Bill Moyers Journal last week featured the California Nurses Association—not the usual Moyers Q and A with a guest, but a reported piece that examined the health care advocacy of a vocal and vociferous group that makes you realize what unions once were and could be. This union has fire in the belly, and the Moyers segment captured it beautifully. The nurses make no apologies for supporting national health insurance, the politically incorrect option they label “Medicare for All.” On camera, the union’s leader, Rose Ann DeMoro, characterized U.S. health care:
“There is no health care system. There’s a health care industry that’s major objective is profit-making, which means not providing the patient all of the care that they need, discharging patients early, patients without insurance being treated differently than wealthy people, frankly. And that is the health care system in America. Those who can afford it get to live and those who can’t suffer needlessly.”
To the nurses, no one exemplifies this health care disparity more than Dick Cheney, the vice president of the United States. And to press the point, they have embarked on a “CheneyCare” campaign, which gave the Moyers show an engaging opening that quickly grabbed my attention. Journal correspondent Rick Karr asked viewers to consider a hypothetical cardiac patient—a sixty-seven-year old man in a high stress job with a history of serious heart problems. The man has had four major heart attacks and a quadruple bypass; he has atrial fibrillation and needs a defibrillator to keep his heart on track. That man, says intensive care nurse Geri Jenkins, might have a hard time getting new insurance if he needed it.
The man, it turns out, is not a hypothetical patient, but Cheney, who has Cadillac coverage that buys Cadillac care simply because he is an employee of the U.S. government. He cannot be denied health insurance no matter how serious his heart condition; he can pick the best hospitals and the best doctors, and, according to the nurses, Cheney is alive today because of that care while many other people with similar conditions are not. The nurses have launched a CheneyCare ad campaign in newspapers and on the Internet, designed to make the argument for a radical change in America’s health care system—a change that would allow everyone to get the kind of care that saved Cheney’s life. Their ads declare that if Cheney were just a regular American, he’d probably be dead by now. That’s no garden variety campaign ad.
On the Moyers program, DeMoro argues that there should no double standard. “We as the public pay for Dick Cheney’s care—Why is the government not providing the same type of care to all Americans?” she asks. And indeed, that is a key question neither the candidates nor the media have discussed during the campaign so far. Health care equity rarely comes up. While there may be growing consensus that all Americans should have something in the way of insurance coverage, there is no agreement on what that something should be. Cadillac health insurance for some and bare bones policies for others might add up to fewer uninsured people overall, and that, in turn, will make the statistics look less grim. But the message of the California nurses is that that is not good enough. Coverage and equity really go together.
Still, equity is a hard concept to sell when the national health care conversation has turned toward consumer choice. Its mantra: choose the health plan that is best for you—as if medical care were like a car or an ipod.
Bill Moyers Journal, through its reportage of the nurses’ activism, suggests that equity is an important question to raise in the presidential race. But it could go further in addressing it. So for Moyers, we offer a modest proposal: Why not build on Friday’s show with a probing Q and A. Explore the topic of equity, the principle that brings about basic medical care for everyone in countries that have national health systems. Such a program would enlighten and plough into ground so far untilled by the rest of the media.Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.