According to one recent poll, healthcare ranks up there in the top concerns of the people of our country as we approach the November Presidential election and prospective voters expect the candidates to address it effectively. What's more, the issue is becoming more and more important to "swing voters" who are considered a decisive factor in the outcome of the balloting. Many of these voters are in the ranks of the increasingly large group of independents; many are young. This probably explains why most of those queried had little complaint about the ability of the healthcare system to meet their needs; at the same time the polling indicated that 75 percent of those questioned are of the opinion that the present set-up does not meet the needs of most other people. Almost 70 percent of those questioned said they are willing to pay more in taxes so that everybody has healthcare coverage. Nearly 7 in 10 respondents go as far as indicating they would be willing to pay more in federal taxes to assure that every American citizen has healthcare coverage.
As a priority concern healthcare ranks behind jobs and the economy. However, as recent events have demonstrated, the three are closely interrelated. Healthcare costs continue to rise, far outstripping the general inflation rate; in our state where the healthcare industry is being concentrated into fewer and fewer hands and into an area for financial speculation, costs are rising faster than in the country as a whole. As this happens, employers who still offer healthcare insurance are shifting more and more of the burden of paying for it onto working people and their families. This was clearly demonstrated in the recent Los Angeles area supermarket strike. Now, emboldened by their success in compelling workers to accept a "two-tier" system of fewer benefits for new hires, the grocery chains are setting the stage for repeat performances all over the country.
The situation is even bleaker for those who are uninsured at their workplaces or unemployed. Even the limited programs to provide healthcare services to the children of low income or jobless, are falling victims to state budget cuts.
We are witnessing an epidemic of economic insecurity, a growing malady that is certain to have an impact on the electoral process - as well it should.
"Millions of middle-class Americans are living from paycheck to paycheck, struggling to pay their bills, having to borrow money and go into debt. Many families are just one layoff or one medical emergency away from going into bankruptcy, U.S. News & World Report Editor-In-Chief Mortimer B. Zuckerman recently wrote. "A silent tidal wave of bankruptcies is now cresting across America's middle class. More people this year will end up bankrupt than will suffer a heart attack or be diagnosed with cancer or graduate from college or file for divorce." ("America's High Anxiety," March 15, 2004).
Zuckerman went on to observe, "Add to this the dramatic increase in healthcare costs, never mind the millions of families forced to take care of a sick relative who has been discharged quicker and sicker from the hospital, and you can appreciate the day-to-day, week-to-week pressures facing middle-class America."
This crisis is very much in the consciousness of the voters, both those who will show up at the polls in November and the many who may not because of a widespread cynicism about the value of voting at all. The latter can be traced to the failure of the electoral process to forthrightly take up and honestly debate the really meaningful issues confronting the nation. It is also the result of the vast sums of money, major corporations, especially in healthcare and pharmaceuticals spend at these moments attempting to ensure that such a dialogue does not take place and that those who are enriching themselves the way things are continue to do so.
The Presidential campaign thus far doesn't look to promising. With the full support of the giants of the healthcare industry, the incumbent administration has unveiled one suspect scheme after another, all of them adding up to anything but relief for working people or anything approaching meaningful healthcare reform. Its promise of prescription drug coverage for seniors produced a meager, jerry-built program that could actually end up increasing the cost of medications for some.
Meanwhile, the idea of universal healthcare coverage for all has been championed only by Ralph Nader in his independent quest for the Presidency, and Al Sharpton and Dennis Kucinich both of whom, while certain not to be the Democratic Party nominee, continue to carry the message.
The question now is whether the issue of healthcare will be forthrightly addressed in the campaign, or will it be swept under the rug accompanied by a few content free sound- bites. I believe that as nurses on the frontline of healthcare delivery who see the crisis up close, we and other healthcare workers should use this moment to insist that candidates - all of them - at the national, state and local levels take a forthright stand for meaningful healthcare reform, universal healthcare with a single standard for all. Its notion that all working people can rally around and it will bring people to the polls.
