Affordable Health Care for All Is Within Grasp Now – If We All Rise to the Moment

President Obama’s speech to a joint session of Congress Wednesday night was a critical turning point in the fight to achieve quality, affordable health care for all Americans. Reform is within reach if we stay involved, work together and make our voices heard over the next few weeks.

The President’s speech came not a moment too soon, after a difficult August dominated by angry town hall protesters and bogus allegations by his right-wing adversaries, coupled with infighting among his progressive allies. Over the last century, several U.S. Presidents before him tried to repair this gap in the social contract. Their failure to meet this clear moral imperative, leaving tens of millions uninsured and tens of millions more at the mercy of capricious and cruel insurance company policies, has left America isolated among the wealthy nations of the world.

In his Presidential campaign, Barack Obama declared, in response to a question during one of his debates with John McCain, that health care was a fundamental human right. Apparently he meant it, since even in the midst of the worst economic downturn in decades, when the conventional wisdom argues against social investments, the President has staked the success of his young Presidency on it.

At The Atlantic Philanthropies, we are doing everything we can to bring about the passage of strong, comprehensive health care reform, resulting in quality affordable coverage for all. We made the decision to do so over a year ago, when it was far from clear who would be the Democratic nominee for President, much less the general election victor. Building on our years of work to promote access to health care in Viet Nam and South Africa, and our steady support for expansion of the State Children’s Health Insurance Program, finally signed into law by President Obama in his first month in office, Atlantic committed $25 million – perhaps the largest advocacy grant made by a foundation in the United States – to Health Care for America Now (HCAN).

In making this grant, we stood on the shoulders of colleague foundations like the Robert Wood Johnson Foundation, the Kaiser Family Foundation, the Commonwealth Fund, the Nathan S. Cummings Foundation, the Public Welfare Foundation, the California Endowment and California Healthcare Foundation, among others, who paved the way through decades of grants for research, communications and advocacy to make this moment possible.

HCAN is an unprecedented coalition of over 1,000 organisations, including many Atlantic grantees, who joined together, fielding organisers in nearly every state, buttressed by aggressive advertising and Congressional advocacy and policy work, to put health care at the top of the national agenda and win it this time, once and for all.

There have been rocky moments in this campaign in recent weeks, but we could not be prouder of this decision and the resources it has made possible for a serious campaign for health care reform. Now that it enters the home stretch, and the President’s leadership has shored up his allies, won over some skeptics, and exposed some of the myths about reform, there is still much critical work to be done.

There is a lot to applaud in the progress that has taken place so far. Many of the groups who killed reform in the past, like physicians and pharmaceutical firms, have come around and with some even standing behind the President’s plan. Four out of five of the Congressional committees with jurisdiction over health care have passed strong bills that reflect both the President’s priorities and the principles of health care reform that HCAN set out over a year ago. For those who have insurance, these steps will address to various degrees discrimination based on gender and age, and against people with pre-existing medical conditions; a ban on insurance companies’ dropping coverage for those who are sick; elimination of extra charges for preventive care that can ward off devastating illness; and closing the gap in Medicare coverage for prescription drugs.

For the nearly 50 million Americans who don’t have insurance, or who have it and fear losing it in the most severe wave of unemployment in decades, the bills create a competitive insurance marketplace of quality, affordable insurance options; tax credits and subsidies to help individuals and businesses afford premiums; and a public health insurance option to offer greater choice and competition.

These are hugely significant steps, but as those following the legislative process know, one more key Senate committee, the Finance Committee, still needs to act, and will likely mark up a bill in the next two weeks. Most attention is focused on whether this committee, and the Senate as a whole, will support the public insurance option that is strongly favoured by the HCAN, the Administration and by a majority of the House of Representatives. That is important, and everyone who supports strong health care reform must continue to press for a meaningful public option.

But with the spotlight on the public option, which is a key element of reform but far from the only one, many have lost sight of the need to make sure insurance for those who don’t have it is truly affordable, and that the benefits offered are adequate. If all Americans will now be required to have health insurance, as most states require car insurance, the price must be well within reach, with strong subsidies for the less well-off, whose household income is at least four times the federal poverty level. In addition, these families must begin to see benefits soon, as economic hard times are causing pain now, not in the distant future.

In the weeks ahead, all of us who support quality, affordable health care for everyone need to make our voices heard in the political process – not by the kind of shouting or disruption which captured attention last month, but by passion channeled into arguments that strengthen reform as much as possible and give political leaders the strength they need to stand up to powerful interests. Go to HCAN’s website, where you’ll find up-to-the-minute information about where the process stands, who needs to hear from you, and what critical decisions about affordability, access and competition require more advocacy.

The next time I write about health care, I hope it is accompanied by a photograph of the President signing a bill that will take its place with other landmark social welfare advances like Social Security and Medicare. Working together and staying the course in the coming weeks, we can make that wish come true.

Gara LaMarche