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I Gotta Tell Ya. with Marc Katz
Since 1776, America has historically been a proving ground for revolutions. The industrial revolution, Civil War, 19th Century inventions, assembly line, labor movement, the Cold War and the ongoing age of computer technology have all been revolutions that transformed America and sometimes changed the world. America is now on the verge of a healthcare revolution, with societal pressures not unlike those that drove earlier revolutions influencing the nationwide healthcare debate. Some facts of our healthcare challenge are straightforward and widely acknowledged. Approximately 47 million Americans are uninsured. Most Americans have, traditionally, relied on employers for health coverage. But health insurance costs have risen steadily, increasing the challenge companies face in providing health insurance to employees while maintaining productivity. Healthcare is shaping up to be a major issue in the 2008 presidential campaign. Major candidates, Clinton and Obama among Democrats, and McCain among Republicans, have proposed healthcare plans aimed at universal coverage. Both federal and state governments have also been working for years to implement health coverage for young people to age 18. A recent New York Times editorial (11/01/07) describes America’s healthcare system as broken and fragmented, citing a recent survey by the Commonwealth Fund, published on the Wed site of Health Affairs, in which one-third of respondents “felt their system is so dysfunctional that it needs to be rebuilt completely.” Americans, the survey states, were more likely than citizens of other comparable nations to go without care because of costs. In addition, American access to “primary care doctors was often rocky” and “the care here was substandard.” While facts tell part of the healthcare story, the mountains of data inundating healthcare deliberations tend to cloud the issue as much as elucidate it. I've often thought that the contributions of business to social change have been largely overlooked in American history. While politicians, intellectuals, artists and reformers have all received due credit, business leaders who supported social movements have been forgotten, like so many Babbitts from the Sinclair Lewis novel. Nonetheless, I propose that business, and the influence and demands of business, have an important, catalytic role to play in resolving America’s healthcare crisis. President Calvin Coolidge, though known more for his silence, once said, “The business of America is business.” When healthcare issues adversely affect American business and productivity, as is now beginning to happen, then America's healthcare system will be put on the road to recovery. Who will put it on that road and how that will happen are yet to be answered. A simple look, however, at past American revolutions offers insight into how a revolution in healthcare might come to pass. I believe that universal access to healthcare is a societal imperative. It’s as inevitable as the American Revolution, abolition of slavery, the Edison light bulb, women’s suffrage, and other movements that took years, even decades, to reach fruition. Though immensely complex and daunting, the idea of healthcare for all has been developing in America since the 1960’s, when Medicare and Medicaid were established. In the last 15 years, healthcare and health insurance have become political issues, topics for media coverage, and a big part of the nation's discussion of its quality of life. The many dimensions of the healthcare issue, viewed as the expression of historical forces, suggest to me that our society, as in other times, is gradually moving toward another revolution—this time in healthcare. Though universal healthcare may still be a dream, it may not be so far from becoming fact. Even if years pass before American business assumes its proper role, as I see it, in healthcare reform, with its aging workforce, pressures from global competition, the drive for productivity and for innovative, creative workers, business will sooner or later push, collectively, for universal healthcare as an essential component, like education, of staying competitive in the world economy. A political solution to healthcare will then follow the lead of business. |
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