Defund Health Care

The chant “Defund Police” is bouncing off the walls of the buildings next to many demonstrations. They are protesting an unjust, cruel death of a nonviolent black man under the crushing knee of a white cop, while three other uniformed officers stood by. Indeed, the “defund” idea is gaining traction in some city councils, some state houses and even our nations capital. If “defund” means to fundamentally, even radically change, I suggest we take this step with whatever institution is failing us.

I don’t just chant. When I was an elected Idaho State Senator serving on the budget committee, I proposed defunding a broken part of Idaho government. The Commission on Pardons and Parole had been poorly run for decades and we just kept sending them tax dollars. P&P couldn’t keep data that allowed an analysis of their efforts.  They couldn’t publish minutes of their hearings, as required by law. Idaho had a huge backlog of offenders clogging our prisons. I saw their dysfunction as part of a bigger problem, but I had no doubt they were a problem. So, in my second year on the budget committee, after studying their dysfunction, I proposed sending them $0. I got a couple Republicans to vote with me, but no Democrats.

 When you are on the budget committee, you can either vote to give them money, or not. So, I proposed the sledge hammer because I didn’t have a wrench.

If defunding police will change something that’s broken, I can support it. Honestly, I don’t think the police force in my town is dysfunctional or broken, so I don’t really want Boise or Washington DC “fixing” anything. I trust our local government to do the right thing. If you think somethings broken, get to work on it. Usually, sledgehammers don’t fix things.

But if we are going to look around for broken things, why don’t we turn our gaze on one of our biggest, cruelest institutions: health care.

Do I need to convince you of the cruelty? Do you need the data on bankruptcies? Would a graph on the incessant rise in costs stir your emotions? Should I reiterate how much we spend and how poorly we perform? Does the declining life expectancy in this county motivate you that we need a change?

I don’t have a viral video to galvanize your emotions. Maybe that’s my problem.

The medical industrial complex is a huge part of our economic engine chugging away.  Lots of folks make their living in this sector (including me!), and defunding would greatly disrupt. Maybe we should just take a wrench to it, not a sledgehammer.

And that’s, unfortunately, all the Affordable Care Act was; a crescent wrench compromise with the health care insurance industry. All it accomplished was to slightly decrease health care inflation, decrease the number of folks uninsured, and slightly limit the profits of health insurance companies. The cost curve has not really bent downward, as promised, because the cost containment strategies have been undercut by, guess who: our congress.

It seems the wrenching process can be politically fraught. All a politician has to do is scream “Death Panels” and the crowd starts cheering.

The “Medicare for All” proposal that didn’t carry Bernie or Elizabeth to the Democratic presidential nomination isn’t really a sledgehammer either. It looked more like a hot air balloon and most voters saw it as too big. But the health insurance industry saw it as a five-ton wrecking ball breaking loose from its chain.

The calls to “defund” are cries of outrage, a demand for change. I can understand why folks may be focused on police right now, but the mess of our US health care system needs an overhaul, badly. A crescent wrench won’t do it. And right now, we don’t have the courage for a sledgehammer. What tool do you propose?

About ddxdx

A Family physician, former county coroner and former Idaho State Senator
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