• Massive persistence
    December 04,2013
     

    The Obama administration ought to keep in mind that a campaign of “massive resistance” must be overcome by a comparable campaign of “massive persistence.”

    Opponents of the Affordable Care Act continue to mount court challenges and pursue other means of undermining the health care law, even as hundreds of thousands of Americans are finding their way to the websites that will help them obtain satisfactory health care for the first time.

    There is precedent for the desperate, rear-guard battle like the one we are seeing in opposition to the health care law. It came in the 1950s and 1960s in the campaign of massive resistance against the civil rights of African-Americans.

    History tells us that Brown v. Board of Education was the landmark case requiring the racial integration of America’s public schools. And yet the ruling, one of the principal victories of the civil rights movement, did not lead to instant integration. Instead resistance continued for many years and took many forms.

    In Virginia, the state government closed down all public schools entirely for months. In Little Rock, Ark., President Eisenhower called out the National Guard to integrate Little Rock schools. President Kennedy sent in the military to integrate the universities of Alabama and Mississippi. In many places white children fled the public schools when their parents established new private schools where integration could be avoided.

    The cause of health care for all is not an exact parallel to the cause of equal rights, but the Affordable Care Act has received the blessing of the Supreme Court, and it is the law of the land. Massive resistance is continuing for a variety of reasons, but as with civil rights, it ought not to be allowed to undermine the historic human rights gain promised by the law.

    Stories like one in The New York Times on Tuesday point to an important question in the health care debate. Preposterous overcharges in many segments of the health care industry channel billions of dollars into the system to pay exorbitant hospital charges ($2,000 for three stitches; $1,696 for a dab of skin glue) and for medications and medical devices for which there are no price controls. Medications and devices in the United States cost many times what they cost in Europe. The question with regard to out-of-control costs is: Who gets all the money?

    Hospital and insurance executives make huge salaries. Pharmaceutical companies enjoy huge profits. In many places physicians, especially in the lucrative specialties, have enormous incomes. The world of corporate medicine is flush, and keeping those profits untouched is one aim of those opposed to Obamacare. Arguments about states’ rights and the meddlesome intrusion of the federal government are really a cover for efforts to protect the economic interests of the medical establishment.

    Getting costs under control is one aim of the Affordable Care Act, and it appears to be working. The escalation of health care costs has already begun to slow, which means that Obamacare’s cost projections are growing more favorable. Further, people who had no access to health care are signing up in many states, and access to health care, website problems notwithstanding, is improving.

    Massive resistance to health care reform is likely to erode more quickly than resistance to civil rights did, as long as the system is up and running in a reasonable amount of time. It will be hard to make the case that people should be forced to give up their health care.

    Advocates of health care reform have promoted the idea that health care is a human right, suggesting a parallel to the advance of civil rights. Indeed, Medicare and Social Security have gained acceptance as fundamental to the well-being of the elderly. Nevertheless, the nation has not coalesced around the idea that everyone has a fundamental right to the basic elements of human security — food, shelter, education, health care. An important strain in American thinking is that we are on our own, and it’s up to each of us to provide for ourselves. And yet another strain is that we don’t let our neighbor starve, we don’t let them suffer from illness in neglect.

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