It’s been a rough week for democracy and genuine healthcare reform.
The Senate revealed itself to be a deeply flawed institution better suited to sausage making than democratic deliberation. The doling out of party favors has resulted in a historic but watered down bill to expand healthcare coverage to 30 million more Americans. Widely shared reform goals–a public option, Medicare expansion–have been killed off by turncoat Senators like Joe Lieberman and Ben Nelson, an anti-democratic filibuster, and a White House unwilling to lead more boldly.
But step back for a moment and look at how a few Senators have worked to leaven this flawed bill–adding some decent and humane measures.
Without fanfare, the good Senator from Vermont, Bernie Sanders, has continued to work behind the scenes to champion community health centers–something he has done for years (also here). These non-profit, community-based facilities provide primary healthcare, dental care, mental health services, and low-cost prescription drugs on a sliding scale. As amendments were added in recent days to win over the Liebermans and Nelsons of the "greatest [undemocratic] deliberative body" in the world, Sanders made sure that a $10 billion increase in funding for the health centers was included.
"This is not gonna solve all the problems of the world," Senator Sanders told me yesterday. "But expanding access to high quality primary healthcare, and low-cost prescription drugs, and mental health counseling, and dental care–which is a big issue–this is a very significant step forward. If you walk into a health clinic and you have no insurance at all they will treat you on a sliding scale basis. So, that’s affordable healthcare."
There has also been little news coverage of Sanders’ fight to allow states waivers so they can move forward with their own "health insurance concepts, including single-payer." Such language is now in the Senate bill and Sanders is still working with Senator Ron Wyden to strengthen it. That is exactly how Canada developed its healthcare system, with a successful program incubated in Saskatchewan. This provision is actually stronger in the Senate bill–it didn’t make it into the House version.