Health Center Federal Policy

The Semantics and Reality of Health Reform

By John Sawyer

Since this debate began in earnest during last year’s campaign, I’ve thought a lot about the difference between the words people use to frame it, and what those words suggest about differing goals.  Mainly I’ve focused on the difference between the terms “health care reform” – which suggests we’re reforming the actual, physical “care” that’s delivered, how it’s paid for, etc. – and “health reform”, with its broader implication that legislation may somehow impact the overall health of the country – at the individual, community, and even national levels.

The New Line from the White House
The New Line from the White House

Anyone who’s followed the debate in the last couple of weeks may have noticed another term, now being used almost exclusively by Congressional Democrats and the Obama administration: “health insurance reform.”  In his weekly address last week, President Obama used the term “health insurance reform” three times.  It’s a change that makes health center advocates like me a bit nervous, since our bottom line message is that while vitally important, insurance isn’t enough to guarantee access to “health care”, much less better “health”.  So why the switch?

The truth lies in a basic lesson of politics: that in order to win a fight, it helps to have an enemy.

Up until now, President Obama has focused like a laser beam on an elusive benefit of his health reform plan: controlling costs.  He stresses how this is the key to solving our long-term fiscal crisis, and making families and businesses more secure.  As the plan actually takes shape in Congress, however, real cost control remains very elusive.  Time, then, to change the focus.

House Speaker Nancy Pelosi has distributed talking points to all House Democrats to use during the August recess, entitled “Health Insurance Reform to Hold Insurance Companies Accountable,” focusing on consumer protections in the House proposals, like elimination of coverage denials based on pre-existing conditions.  She has taken to calling the insurance companies “immoral” “villains” in recent days, even though many of the changes called for in the House proposals are part of a grander deal with insurers, who’ve been willing to submit to tighter regulation in exchange for a requirement that all Americans purchase coverage.

What gets lost in the various debates about insurance regulation, runaway costs and the like is the simple, moral case for health reform – that in the wealthiest country in the world, something is fundamentally wrong when millions of people can’t get the care they need.

It’s a moral challenge that health centers across the country have committed themselves to solving, by bringing meaningful, high-quality, affordable care to those patients and communities most in need.  When you see your Member of Congress over the August break, be sure to demonstrate exactly what “health reform” is already happening every day at your health center.

1 Comment

  1. We desperately need health centers in Quincy, Florida. I am a dietitian in private practice. What can I do to help start the process of making that happen? What resources do you have that outline the process of creating a community health center?

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