Once, while serving on the board of my neighborhood pool club, I listened as fellow members discussed facility improvements that absolutely needed to be done and the subsequent dues increase that would be required. The plan was reasonable, responsible, even inevitable, and everyone agreed. The challenge was convincing a reluctant membership that the maintenance of the club, a common good, was worth the sacrifice of higher dues. I suspect I was the only one in the room dumbfounded.
Dumbfounded because among my fellow board members were outspoken opponents of our wicked government, patriots ever ready to raise the sword of freedom to slash spending and fight any tax increase. Yet, when faced with the responsibility to govern, to be good stewards of our club, they sounded like seasoned “tax and spend liberals.”
The experience got me thinking about ways we organize as human beings in society, from roaming around in self-sufficient tribes to subjecting ourselves to autocratic tyrants: a spectrum from relative freedom to its distinct opposite. The middle ground is some version of a representative government like the one we have. We the people. My neighborhood club board—only with 350 million people to govern.
For nearly two years, a whole lot of we the people have been urging our state Legislature to pass Insure Tennessee to extend health insurance to uninsured Tennesseans and to support our hospitals. We have been stymied by opponents who warn it will take away our freedom. Our freedom, they say. It’s an argument I might take more seriously if they would rustle up a few people from somewhere like North Korea to commiserate with them over how un-free they feel having to buy health insurance and car insurance and nobody locks them up for complaining about it. Freedom is just another word for an awful lot of other things, but one matter is certain: You are not “free” if you don’t have access to health care.
Modern health care is accessed in a limited number of ways. It can work as a commodity, like a television: if you can afford it, you can have it. (Proponents of this option insist that the poor can just go to the ER, which is like sending hungry people to Kroger for free food.) It can be consolidated into a system of universal, government-provided health care. Or it can operate as a kind of hybrid between government funding and private insurance, which is what we have.
Insure Tennessee is part of this hybrid and, like Obamacare from which it sprang, it is not perfect—but it does not take away anybody’s freedom. Insure Tennessee is a reasonable, rational way to extend health coverage to some 280,000 uninsured Tennesseans who do not qualify for subsidies. It’s what the people want—64 percent of registered voters, according to the latest Vanderbilt poll—and it’s backed by the Tennessee Chamber of Commerce and our hospitals, who need it to continue taking care of all the patients who show up at their doors. But evidently we’re not going to get it, and the reason given by Lieutenant Gov. Ron Ramsey is: It’s an election year.
He won’t say it, but voting on legislation in an election year is bad because legislators don’t like having anything dicey on their records when they run for re-election—and Insure Tennessee happens to be dicey because Republicans like Ramsey keep screaming that it will take away your freedom. It’s a circular trap they’ve built for themselves: You can’t scream the sky is falling then turn around and say but it’s not so bad.
Ramsey will say that voting this year is imprudent because, who knows, a Republican might be the next president and Obamacare will be repealed and then. And then. Who knows what the Republicans might do, but so far their alternatives would do nothing to help those 280,000 people who need Insure Tennessee or those currently getting subsidies.
I suspect Ramsey’s election-year argument is just one more excuse to hide the real reason we won’t get Insure Tennessee: The most powerful voice in Nashville is not we the people. It’s not even the Republican Party. It’s Americans for Prosperity, the advocacy group founded by Charles and David Koch. I say this because I’ve heard more than one legislator complain about being been bullied by these folks, using the threat of a more conciliatory primary challenger. Do it our way, or else. And why does Americans for Prosperity oppose Insure Tennessee?
Because it can.
Earlier in March, a House sub-committee sent the issue to “summer study” where good ideas tend to die. House Democrats have filed a hail-Mary bill that would require the state to accept the federal funds allocated by the Affordable Care Act and activists have launched a billboard campaign to pressure House Speaker Beth Harwell to bring the bill to a vote, but I’m not holding my breath. Many of us are disappointed, but for those who need it the failure means another year without easy access to health care. That’s both scary and no way run a state.
A lot of people have gathered in rooms like my neighborhood pool club to discuss the health care access problem, and they have concluded that Insure Tennessee is the best solution. Not perfect, just best. But this fight has nothing to do with people sitting in a room, coming up with reasonable solutions, striving to be good stewards of lives and resources. This fight is not even about health care. It’s about power. It’s about ideology trumping governance.
How free does that make you feel?
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