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Health Care for All: Why We Need a New Prescription

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Posted on Oct 1, 2013
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By Scott Tucker

The right-wing assault on Obamacare is a distraction, but the “progressive” (or rather party line) defense of the Affordable Care Act is also a dead end. While the tea party and MoveOn descend to mud wrestling, Dr. Don McCanne of Physicians for a National Health Program is not just staking out the moral high ground in the debate on health care. He is also making the practical case for the kind of health care we, the people, both deserve and can afford.

McCanne quotes passages from the daily news, political debates, and medical journals, and adds his running commentary. These columns are collectively titled Quote of the Day, and can be found archived at the website of PNHP. His columns are also available by email subscription.

McCanne’s daily comments on health care range over both present policies and the possibilities of comprehensive reform. He is helping to build the bridge from here to there, but he is not pointing to some utopian island over the horizon. Medicare, for example, offers one flawed but real foundation for health care justice. We need a single payer system, but we also need a wider network of community health clinics, and health maintenance programs in schools, neighborhoods and workplaces. If we limit our vision of health care reform only to the programs that career politicians deem “pragmatic,” then we are placing their careers above our own lives.

McCanne’s decency and public spirit shine through his work, though he was almost self-effacing when I first asked him to consider an interview. For myself, and many others, McCanne is our translator of choice when we try to orient ourselves in health care policy debates. He received his B.A. at the UC Riverside in 1959 and his M.D. from the UC San Francisco in 1963. He served two years as a medical officer in the U.S. Army, and then practiced as a family physician for more than 30 years in San Clemente, Calif. He has served as chief of staff of his community hospital and as chairman of the board of a community bank. He served as president of PNHP for two terms, in 2002 and 2003, and is currently senior health policy fellow for PNHP. Every good cause involves a division of labor, and McCanne is a daily laborer for health care justice through PNHP and through his public talks and writing.

I first met McCanne during the founding meetings of the Santa Monica chapter of PNHP, and on Sept. 1 of this year my husband and I joined Don McCanne and his wife, Sandy, for lunch at their home in San Juan Capistrano. We had a long talk about public health, private wealth and politics. Don and I continued the conversation by exchanging emails. Our points of disagreement are plain enough, but so is our common ground. We encourage all supporters of health care for all to carry this conversation from kitchen tables to union halls, and from community clinics to public elections.

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My first work in health care activism began as a member of the Reproductive Rights National Network, and continued with the AIDS Coalition to Unleash Power (ACT UP) in Philadelphia. Moving to Los Angeles 10 years ago has taught me new lessons in how the present health care system is both formed and fractured by a class divided society. I was diagnosed HIV positive in 1986, and political activism is one among many reasons for my survival. I have witnessed the malign neglect and direct brutality this political system inflicts on workers, the unemployed, the poor and the ill. In my view, the hope of removing politics from the struggle for health care is like the hope of removing the profit motive from the ruling class.

The fact that doctors are also creatures of our class culture is unsurprising. Unfortunately, some doctors also proved to be slow learners even during an epidemic. In the early years of the AIDS epidemic, patients were often the people who had to educate our own doctors in the Standard of Care. And we also had to teach some doctors “the facts of life,” namely, the facts of our own lives. As for class politics, most doctors never learned any such subject in their classes, and yet medical training and practice carries all the background radiation of a corporate economy. PNHP is therefore in no position to teach health care activists the alphabet of class consciousness. A strictly empirical approach to science and medicine must be fused with resolute opposition to a class divided health care system. That is the true test of translating our common ethics into gaining the common ground of practical health care reform.

On that subject the good doctors in PNHP might listen more closely to their patients. Am I therefore “disenchanted” with PNHP? No, on the contrary, all political enchantment requires the cold shower of reality, and then we will find the work we can do in common. I regard PNHP as a crucial and honorable ally in the struggle for a civilized health care system in this country.

This conversation between one doctor and one writer, both of us active in the reform of our health care system, is not a detailed map of that terrain, and far less a scripture for those looking for a new religion. Any proposals for public policy must, of course, be discussed before the widest public. Within the secular horizon of the public realm, we must not lose our sense of balance and common sense, nor our sense of right and wrong. The right to health care is a human right, but the political will to win that right as a daily fact of life begins with a moral commitment to care for the poor, the sick and the dying, and for all of us without exception.


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