Despite having by far the most expensive health care system in the world – double the per capita cost of the next closest nation – “The United States no longer boasts anywhere near the world’s longest life expectancy,” reports this month’s HARVARD Magazine.  “It doesn’t even make the top 40.  In this and many other ways, the richest nation on earth is not the healthiest.” 

But here’s the good news:  “Poor health is not distributed evenly across the population, but concentrated among the disadvantaged.”  

It is, as I’ve been saying for several years, a positively grand time to be rich and powerful in America – which may help to explain why the rich and powerful Republicans can be counted on so reliably to fight health care reform.

Before you reach through the screen to throttle me, let me quickly acknowledge (as the HARVARD article immediately does) that, of course, “disparities in health tend to fall along income lines everywhere: the poor generally get sicker and die sooner than the rich.”  

“But in the United States,” it continues, “the gap between the rich and the poor is far wider than in most other developed democracies, and it is getting wider.”

Not to mention how the inefficiencies in the system sap our economic competitiveness. 

With that in mind, I urge you to read this prescription for reform from THE AMERICAN PROSPECT Magazine.  It begins:

Doctors have historically been the watchdogs of the U.S. medical system, with the American Medical Association scaring New Dealers into dropping national health coverage from the Social Security Act and then the AMA shredding Harry Truman's reform efforts in the late 1940s. But a new poll and other significant indicators suggest that doctors are turning against the health-insurance firms that increasingly dominate American health care.

The latest sign is a poll published recently in the Annals of Internal Medicine showing that 59 percent of U.S. doctors support a "single payer" plan that essentially eliminates the central role of private insurers. Most industrial societies -- including nations as diverse as Taiwan, France, and Canada -- have adopted universal health systems that provide health care to all citizens and permit them free choice of their doctors and hospitals. These plans are typically funded by a mix of general tax revenues and payroll taxes, and essential health-care is administered by nonprofit government agencies rather than private insurers.

The new poll, conducted by Indiana University's Center for Health Policy and Professionalism Research, shows a sharp 10 percent spike in the number of doctors supporting national insurance: 59 percent in 2007 compared to 49 percent five years earlier. . . .

F Do you remember the Mike Nichols / Elaine May skit where Elaine drives home a point triumphantly with the phrase, “And that man’s a doctor!” ?  Well, 59% of American doctors now in effect think Michael Moore – with his documentary, Sicko, last year – was right.

And how might we get change in America?

IN THE FIELD WITH A DOCTOR FOR OBAMA

Last month I ran an account (“In the Field for Obama”) by my young pal and UCLA pediatrics resident Alex Blum, on leave as an Obama Organizing Fellow.

His latest account – cracking a tough nut . . . and meeting Obama:

One of the counties I organize for the Obama Campaign has some very interesting local politics.  The woman who is the local Dem Chairperson is at war with the others in the county party hierarchy.  I had been warned by the soon to be elected state Assemblyman and my field director that the Chairwoman, we'll call her Sarah, is hyper-controlling and "all talk and no action."  Apparently in the recent past, members of the local Democratic leadership had tried unsuccessfully to take away her Chairmanship.

I decided to deal with the Chairwoman head-on; I called her.  Sarah immediately tested me by firing off a number of names of Dem activists in her town and asked if I had talked to them.  Then she paused, "you haven't talked to Russ, have you?" I later learned that she is also at war with Russ (who is the vice chairman). She described how decimated she had been in 2004 by Kerry's lose and at that point needed to act. At that point she had recently retired, she was in her mid sixties, and everyday she went door to door trying to stir up interest in the local Democratic party. She clearly felt proud and without articulating the words, pointed out that she had established the local Democratic community. I got the feeling that she didn't want me to intrude on her turf. I explained the Obama Campaign's philosophy: we will build a lasting grassroots movement. Unlike other campaigns I’ve worked on (congressional campaigns in South Dakota, Ohio, Nevada, and California), this campaign focuses on building strong relationships with community members and working hard to empower them.

This philosophy is based on the social science work of the famous organizer Marshall Ganz. He teaches organizing and leadership at Harvard's Kennedy School of Government and emphasizes the empowerment of people in the community.  We place our focus on developing our own persona narrative, our story, and this is a tool we use to form relationships with community members.  After sharing our story, we ask them theirs.  The other campaigns I have worked on tend to hand you talking points, a list of doors to knock on, or calls to make.  Here we spend little time talking policy.  If we speak openly and put ourselves at risk by telling our very personal story, it will inspire community members to open up about their lives.  Our goal is to identify and befriend like minded people who have not been politically active and have them open their homes and hold house meetings so all their contacts become more involved in the Campaign.

Those that attend house meetings may be inspired to hold their own house meeting and/or become involved in voter registration efforts. The concept is to build a grassroots infrastructure of empowered community members who will become part of a national structure; this network of grassroots, progressive activists will be in place and ready to move in future campaigns (either issue-oriented, which the Obama Administration plans on using, or elections).

But the local Chairwoman had no interest in holding her own house meeting and didn't seem interested to help;  she told me that she would prefer to have a "supervising" role.  I decided to end the conversation as soon as I could by pretending that my wife was calling on the other line.
I got a call a few days later from Sarah; she told me that I was making too many calls to people in her district and that I should "just cool it, Alex."  I brushed her off with a joke and mentioned that in the previous phone call she had complained to me about how lazy the previous Democratic organizers had been.  I finally met her in person at a State Senator's fund raiser.  At this event held in a park, the Senator wore cowboy boots and sang cowboy songs for the crowd as he grilled burgers from cows off his ranch.  I had been at this event not 5 minutes, sitting next to Sarah, when the number 3 person in the local Democratic party walked up to the Chairwoman and said in a loud voice that she was going to hold an emergency meeting to revoke Sarah's chairmanship.  

Though Sarah had been terse and obstinate, it was still difficult to see her embarresed in front of a large crowd. Later that night, after her husband, she, and I left the fundraiser and returned to her home, she explained how she had been at war with others in the local Dem party. Basically they have personality conflicts that are years old; to me they seem stubborn and threatened by each other. I spent the night chatting with her; I explained my story, and she shared her complaints about local small town politics and how she had got involved in the Democratic party. By the end of the night she still would not agree to host a house meeting and mentioned again her desire to help "supervise" others.  I told her that I was interested in approaching those in her community who had not been traditionally involved in politics (for me, this is where the growth of our movement stems from).  She seemed to like the notion of me not contacting her loyalists and helping to build her party. That was last week; after multiple more phone conversations in which we discussed me trying to pull in new community members to be more politically involved, she turned from an obstacle to an ally. Last night, Sarah e-mailed all the Dems on her local e-mail list and described me as "a pediatrician who really cares about changing our country" and encouraged them to meet with me.

On a slightly different note, I worked as an usher last week at a speech Obama made in Colorado Springs about community service.  The speech was great. Afterwards I made my way upstairs; I will admit I may have been hoping to bump into Obama.  I ran into a couple I know that are Latino leaders in Pueblo.  They introduced me to Frederico Pena (former Secretary of Transportation and Energy) and we chatted for a while; I explained to them my story. I could tell that the crowd of 10 - 15 were waiting to meet Obama, because they were well dressed in suits, and kept glancing down the hall anxiously at the Secret Service.

Sure enough, a few minutes later the Secret Service ushered us into a small room. The head of the Colorado Obama Campaign entered the room and started to hit people up for donations; I kept my head down.  A few minutes later, in walked Obama.  We were lined up in a semi crescent greeting line, and he walked down the line stopping to chat with each of us.  I told him my name, how proud I was to meet him.  I briefly explained my story about how I am a Pediatrician volunteering this summer with his organizing fellowship.  He asked me to repeat my name and he said my name back to himself.  He asked if I was enjoying the summer and I told him I’m having a ball!