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Discuss this topic in the Body Politic forum of Post & Riposte.

Previously in Politics & Prose:

  • America, Inc. -- July 1998
    A review of Gain, the new novel by Richard Powers in which the corporation is the shaping force of American history.

  • Do the Right Thing -- June 1998
    Thinking globally -- and acting ethically -- in the new world economic order.

  • The Graveyard of the American Dream -- May 1998
    What's behind California's decline, and what's at stake for the rest of the country.

  • Games of Monopoly -- April 1998
    A look at the tactics of John D. Rockefeller shows that capitalism, like history, repeats itself.

  • The Price of Longevity -- March 1998
    Medicare and what we have to look forward to.

  • The King of Drudge -- February 1998
    A review of a new biography of the man behind the assembly line -- whose ideas need to be acknowledged and abandoned.

  • Color Us Green -- January 1998
    A heretical new approach to economics puts ecology first -- and may change the way we think about growth.

  • The Deep Slumber of Decided Opinion -- December 1997
    Those who hail the virtues of trade without limits are this era's reactionaries.

    More by Jack Beatty in Atlantic Unbound

  • The Dissipation of Decency
    The real political scandal these days is the abandonment of those without health insurance

    by Jack Beatty

    August 19, 1998

    With his presidency now undermined by scandal, Bill Clinton's one chance to make historic change comparable to what F.D.R. did with Social Security and L.B.J. did with civil rights may have come in the summer of 1994. After a year's delay the Democratic Senate was preparing to vote on a version of "Clintoncare" -- guaranteed health insurance for all Americans. Clinton had launched the plan in a major speech to a joint-session of Congress the previous September; the First Lady, heading up a huge staff, had been preparing it since the inauguration in January, and in his address before Congress the President saluted her for her unprecedented work. "When I launched our nation on this journey to reform America's health care system, I knew we needed a talented navigator, someone with a rigorous mind, a steady compass, a caring heart," he said. "Luckily for me, and for our nation, I didn't have to look very far. Over the last eight months, Hillary and those working with her have talked to literally thousands of Americans to understand the strengths and frailties of this system of ours...." Hillary Rodham Clinton, as she then still dared to be known, stood up to a standing ovation.

    The President had begun what Haynes Johnson and David S. Broder, in The System, their 1996 book on the politics of health-care reform, called "a titanic battle affecting the lives of every citizen and a seventh of the U.S. economy, that could define his presidency, restore badly eroded public faith in the political system's ability to serve the people, and redeem a promise more than sixty years in the making to provide universal health care...." By the fall of 1994 Clinton had lost the battle, partly because of a massive advertising campaign -- paid for by the insurance industry, attacking Clintoncare, and featuring the infamous "Harry and Louise" commercials, in which a couple worried that under the new plan government bureaucrats could deny them health care -- and partly because of an all-but monolithic opposition from House and Senate Republicans.

    It all seems to belong to another era now, a time of social hope and political possibility, the high-tide of post-war American liberalism. A defeat for liberalism, yes, and for the Clintons, certainly; but also, and primarily, for the millions of Americans without health insurance.

    In this season of (increasingly anxious) triumphalism about the surging economy, in this season of political deadlock in Washington over modest changes in HMO regulations to protect the already insured, in this season, finally, of bawdy public talk about Clinton's secretions, the Henry J. Kaiser Family Foundation has issued a comprehensive report on a much more important and fitting subject for our public focus.

    Uninsured in America: A Chartbook describes the shameful plight of an estimated 41 million Americans: 18 percent of the nonelderly population, and 10 percent of America's children.

    In 1997, the charts tell us, 32 percent of nonelderly adults had been without health insurance at some time in the previous two years. In 1995 22 million employed Americans, half of them in full-time jobs for the whole year, were uninsured -- and not just because they worked for small business: in businesses with more than 1,000 employees, 20 percent of those earning under $20,000 were uninsured.

    Thirty percent of uninsured adults went without "needed medical care" in 1997, while 25 percent of uninsured children did not receive needed medical, psychiatric, or dental care. Yet 62 percent of those polled believe that the uninsured can get all the care they need.

    We, the insured, are the problem, of course. Our indifference to those who desperately need health care -- the 74 percent of the uninsured with an untreated painful medical condition, the women who forgo mammograms and the men who forgo prostate exams because they cannot afford the daunting uninsured cost of care -- is the problem. We are the people, after all, who let Harry and Louise persuade us that insuring the uninsured would hurt us -- that common decency toward those with the worst jobs in the country, at the expanding bottom of the service economy, was something we could just not afford. There has been an erosion in the national character all right, not toward loose morals but toward an I've-got-mine complacency, a narrowing to our families of who we mean by "us." We have reached an ethical dead end. This is a scandal far worse than anything Bill did with Monica.

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    Body Politic forum of Post & Riposte.

    More by Jack Beatty in Atlantic Unbound

    Jack Beatty is a senior editor at The Atlantic Monthly and the author of The World According to Peter Drucker (1997) and The Rascal King: The Life and Times of James Michael Curley (1992).

    Copyright © 1998 by The Atlantic Monthly Company. All rights reserved.
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