Friday, July 31, 2009

The Commons in the Health Care Debate

Although the Commons hasn’t been discussed outright in the health care debate, Commons-based thinking and values have been at the core of proposals and opinions over how to reform the health care system.

The central policy fight is over a government-backed public plan that would compete with private insurers. It may not be as perfect an example of commons-based thinking as universal/single-payer proposals, but the sort of public-private hybrid of maintaining private insurance while adding governmental insurance would represent a leap forward in making health care less of a market good and more a fundamental right that our society collectively contributes to providing for all of us.

Of course, the public plan is strongly opposed by the healthcare industry of drugmakers, hospitals and insurers who have profited from the system as it is now. The profit motive has led the industry to pour $1.4 million each day into lobbying to defeat the public option and $1.1 million into the Blue Dogs’ political action committee, since the Blue Dogs have become the crucial swing vote needed to either pass or block real reform.

Even though the media has lately hyped slipping support for health care reform, recent polls show continued support for treating health care as more of an inclusive Commons, rather than the dysfunctional and exclusive market we have now. According to a Time Magazine poll at the beginning of the week, 63% of Americans support the principle and core value of providing coverage for nearly all Americans, even if the government has to step in to help cover those who can’t afford insurance on their own. And a CBS/New York Times poll from this week also found that more than half of Americans still think that providing health insurance for the uninsured is more important than keeping health care costs down.

These finding won’t turn the policy debate around and don’t necessarily balance the somewhat discouraging trends in the polling on the issue; but the fact that Commons-based values and thinking have so much traction for average Americans is underappreciated. Advocates for a more robust Commons should be heartened by the public’s support for inclusive solutions to the health care crisis. And if the public option does make it through the legislative process, just imagine what the potential could be for generating support for other Commons-based solutions.

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