Brokering dialogue with the Tea Party

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Last week was my spring break from UCLA, and instead of going to a tropical locale with umbrella drinks, I decided to get a jump on earning course credits and learn new skills through taking a class on public mediation.  For those of you not familiar with mediation as a form of dispute resolution, the basic concept is that two parties (referred to as "disputants" in our training course) will agree to meet with a neutral mediator, and the mediator will work to facilitate a dialogue between the disputants to foster an understanding of each other's interests between them.  The mediator will attempt to structure the dialogue so that the disputants can come to a resolution between each other that is mutually agreeable, not a resolution that is imposed by a judge  or arbitrator, as in other dispute resolution approaches.

The key aspects of the mediation strategy are in active listening, where the mediator seeks to give full attention to each disputant to hear their side of the story, and then, through active listening, to discover what each disputant's interests are.  "Interests" in a dispute can range from the purely economic, as in unpaid wages owed a worker, to the purely emotional, as when a person feels disrespected by his/her spouse.  Mediation is an attempt to deal with not only surface-level concerns, such as money issues, but the deeper feelings that may lie underneath those issues that conspire to prevent the disputants from reaching a mutually satisfactory resolution.  In mediation lies the idea that conflicts can be an opportunity for greater understanding and better relationships between individuals, not just power struggles where the winner takes all.

When I entered the class, I figured that I would simply learn some new skills for conflict resolution, skills that would be especially handy for me since I am a person who fears conflict with others.  What I discovered, however, was a new approach towards dialogue and communication, and a new framework through which to view political and policy debates.  By attempting to "hear" the other's concerns - to not judge the other immediately, but to give them an opportunity to feel heard and respected - I found that the disputants would be able to give voice to the feelings underlying their side of the dispute.  Once the two parties' emotions were acknowledged, resolution became more possible.

Since President Obama's inauguration, and especially with the raucous health care reform town hall meetings last August, I have been troubled by the rise of the Tea Party movement in American politics.  Beyond the basic inconsistencies of the Tea Partiers' main messages (if they're so concerned with government spending, where were they during the 8 years of the Bush Administration's unprecedented deficit-spending?  If they're so concerned with increasing taxes, why are they protesting when the Obama Administration just gave tax cuts to 95% of Americans (okay, maybe 92%)?  If they're worried about Big Government, why didn't we hear a peep out of them when President Bush presided over the largest expansion of government since the days of FDR?) I have puzzled over what is uniting all of these generally white, older, lower- to middle-class conservatives in such strident opposition to a government that is seeking to make their lives better.  Are they just mad that "their guy" lost the election?  It's doubtful that such resentment would still sustain such a large movement a year and a half after the election ended.  Are they all just racist?  I have to admit that I've certainly thought and expressed that belief in recent months, but again, it's hard to believe that such a large swath of the population would be motivated solely by racial issues.  No, I believe that race plays a significant role, but it's something more subtle than that.

Yesterday, a classmate forwarded me a link to a post by Steve Benen of Washington Monthly magazine that helped to clear up my thinking on the Tea Partiers and their sympathizers across the country.  Benen discusses a fascinating Dallas Morning News article profiling a family that is suffering under the strain of breast cancer, unemployment, and high out-of-pocket health care expenses; in other words, exactly the kind of family that the health insurance reform bill is intended to help.  But the family opposes the health reform bill, fearing government inefficiency and death panels, which Benen states

...makes the response all the more fascinating. Amy Townsend appears to have heard the right-wing propaganda, and seems inclined to believe it. "Every government program," she told the paper, "none of them work very well." 

The Townsend family is, however, currently getting by on unemployment benefits (a government program), and is holding onto some coverage through COBRA (another government program), which they can afford thanks to federal subsidies (through another government program). 

The point isn't to mock the Townsends or to question their judgment. The point is to appreciate the power of conservative political rhetoric in 2010. Many of those who stand to benefit from a stronger safety net have been led to believe they want a weaker one. Many of those who'll finally be able to get better care under a health care system that's been screwing them over have been convinced that they won't, or can't, benefit from reform.

There's a lot to unpack here.  I have thought a lot about an idea that many Democrats subscribe to (and that Benen represents well here), which is that the GOP convinces people through "rhetoric" or "propaganda" to vote against their own "interests," as if their interests are strictly economic in nature.  It's an essentialist argument on its face, that people can be defined solely by their economic concerns, and it gives credence to the widespread conservative critique of liberal conceit; that liberals believe they "know" another person's interests better than the people themselves do.

My contention is that the Tea Partiers are protesting mainly against the "face" of the government that is supposed to represent them, and the changing of American culture that has been going on for decades, but the evidence of which had been remarkably suppressed by the Bush Administration and its overwhelmingly white male leadership (with the notable exceptions of Condoleeza Rice and Colin Powell, of course).  Now we have not only a black President, but a female Speaker of the House, female Secretary of State, black Attorney General, Asian-American Secretary of Energy, etc.  This is not the government that many Americans are used to, and I think that, while one can call the Tea Partiers' reactions "racism" (and I certainly have!) I have come to believe, as noted above, that it's more subtle than that.  People feel that their government no longer represents them - they can no longer "see themselves" in the government, and they can't trust those "other people" to handle their tax money, help them afford health care, protect them from terrorism, etc.  As noted above, the vast majority of Tea Partiers are conservative and white, and would likely not vote Democratic anyways.  But then watching Fox News increases peoples' levels of fear and distrust by Fox speaking directly to their feelings of being unsettled with the "new order" running the government, and telling them that those feelings are widespread and that people should act on those feelings rather than hearing what the other side actually has to say.

So all this to say that I think that people also have an "interest" in feeling that their government represents them and their interests, and that speaking to their intellects, rather than their gut feelings of disorientation, will not ultimately be very productive for Democrats.  While this family in the article quoted may be going directly against their own economic interests, they are choosing instead to act on their interest in being represented by a government they "recognize," I suppose.  I'm not at all trying to justify the Tea Partiers, and I certainly do believe there is a strong racist element in the Tea Party movement, I've just been trying to imagine what it is that people react to so viscerally, and these last few paragraphs are what I've come up with thus far.

So how does one have a productive dialogue with the other side?  I'm not really sure yet, but through my basic studies of mediation I came to this point in my understanding of the Tea Party movement, and I believe that mediation represents a potentially useful tool for engaging in that dialogue.  How one engages a national dialogue is far beyond me, but I believe that initially at least it comes down to showing respect on an individual level, and an understanding that another's experience of the world is not your own.  So if you encounter a person who holds diametrically opposite views to your own, and there is not a fear of physical violence ensuing between you, I'd say take a moment to really listen to their concerns, you might be surprised what they tell you.

I plan to revisit this topic in future posts, and I'm in the process of formulating a major research project for next year that just might involve mediation...stay tuned.  In the meantime, if you're interested in learning more about the power of engaged dialogue, take a look here.

One more thing about the energy proposal...

President Obama made the announcement that I discussed in my previous post in front of an F/A-18 "Green Hornet", a combat jet that runs on a 50/50 blend of conventional jet fuel and biofuel.  The biofuel that the Hornet runs on is derived from camelina sativa, an oilseed that has been grown primarily in Montana after being brought over from Europe in the 1980s.  Camelina shows great promise as a biodiesel and biojet fuel feedstock, due to the fact that, in contrast to other biofuels such as corn ethanol and soybean biodiesel, camelina does not compete with food crops in its growth, harvesting, and production processes.  For every acre of corn grown to be used as ethanol fuel, that is an acre that is not being devoted to food production.  Multiply that scenario by the thousands of acres currently devoted to corn ethanol production and you have a scenario where the drive for energy is driving up the price of food, which I discussed in a post a bit over a year ago.

Camelina can be grown on "marginal" land, which refers essentially to non-farm-quality land, with minimum fertilizer and irrigation needs, so that the resource intensity of camelina development is far lower than resource-heavy corn production.  Thus, camelina and other second-generation biofuels show the way forward for biofuel development globally, a future where biofuel development is a sustainable enterprise that can coexist easily with food production processes.

I'm personally very excited about sustainable, domestically-produced camelina, due to the great national security risks that importing foreign energy presents to our country, and the fact that first-generation corn ethanol is simply not sustainable over the longer term from either an environmental or economic standpoint.  I produced a Powerpoint presentation and a research paper last fall about camelina that I have now posted on the right-hand column of the blog under "Recent Works," so if you have further interest in learning more about camelina and about biofuels more generally, I encourage you to take a look.

To drill or not to drill, that is the question, baby

President Obama announced a new energy policy proposal yesterday, which appears to have surprised both environmentalists and fossil fuel interests in that the proposal seeks to open vast new areas of US coastline for offshore oil drilling.  The new drilling is combined with new regulations and policies to invest significantly in green energy resources, including new auto regulations mandating higher fuel economy standards of 35.5 miles per gallon across a company's entire fleet of cars and trucks by 2016.

But ultimately, nobody's really paying attention to the higher fuel economy standards, despite the very positive climate benefits those standards will have, when the topic du jour is offshore drilling.  Did the President really just give in to the "drill baby drill" crowd?

Well, I would argue that the answer is yes and no.  The President has just deftly given the Republican party, and its oil and gas interest supporters, enough rope with which to hang themselves, policy-wise.  Take a look at the chart below, helpfully supplied by the NY Times:

Copyright 2009 New York Times

All of the state coastlines that are now opened to new offshore drilling have Republican governors, except for Maryland, Delaware, and North Carolina.  Meanwhile, the areas north of Delaware on the Atlantic side, and all of the Pacific coast will remain off-limits to drilling, with the environmentally sensitive Bristol Bay in Alaska that was opened for exploration by President Bush now closed off for at least seven years.

The way I read it is, if Republicans want to drill so badly then let them, for as others have noted, allowing them to do what they have claimed offshore drilling would do - completely solve America's oil needs indefinitely - will be shown to be false.  Offshore drilling, because it has been anathema to environmentalists, has been built up to mythical status among Republicans, when any responsible politician would admit that there likely won't be enough oil to supply the US for long, and even then, the new oil will not affect gas prices at the pump.  The government lease and exploration process will take years, and then the companies that purchase the leases will need to actually extract and refine the oil, so don't expect any new "homegrown" oil for at least 10 years.

But that scenario only plays out if everything goes smoothly on the political end of things, and when does that ever happen?

Access to oil and gas in South Atlantic waters also would probably meet stiff resistance from the coastal states unless Congress first enacts a plan to share the billions of dollars in potential revenue from lease sales and oil and gas development. And that's not easy.

Lawmakers from coastal states that would benefit have been pushing for that, but some other senators argue that proceeds from oil and gas resources in federal waters should go to the U.S. Treasury.

Here's the thing, the governors will likely take a lot of flak from environmental and concerned citizens' groups from within their states if they agree to allow the offshore drilling, no matter where on the political spectrum they are.  What would help the governors neutralize that criticism is the prospect of increased state revenues from oil and gas development to help their states, but Congress would have to approve those deals.  Politicians never like to give up "free" money coming to their states at the expense of other states, so it would be quite a battle between the interior-state politicians and the coastal-state ones over who receives the proceeds from oil and gas development.  Hmm, divide and conquer, Mr. President?

Then there's the idea that Americans appear to have that any oil that is drilled from US territory by a multinational corporation like Exxon Mobil will automatically be sold in the US.  This is just wrong.  Oil drilled in the US will be shipped to wherever the demand is greatest in the world, just as oil is now.  While the US is currently a major consumer of oil in the world, who is to say that the oil drilled here won't be shipped to China instead?  In a few years the Chinese economy will only have grown further, so it isn't beyond the realm of possibility.

So all in all, what should we take away from these developments?  I believe this report from Kate Sheppard at Mother Jones provides a clue:

Environmentalists are not just angry that Obama is giving away the store on oil and gas drilling, they also feel that he's basing his decision on a dubious premise—that more drilling will enhance the nation's energy security. The US currently imports 57 percent of its oil, according to the Energy Information Administration. The nation accounts for 23 percent of total world oil consumption, but has only 3 percent the world’s oil reserves within its borders. Drilling off every coast in the US won’t resolve that issue. Even the most productive portion of the area opened to drilling, the eastern Gulf, is expected to yield only 3.5 billion barrels of oil. The US consumes 19.5 million barrels of oil per day, which means that these wells would only produce about 180 days worth of oil. And at current global oil prices, recoverable American-produced petroleum isn't likely to be cost-competive. (emphasis added)

Did you catch that?  For any offshore drilling to occur in this country, the oil companies have to actually believe that there is enough oil for them to recover before they make any capital investments.  It's dubious whether a sufficient amount of oil exists in these newly-opened areas to make it worth the oil companies' while to drill.  And therein lies the rub - President Obama just gave the Republicans and oil companies the access to offshore oil wells that they've been clamoring for for years, and now they're going to have to work to roll back Americans' expectations of just how much oil there is within our borders.  Republicans will have to explain to Americans that just because oil companies now can drill offshore, gas prices will not drop back to $1.50/gallon, indeed:

"Where are the Republicans out there talking about how crude is going to go down" when drilling is allowed, "because oil certainly isn't reacting to it today," said Michael Masters, a hedge fund manager who's testified repeatedly before Congress that big inflows of investment dollars are driving up oil prices, not supply shortages. "It's not a supply and demand issue. ... Crude is detached from the fundamentals."

Masters is referring to oil futures markets, where speculators have notoriously been driving up the price of oil for years now, apart from any increase or decrease in production.

So Obama has managed (it appears thus far, anyways) to divide Republicans on oil drilling, while simultaneously putting them on the defensive regarding their previous claims of the amount of oil the US truly has within its borders.  With the Trojan Horse of offshore drilling, Obama managed to slip by the first increase in vehicle mileage standards in nearly 30 years, a move that on any other day would have provoked howls of protest from the Republican side of the aisle.  On balance, it appears that the positive environmental effects of the new vehicle mileage standards regulations may well outweigh the negatives of offshore oil drilling, but Obama was able to distract the other side (and much of the media) from noticing with the shiny, glossy offshore drilling announcement.

And as for the environmentalists, well I noticed a curious coincidence regarding two of the largest environmental organizations, the Sierra Club and Greenpeace, see if you notice a certain similarity:

"Is this President Obama's clean energy plan or Palin's drill baby drill campaign?" quipped Greenpeace Executive Director Phil Radford in a statement on Wednesday.

“Drilling our coasts will do nothing to lower gas prices or create energy independence,” Michael Brune, executive director of the Sierra Club, said in a statement. It will only jeopardize beaches, marine life, and coastal tourist economies, all so the oil industry can make a short-term profit.” (emphases added)

So both Greenpeace and the Sierra Club released statements, indicating that they were notified ahead of time about the drilling plans, and taking a look at their websites (Greenpeace, Sierra Club) there was either no mention of Obama's announcement on the Sierra Club website, or just a rather rote statement from Greenpeace's Executive Director.  If this plan were so terrible, wouldn't the greens be shouting into any TV camera they could find about how terrible it is?  Could it be that they're in cahoots with the President on a strategy to mollify the "drill baby drillers" while the actually environmentally progressive legislation gets passed in the background?  I think that the President and the enviros are betting that in the time it takes for any sort of viable oil drilling operations to get set up offshore, the US would have already begun the transition towards alternative fuels, obviating the need for major drilling operations at massive costs.  Also, the Bristol Bay area that has now reverted back to protected status in the Obama plan was a key sticking point with environmentalists, so it's not as though they lost out entirely.  But then again, I could be totally wrong.  I just find the curiosities of this particular announcement and the context surrounding it too intriguing not to try to suss it out.  Time will tell.

A Public Service Announcement

Speaker Pelosi and President Obama, take a bow
I didn't think I would blog tonight, despite many interesting developments in the political world since Sunday night (did you know that 24% of Republicans think our President could be the Antichrist?)  I strive for substance over filler on this blog, and I didn't feel I could summon the mental energy to write a quality post, but something caught my attention which was just too good not to share.  Following up on Sunday's posting about the health insurance reform bill, I was directed to this fantastic, clearly-defined blog posting from Speaker Pelosi's website detailing further what Americans can immediately expect from the health care bill; there's something for everyone:

(And before you check the posting below, just another note that the health care bill has now jumped in popularity since even last weekend, "By 49%-40%, those polled say it was 'a good thing' rather than a bad one that Congress passed the bill."  Compare that to approximately 45% for/48% against on March 9th, not too shabby.  Now that Americans can stop hearing about the sausage-making that went on for 14 months and can start focusing on what the legislation will actually do for them, these reform measures will only rise in popularity.  Also, Sen. Harry Reid is aiming to have the Senate pass the reconciliation bill on Saturday, which will put the final fixes to the reform bill in place, so we will be officially free and clear of this debate.  Onwards to financial reform!)

Lastly lastly: this photo is just beyond words.

What’s In The Health Reform Bill For You Right Away?

March 23rd, 2010 by Karina

Under the legislative package the House passed on Sunday (the Senate-passed health bill as amended by the reconciliation bill) many key provisions take effect this year - here are some of them:

IF YOU ARE A SMALL BUSINESSES OWNER:

SMALL BUSINESS TAX CREDITS—Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available. Effective beginning for calendar year 2010. (Beginning in 2014, small business tax credits will cover 50 percent of premiums.)

IF YOU ARE A SENIOR:

BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE—Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand-name drugs in the donut hole; also completely closes the donut hole by 2020.)

FREE PREVENTIVE CARE UNDER MEDICARE—Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.

HELP FOR EARLY RETIREES—Creates a temporary re-insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64. Effective 90 days after enactment.

IF YOU HAVE PRIVATE HEALTH INSURANCE:

NO DISCRIMINATION AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS—Prohibits health plans from denying coverage to children with pre-existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to adults as well.)

NO RESCISSIONS—Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.

NO LIFETIME LIMITS ON COVERAGE—Prohibits health plans from placing lifetime caps on coverage. Effective 6 months after enactment.

NO RESTRICTIVE ANNUAL LIMITS ON COVERAGE—Tightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)

FREE PREVENTIVE CARE UNDER NEW PLANS—Requires new private plans to cover preventive services with no co-payments and with preventive services being exempt from deductibles. Effective 6 months after enactment.

NEW, INDEPENDENT APPEALS PROCESS FOR NEW PLANS—Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions. Effective 6 months after enactment.

MORE FOR YOUR PREMIUM DOLLAR—Requires plans to put more of your premiums into your care, and less into profits, CEO pay, etc. This medical loss ratio requires plans in the individual and small group market to spend 80 percent of premiums on medical services, and plans in the large group market to spend 85 percent. Insurers that don’t meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.

NO DISCRIMINATION BASED ON SALARY—Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.

IF YOU DON’T HAVE HEALTH INSURANCE:

IMMEDIATE HELP FOR THE UNINSURED WITH PRE-EXISTING CONDITIONS (INTERIM HIGH-RISK POOL)—Provides immediate access to insurance for Americans who are uninsured because of a pre-existing condition - through a temporary high-risk pool – until the Exchanges up and running in 2014. Effective 90 days after enactment. (Beginning in 2014, health plans are banned from discriminating against all people with pre-existing conditions, so high-risk pools would phase out).

EXTENDING COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE – Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.

GENERAL REFORMS:

COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for nearly doubling the number of patients served over the next 5 years. Effective beginning in fiscal year 2010.

MORE PRIMARY CARE DOCTORS—Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.

HEALTH INSURANCE CONSUMER ASSISTANCE—Provides aid to states to establish offices of health insurance consumer assistance to help consumers file complaints and appeals. Effective beginning in FY 2010.

A NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM—Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.

And in 2014, once the exchanges have formed, more insurance reforms go into effect, including:

NO DISCRIMINATION AGAINST ADULTS WITH PRE-EXISTING CONDITIONS
BAN ON HIGHER PREMIUMS FOR WOMEN
PREMIUMS BASED ON AGE CAN ONLY VARY BY A MAXIMUM OF 3-TO-1 RATIO
CAP ON OUT-OF-POCKET EXPENSES for private health plans

Why I Support The Health Insurance Reform Bill

Speaker of the House Nancy Pelosi

The interminable march towards health care reform (HCR) is continuing in earnest today, with an end finally (FINALLY) in sight.  So what is actually happening right now?  And what's this "reconciliation" business all about?  There's no good way to sum up parliamentary procedures into a bite-size format, so bear with me, as this email will be long.  

Procedural Issues

In brief, the House of Representatives voted today on the HCR bill passed by the Senate in December.  The Senate bill, as you may have heard, includes some rather unsavory deals that were cut in order to win 60 votes and to pass the bill; deals such as the "Cornhusker Kickback" that was negotiated by Sen. Ben Nelson (D-NB) that would provide indefinite federal funding to cover the expected increase in Nebraska's Medicaid costs due to expanding coverage to more people (Medicaid is paid for in part by federal funds and in part by state funds, so any increase in Medicaid costs will cost the states directly).  The Kickback and other deals that were made for specific Senators in specific states to win their votes are obviously not terribly popular with rank-and-file Democrats, and so by the House voting for the Senate bill as it is, they made those Senate deals into law.

However, over the last few weeks President Obama, Nancy Pelosi, Harry Reid, and other key Democrats in both chambers of Congress have worked out a deal to pass a reconciliation bill that "fixes" all of the deals that were passed in the Senate bill and that will work to further reduce the deficit (the Congressional Budget Office, the main non-partisan arbiter of all things budgetary, has stated that the bill will reduce the federal deficit by $140 billion over the first 10 years it is in place and by $1.2 trillion over the second 10 years it's in place, although those numbers are subject to a large amount of skepticism on both sides).  This reconciliation bill will be voted on tonight by the House once the Senate bill is passed by the House, and then that reconciliation bill is supposed to be passed by the Senate, hopefully later this week, although the timing is debatable.  Members of the House are afraid that the Senate will seek to alter the reconciliation bill, upsetting the delicate balance that has been struck between leadership and the members, although Senate leadership has worked to reassure nervous House Democrats that the Senate will pass the bill as-is.  Any changes that are made in the Senate will have to be voted upon again by the House before President Obama can sign the bill, delaying the legislation further, an outcome Democrats are working to avoid.  

So is the use of reconciliation by the Democratic majority "unconstitutional" or a "nuclear" procedure, as Republicans have sought to portray it?  Well, considering that the majority of the uses of reconciliation have come when Republicans were the majority in Congress (16 out of 22 reconciliation bills) it seems a bit rich for Republicans to call it an extraordinary procedure now.

Finally, abortion.  A lot of hay has been made in the last few weeks about whether there is any federal funding of abortion in this HCR bill, and the fact is, there never was any federal money for funding abortions.  There is a provision in the House called the Hyde Amendment, that bans spending federal money on abortions, and the HCR bills that have been debated have always upheld that provision.  It has now been reported that President Obama has issued an Executive Order banning the use of federal money on abortions, as an extra safeguard, so thankfully, this argument is now moot.

Why I Support The Bill

The primary reason that I am in favor of passing this bill, despite the fact that it does not include the most effective cost-saving measures of either a public option or single-payer system, is that the bill enshrines in US law the fundamental concept that health care is a right, not a privilege.  For too long in this country, we have consigned our fellow Americans to suffer from treatable, often preventable illnesses and conditions by claiming that people have the "choice" to buy health insurance if they want it.  Sadly, the reality has never been quite so simple.  Two of the more significant reforms in this bill are those ending the denial of health insurance for those people with pre-existing conditions, and making illegal the use of rescission (where the insurer cancels your health insurance just when you need it most due to a usually dubious claim of "fraud" on your insurance application).  These two revisions alone will help keep far fewer people from going bankrupt due to medical care (click for shocking statistics).  

Consider the fact that if you receive your health insurance through your employer, as the vast majority of Americans do, what will you do if you lose your job?  You will have COBRA coverage for a few months, but generally COBRA is quite expensive, and moreover, it's temporary.  How many of you who are lucky enough to have jobs still are unwilling to leave a job that is no longer satisfying because you are afraid of losing your health insurance?  Is that lack of mobility not an impediment to your freedom?  Does not the health insurance system we have now foreclose upon choices that we would otherwise have if we were assured of health insurance?  Far from reducing our freedom as many opponents of the bill have claimed, this bill will greatly enhance freedom and will enhance job mobility.

For small business owners and entrepreneurs who would like to start out on their own, but are not able to afford exorbitant health insurance costs, this bill provides subsidies for health insurance for their employees.  Whereas the current system has skewed the benefits towards existing companies, and especially towards companies with large employee bases that can be insured under group plans, this bill begins to level the playing field between newer and more-established businesses, and between larger and smaller businesses.  

As a young person, I will be paying for this bill for the rest of my days, and despite that (in fact, because of that) I still support it.  I have faith that the bill will be improved, refined, expanded, and remade in time.  Young people are the linchpins upon which reform depends.  The reason we have coverage mandates in the bill is so that younger, healthier people (who tend not to buy health insurance) will be forced to buy insurance.  Younger people tend to have better health than the not-as-young, and because of that, it is unlikely that a young person will spend as much on health care as they pay in annual premiums.  The idea is that the insurance companies will shift those excess premium dollars (after shaving off a nice profit) to pay for more expensive people's health care, who may have spent more on care than they paid in premiums.  So they need us, which is a reason why the HCR bill has a provision that allows dependent children to be covered under their parents' health insurance plan until they're age 26.  As long as somebody's paying the premiums for their insurance and not costing insurance that much money on care, the insurance companies are happy.

Finally, I support this bill because even if you have insurance and you're happy with it, you already are paying for the uninsured.  In fact, you're paying quite a lot for the uninsured, and it'll only get worse unless something is done.  When a person does not have health insurance and gets sick, they'll probably wait until they're really sick and then go to the emergency room for treatment.  As everyone is surely well aware, emergency room treatment is the most expensive kind, and when patients can't pay the hospitals back for the care they've received, the hospitals then charge insurers more for patients with insurance, which leads to higher premiums for insurance, which more people can't pay, and so they become uninsured...the cycle goes on.  This bill is an attempt to stop that cycle.

It's not perfect by any stretch of the imagination, but this bill is far, far better than the status quo.  For more information, see the two links below, both by the non-partisan Kaiser Family Foundation's Health News:

The Immediate Effects of The Health Reform Bill

A Consumers' Guide to Health Reform