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Not Half a Loaf – a broken machine

We all know about the critical negotiations going on now and how hard it is to discern what is really happening behind close doors. So what can we outside the doors be doing? Badgering Congresspeople and giving money, to be sure, but also contributing to the debate. Much as I love data and logic, we of the wonk-i-verse fail when we make normal people’s eyes glaze over. We need reason and logic, we need to work the machinery, we need bargaining, flattery, threats. We need soaring rhetoric. But we also need clear and compelling narrative about why people should care. Here is my small contribution, trying to make the point about why normal people should sweat the details of what happens with the public option. If you agree, please spread this meme (originally a letter to the Boston Globe):

The specifics of health care legislation being hammered out now in the House and Senate will determine whether we get real reform or something worse than nothing. In particular, if the final bill compels people to buy health insurance (the individual mandate) but does not create real competition for private insurers (a robust public option), it will impose a severe financial burden upon ordinary people struggling to afford health coverage. It will also be a huge windfall for the very corporations that have been a big part of the problem. It is important that we change a misleading analogy: This is not a case where we are arguing over whether to settle for half a loaf. Instead, the legislation is like a machine where if the parts do not balance, the end result will be ruinously expensive to operate, fail to do its job, and injure the very people who need to use it. The next few weeks are critical and the outcome still very uncertain. Now is the time for people to push back against the millions of dollars in lobbyist money trying desperately to stick us with a broken (but very profitable) machine. Everyone who cares about this -and that should be all of us- should contact their representatives and urge them to vote against any bill with a mandate but no effective public option.

Robin Colgrove, MD
Attending Physician in Infectious Diseases, Mt. Auburn Hospital, Cambridge MA
Instructor in Microbiology and Molecular Genetics, Harvard Medical School, Boston MA

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