Health Care Reform’s Success Depends on You

All agree that the health care reform accomplished this week is sweeping, sprawling, and significant. But will it be successful? That depends on us — collectively and individually.
The great unknown variable in the formula is how you and I and our working-age children will react to the “new normal.” Government-guaranteed health insurance provides a new safety net for working Americans, but what will we do with the net? Will we take new risks because the downside is not so far down, or will this new protection dissuade us from our ambitions?
Has Congress created a new New Deal that builds worker pride and productivity, propelling our society forward? Or will it resemble the unreformed welfare system that transmitted a culture of dependency across generations?
We’ll soon find out.
Think about that middle manager on a middle floor of the U.S. Bank Building who hates his boss and knows his prospects there will never match his ambitions. He’d like to quit, but he hears a clicking sound near his left knee when he walks too quickly down stairs. He’s pretty sure some medical catastrophes lurk in his future, and corporate employment has been the only safeguard against those becoming financial catastrophes.
So he makes do, stays busy, keeps his head down. He’s not been creating wealth for himself, his company or his customers for a long time. He’s been stalling.
He’d really like to start his own company, maybe someday to compete with that good-for-nothing in the corner office. His brother’s situation is no different. He has an eight-year-old with asthma, so that invention in his garage just sits there. He has no time to perfect it after a full day at his office job. Both brothers would love to brag at Thanksgivings about their business ventures, but instead they’re trapped in dead-end corporate jobs. “Give ‘em eight, and hit the gate.”
Will these brothers now take chances they felt they couldn’t take before?
Or consider the waiter at a restaurant on 13th Avenue. He graduated two years ago with a degree in anthropology. He soured on the field, but it was too late to change majors. He finished up, got a couple of job interviews, but nothing panned out. Moving back to Medford is not an option. His parents dislike facial hair and they bug him about his teeth. He’s getting by just fine. He pulls just a few shifts each week at the restaurant, but he gets food stamps, gave his car back to the bank, and finally has time to relax.
As he and his friends say, “it’s all good.” Except his vision does this weird thing once in a while. When he looks far to the right, he can get a wicked headache and almost lose his balance. He nearly blacked out once, so his friend took him to the emergency room. But the doctors couldn’t replicate the trauma, so they sent him home. Now he’ll be able to get what that nice nurse said he really needed: regular check-ups with his own primary care physician.
Will this waiter decide now that following his bliss can be prolonged indefinitely?
If more Americans take more risks, some will create wealth for themselves and the nation, keeping this new government expenditure sustainable. But if we use the new safeguards to become complacent, our nation will slide into deeper debt and lose its stature in the world.
We’ve heard for the past year how the crafting of this legislation resembles the work done in a sausage factory — an ugly reality disconnected from its tasty outcome. I think the safety net itself is the better metaphor to understand both the process and its product.
A new net has been painstakingly woven for the American people. Each knot was a compromise. Plenty of holes remain. This week that net got staked into the ground, when it became the law of the land. There will be a new cushion between the American worker and the hard reality of medically induced financial ruin.
Now comes the question. Will we become more a nation of trapeze artists or hammock nappers?
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Don Kahle (fridays@dksez.com) writes a weekly column for The Register-Guard and blogs