The struggle over what happens to you if you get sick or fall off a ladder in this country is going into overdrive. Pundits and news anchors have hauled out their military field manuals in an effort to convey the intensity of the situation. Efforts to craft health care legislation are now a "battle" in which differing interests are attempting to "out maneuver" one another by "deploying" money and influence in "strategic" places.
A Republican senator, Jim DeMint of South Carolina, went so far as to say that preventing President Obama from enacting health care reform would amount to Obama's Waterloo. "It will break him," DeMint said.
Behind all this rhetorical saber rattling is the oft-asserted claim that health care reform is an incredibly complicated business that's way too hard for most Americans to understand.
This is not true.
The essence of the struggle over health care boils down to this: Is the purpose of our government to serve the people of this country, or not?
For at least two generations, we've been conditioned to believe that government can't do anything right. Ronald Reagan famously said that government wasn't the solution to our troubles, it was the problem -- a pithy remark that set the stage, not as some conservatives would have had it, for the dismantling of government, but for government's makeover as headwaiter to corporate power.
Like a good headwaiter, Reagan made sure that the country's best tables were reserved for its biggest spenders. His response to the deep recession he inherited in the early 1980s was to pour billions of dollars into the coffers of the corporate establishment, creating the largest federal deficit on record to that point.
Rush Limbaugh and Co. would have us believe that Reagan's policies created unparalleled prosperity. And, for some, this was true. But Reagan also used the creation of budget deficits as an excuse to turn government away from spending on programs that served people: education, health and welfare. This was how he placated his base.
You started hearing people talking up the virtues of volunteerism and philanthropy with a new sense of urgency in those days. Homelessness became a visible part of our public consciousness -- an everyday fact of urban life.
Meanwhile, the rich were getting richer. For some people, this has always been the ultimate proof of what this country is all about. "If you're so smart, why ain't you rich?" is an old challenge to anybody with a new idea who lacks the financial clout to make it happen. For many of us, being rich is not only evidence of hard work and good luck, it's proof of an overriding superiority. Reagan's budget director, David Stockman, described his boss' economic policy as "trickle down" economics -- the idea that jobs, investments and opportunities trickled down from the wealthy to everybody else.
This idea -- that the rich are the straw stirring the American cocktail -- has been regarded not only as an article of faith for the better part of the past 30 years, but as the basis of policy by both Republican and Democratic administrations. After all, it was Bill Clinton who ended "welfare as we know it" and broke the final barriers designed to keep banks from becoming too big to fail.
Our reverence for the rich becomes downright weird when it comes to health care. It is well-documented that America has the most expensive health care delivery system in the world. Our hospital stays, treatments and medicines all cost more than they do in other countries. And, in many cases, our outcomes are actually worse.
Health care costs here are so high, they figure prominently in our increasing numbers of personal bankruptcies and home foreclosures. They have crippled major industries. U.S. autoworkers make about $24 an hour more than their Japanese counterparts. But that extra $24 isn't take-home pay. It goes to pay the cost of health care and pensions to autoworker retirees.
In 2010, employers who offer their workers health insurance can expect costs to increase by at least another 9 percent.
Health care has made insurance companies rich. They're seeing huge profits; their CEOs are millionaires several times over. In large part, this is because private health insurers face little or no competition. In Indianapolis, one company, WellPoint, controls 68 percent of the market.
WellPoint and the other businesses that have gotten rich from peoples' misfortune want health care reform to be about them, not us. That's what they're used to from a government that's been run for the benefit of the richest and most powerful for the past 30 years. And that's why they don't want the government to make a public option available. That would give us all a choice in coverage that could drive the cost of health care down and, yes, cut private health insurers' profits. They want this so-called "battle" over health care to seem too complicated to understand.
But it's not. It's about whether government serves them -- or us.