and to educate people about the options that other countries have used. Many people simply accept as ‘natural’ the idea that their “insurance” is not really insurance, that it should be employer based, that other people should not be covered at all. When you can really start talking to them about what is available in other countries, and how it is paid for, you can start to help them see that they need to be politically active on this issue. The politicians won’t lead until their constituents demand it. At any rate, that is why I’m doing this.
Kate G.
September 21st, 2005 at 10:14 am
Hi Kate and welcome! Thanks so much. I’m glad to see this issue taking off with so many different groups - churches, unions, businesses, community orgs…this is an issue that affects us all, and we all should be working towards a solution.
I come from a conservative family. My dad is from Quebec, and is notoriously against the social health care system they have - he spouts all sorts of anecdotal evidence of waiting lists, what have you. However, he’s increasingly unable to afford health care premiums (he’s self-employed), and as the breadwinner in our family, struggled throughout our childhood with this…switching from plan to plan, always shopping around for the best price, because the increases in cost were so huge. He also watched me as an adult, his oldest child, struggle without health care for 6 years. Yet he still clings to his “private sector does best” idea.
That’s the sort of stubborness we’re up against. If we could get a viable single-payer system in MA, we could prove to the naysayers that we can have cheaper, better quality health care for all citizens, no matter what their employers do. And we can take the burden directly off of businesses and make them more competative with their counterparts in other industrialized nations.
September 22nd, 2005 at 12:37 pm
I wish I had a good answer, but this health care problem has been around some time and no one has really come up with a good solution.
UK has a universal system, but I understand it is poor on preventative care, and required care is sometimes rationed as the need for care exceeds the supply of care.
I have a general aversion to taxing work, whether it be the federal or state income tax, the social security/medicare payroll taxes or a mandated health care “tax”. I would much rather tax consumption (sales taxes, such as the proposed added cigarette tax). My reasons are that the current system of taxing work a) penalizes workers (low/middle income that pay all of the above) compared to investors (mostly rich who pay only capital gains tax) and b) puts US based companies at a disadvantage to foreign based companies. So the source of funds for any single payer system would have to be defined, and be such that it did not exacerbate the penalties on work.
Am I correct in assuming that the single payer system is a government-run program like Medicare? If so, it may avoid some of the costs that currently go to the insurance companies, but it would like suffer from the lack of administrative controls that currently plague the Medicare system.
September 23rd, 2005 at 11:41 am
I suggest reading this very recent post by sco - he links to an article talking about the UK’s problems and how come they aren’t inevitable.
Personally, even the UK is more efficient at delivery over all on average than our system…the most ineffcient in the world.
And I say, tax businesses. They are social institutions as well as financial ones. If everyone is taxed fairly (ie - no stupid loopholes, and at a decent but not overburdensome rate), then the playing field is fair. Remember, taxes for businesses are assessed on profit, not incoming money. I think it’s fair to tax profit (so long as one company can’t get away with using a loophole to not pay and the other one can’t).
Progressive income taxes (ie proportionately higher the more you make) are very successful at also creating a more fair playing field. Consumption taxes hit everyone - poor pay them as well as rich, and it hits them harder - but an income tax can be structured to be less burdensome on the poor.
If I ever become a rich millionaire and complain about being taxed, I would like someone to kick me in the head. It is much easier to go upwards income when you already make a lot. Therefore, taxing that upper income bracket doesn’t really hurt them (they can easily pay for food, shelter, education, etc) but you can use that tax to then help the bottom end have a better chance of moving up themselves.
September 23rd, 2005 at 11:43 am
RE “the most ineffcient in the world” I should qualify - the most ineffcient in the first world of industrialized nations.
September 23rd, 2005 at 5:47 pm
It appears we have a point of contention on taxes, but I understand your position, Lynne. Consumption taxes can be structured to be somewhat progressive through rebates (see fairtax.org), while income taxes can be very regressive (capital gains @ 15%, whereas marginal rate of middle income payers is 32.65%, or 40.3% if self-employed). In any case, that is another subject.
The article on UK health care makes a good point. It is not the single-payer that creates the “under-care”, but the level of commitment. It would work here, as long as we had our priorities straight. However, I’m not sure the federal government (this administration) would have our interests before those of the big corporations (drug companies).
July 10th, 2006 at 12:51 pm
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