The vote is over. The Senate bill has been passed. Millions of Americans who previously did not have access to affordable healthcare coverage will now be covered. As the 51st vote was tallied in the Senate I wanted to be happy, to be celebratory, to feel exultation and relief. But I just can't. As so many supporters of this bill have argued, truthfully and eloquently, this bill is a deliverance for millions of people, for whom I'm genuinely happy. But my thoughts right now are with the millions who will remain uncovered, and the millions more who, though now covered, continue to face the grave prospect of being driven into destitution and financial desperation merely because they've become ill. It somehow seems unseemly to celebrate while so many remain so vulnerable.
We remain the only country among our peers for whom healthcare is not a right. And despite the differences among us on this bill, I think there is an overwhelming consensus in this community that healthcare is indeed a right, a right no less precious and basic than the civil rights our predecessors in the progressive community fought to hard to secure in the 1950's and 1960's. I ask myself, how would I have felt if the civil rights and voting rights bills of the '60s had vindicated the constitutional rights of millions but left millions of others still subject to the indignity of state-sanctioned racism? Would have I hailed this deliverance as a "step in the right direction"? Would I have embraced these new civil rights laws despite their manifest deficiencies while promising to "fix the problems later"?
All of us, except the extremely wealthy, continue to be threatened with financial ruin as a consequence of illness. I recently saw a terrifying glimpse of the crushing psychological and emotional burden of being faced with financial ruin at the same time one is battling a terminal or disabling illness. I recently lost a dear friend to leukemia. He was 51 years old. He was affluent. Before he and his wife started having children five years ago we enjoyed annuals vacations together in Europe. He had a health insurance plan that was, by U.S. standards, generous. But after 18 months of battling this terrible disease, after his disability coverage had lapsed, after incurring the costs of deductibles and copays for the drugs and treatments that were keeping him alive, he was facing a desperate financial situation.
This was the strongest and bravest man I've ever known, one who never shed a tear for himself over his illness. At the end he faced death with towering dignity and strength. There were only two times I saw him weep: when talking about the love and support he had received from his family and friends, and when discussing his fears that his illness would leave his wife and children in desperate financial straits. I learned something that I may have previously understood in the abstract but couldn't fully comprehend: confronting a grave disease and looming mortality is the greatest battle any of us will ever face, and it is unconscionable that we expect so many of our fellow citizens to do so while simultaneously fighting a rearguard action against financial ruin.
These are the sobering realities. Universal healthcare, a given in every other developed nation, remains a distant dream here in the U.S. The only proposals that promised truly universal coverage were never even seriously considered in Congress. The corrupt and immoral private health insurance industry waged a battle against universal healthcare and won, easily and overwhelmingly. The hopes and ardor of tens of millions of universal healthcare supporters were routed by an army of lobbyists and influence peddlers.
As Churchill said of Dunkirk, "we must be careful not to assign to this deliverance the attributes of victory." We may have avoided a crushing defeat and lived to fight another day, an achievement I do not mean to minimize, but this is not victory. Not even close.