When the US healthcare system keeps killing, who still cares enough to fight?

We can tally the deaths that we know are caused by denials of care or medical errors in the U.S. health care system, and those numbers are horrifying. Yet most of the American public doesn’t pay much attention to the issue, and many only gripe about the health care system when their costs for maintaining health coverage or getting care exceed what is available in their personal budgets. We live in a highly individualistic and selfish society when it comes to many of life’s most essential needs. And unless we can figure out a way to reward most Americans for having a sense of empathy toward those who are sick or weak, I am afraid it will be difficult to protect our current social safety net programs (including Medicare) or to reinvent our health care system without profit and business success as its primary motivations.

I work for a small non-profit that supports single-payer reform in health care financing. We want to achieve an improved and expanded Medicare for all for life system. My work is often with other progressive individuals and groups that share a vision of economic and social justice yet even many of those groups will not engage in the continued fight to reform the health care system as the Affordable Care Act/Obamacare is being implemented. Our struggle for a better health system seems like yesterday’s news to some progressives, and to others it has become part of a larger agenda for a completely overhauled economic system. But the deaths and bankruptcies just keep right on growing in numbers while many activists and advocates turn their attention elsewhere. For some it’s a calculation about the political climate and the timing of upcoming elections. That’s not surprising but it certainly isn’t indicative of overwhelming and unwavering support for ending the slaughter of innocents at the hands of health care industry profits.

Many of us who are among the expendables in society have grown accustomed to our lives being devalued by the greedy, for-profit interests inside the health care system. It is harder to accept that our value ebbs and flows with the political tides or with the ambitions and desires of those who run many social movements and organizations. Every time I confront some cancer recheck or scare, I cannot help wondering at what point I become a case of diminishing returns so costly that it’s not worth the trouble for me or others around me. If I listen to the more valued voices in health care policy and politics in America, the nation will be locked in a struggle to protect or perhaps shave Medicare benefits, protect or abolish the ACA/Obamacare, and to protect or slash the social safety net for the foreseeable future. Under the very best case scenario, things will stay as they are unfolding now, and that’s just not very good.

How much suffering will it take to make most Americans, or at least enough Americans, care to change this greedy system? A lot. And that suffering will not be the only condition required for change to come. Those who are in power both inside government and in political and social advocacy groups will need to see their own success as tied to improved conditions for the masses. Right now, many in power owe their personal success to the continued suffering as they either rage against the “system” or profit mightily off continued suffering or enjoy support from those who have power and money within the dysfunctional health industry.

We have largely forgotten that people are at the core of the actions we take in politics and social justice work. Individuals are fighting daily to stay afloat, and their voices are the most honest and clear we have to guide our work. The tides of politics do not stop the suffering until after the next election cycle, and we cannot wait until after November 2014 to push ahead on health care justice. If we make the decision to wait for more practical political timing, we are little better than those who make denial decisions for private insurance companies and the credit decisions for providers. Until the suffering stops, our work cannot slow.

Please, for people like me and for people in your own circles, demand that the health system (and the political system) stop making patients pawns for personal power and wealth. Even if you are safe now, I guarantee you that someone you love or need in your life is doing what I do every day as they question the value of life in the face of such cruelty and dysfunction. With Medicare for all for life, we all matter equally. We don’t all get the same result, but we all have a fighting chance.