In preparation for Congress reconvening today – and to spin up activits’ energy ahead of the President’s health reform speech on Wednesday – there was a rally yesterday on the Boston Common.  (See pictures below.)

Because this event was in Massachusetts, the speakers – and many of the hand-held signs – referred to Senator Ted Kennedy’s decades of work on healthcare, and invoked his memory to energize the reform efforts.  From an historical perspective, in addition to Ted Kennedy’s legacy the words and deeds of his brothers JFK and RFK may also be important for creating social momentum for improving healthcare in the US. Two quotes are specifically applicable to the current debate:

Ask not what your country can do for you – ask what you can do for your country.  (Inaugural Address by John F. Kennedy, January 20th 1961)

This concept of sacrifice for the greater good of society is being played out in interesting ways in the current debate.  On the corporate side, in contrast to the 1993-4 reform efforts, most of the major industries have engaged in the dialogue, and in many cases come to some agreement with the Administration about what changes they will accept in exchange for other changes. For example, insurers are willing to accept regulations restricting or eliminating coverage denials for pre-existing conditions and other practices to avoid or limit adverse selection in exchange for government actions to achieve near universal insurance coverage.

On the individual side, there seems to be much less willingness to sacrifice for the common good.  This may be due to individuals – particularly small employers, the self-employed, and those unable to find or afford insurance – feeling that they have already sacrificed in the form of excessively high insurance premiums.  On the other hand, resistance to sacrifice (or change) from individuals who may be concerned about loosing some aspects of their health benefits, may be seen in the President’s key message point that people will be able to keep the insurance they already have.

Some men see things as they are and ask “why?”  I dream things that never were and ask “why not?” (Robert F. Kennedy speeches, 1968 & also attributed to George Bernard Shaw)

This visionary statement about achieving things only dreamed about could cut two ways in the current debate.  On one side are the practical policy wonks who are looking at how to increase insurance coverage, control costs and improve quality – without adherence to specific philosophical or political flavors.  And on the other extremes are those advocating for changing the tax deductibility of health benefits, and those advocating for a Single Payer health system.  At yesterday’s rally, there were no counter-protesters or signs for changing the tax treatment of health benefits, but in talking with people at yesterday’s rally, Single Payer advocate where there, although only a few carried signs with that message.

Conclusions About Seeing the Future

• See what the President says in his address on Wednesday night.
• See what areas of agreement the Senate Finance Committee can achieve – including a substitute for a public plan option.
• See what positions advocates take if the legislation starts moving forward without a strong public plan option.
• See what happens as the October 15 trigger date enabling the Democrats to use reconciliation rules in the Senate gets closer.
• See how the historical precedents of health reform successes and failures shape the debate about – and the actual substance of – Federal legislation in the next 4 months.