As my plane takes off from Washington, D.C., monuments dot the landscape below me. The Capitol stands tall, overlooking the city, a commanding symbol of a government that is truly of, by, and for the people. What happens under its roof permeates our nation's capital city. What is discussed on the floor of the legislature is then discussed and overheard at dinners, in the streets, and on the train. It is people's livelihood, their hobby, their interest.
As my plane flies farther west, the landscape changes. There is more green space, which later turns to brown terrain. Every now and again you see a house.
The people in these houses are obviously talking about healthcare, just as people in Washington are. After all, what happens in the legislature has an enormous impact on their lives.
But out here, far outside of the Washington beltway, the conversation is different. People are not talking about the different legislative options. They are not discussing the public option versus a co-op plan. Outside the beltway, the healthcare discussion is binary: government intervention or not?
This conversation has been more than apparent in town hall meetings, which have been volatile not among people supporting different government options, but between those who support any degree of government intervention and those who feel that they can get along just fine without the government's help. Why is this so hard for Washingtonians to see?
In Washington, the federal government is what people live and breathe. It is hard for people here, especially lawmakers, to imagine a place where dinner conversation is not dominated by politics. A place where, instead, dinner conversation is dominated by concern over the well-being of the family, by the bills that have to be paid, and by the everyday stresses of life.
Outside of Washington, interactions with the federal government are far less frequent, and the local government is what really affects people's lives. Where people do interact with the federal government, their experience is usually negative -- making it understandable that they have doubts about government intrusion into their healthcare, which is literally a life-or-death issue.
The place where most people interact with the federal government the most frequently is the post office. People also often complain about the post office. Mail is constantly getting lost or taking entirely too long to arrive at its destination. Private sector competitors continually prove themselves more reliable and more profitable.
I recently tried to forward my mail while I was away for the summer. The post office -- the post office itself -- sent me a letter confirming the forward. I received it two months later, along with some two-month-old forwarded mail. The rest was lost.
Nancy Pelosi's website urges constituents to contact her "if you are experiencing persistent problems with mail delivery." This is not an isolated problem.
After the post office, the next most frequent contact that people have with the federal government occurs when obtaining or renewing a passport. This administrative process is so inconsistent, inefficient, and impossible to maneuver, that most members of Congress pay staff members to help constituents who have problems or need help navigating the procedures.
While a problem in the private sector is generally easily solved, a problem with the federal government can become a full-time job with no resolution. What if that problem is your health?
"Having a problem with the federal government can be very frustrating," says Senate Majority Leader Harry Reid on his website. That, Mr. Reid, is exactly why Americans don't want to deal with the Federal Government when it comes to their health and well-being.
Don't forget the government is already in the healthcare business to a great extent. Medicaid, for example, is a broken system. Private charity has popped up to try and find volunteer doctors because Medicaid patients cannot find medical professionals willing to provide care for them.
Medicare, likewise, does not fully cover the individuals it promises to support. Seniors are regularly buying private Medicare supplemental insurance because Medicare does not provide adequate care. How are we to trust that an overall government healthcare system wouldn't require private insurance as well?
The American people don't trust the government to manage their health because their experiences with the federal government have largely been off-putting. Add to that the fact that less than 20%, according to a Gallup poll, perceive the healthcare system is in a state of crisis and that most Americans rate the quality of the healthcare they receive, and even their healthcare coverage, as excellent or good. Then, try to convince the people across America, 70% of which think the economy is our top problem, that we should spend more money to fix what ain't broke.
While policymakers in Washington figure out how to craft and sell a plan, the rest of America is worried about keeping their jobs and making their house payments. They are worried about their children's education -- both now and how they will pay for it as their children grow older. Paying for healthcare is important to them -- money is not free, as it seems to be in Washington sometimes.
Americans across the country have had nothing but bad experiences with poorly run government programs and agencies that operate at a high cost for little benefit. Why should they believe healthcare will be any different?
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