The long view…

Every so often it is important to take stock of where you are, where you have been and where you are going in politics. The national debate around healthcare reform has garnered a majority of the TV time and column inches in the newspaper. Events happening in DC right now are critical. Regardless of the changes made to any future Federal Health Insurance reform package, this is but one step in a long journey. This is not an end, rather it is a beginning.
That said Washington isn’t the only place people are talking about making change in the healthcare system. There are those amongst us that look at the pace of change and feel overwhelmed by its speed. Others amongst us look at the pace of change in Congress and believe this process has become arduous and played out. Meanwhile, the states continue to plug away with their individual efforts. Over the last few weeks, Connecticut has joined Massachusetts in moving toward a universal access program for healthcare. Utah, Oregon, Vermont, New Hampshire, Maine, and Rhode Island all are experimenting with various aspects of reform from bulk purchasing and re-importation of prescription drugs to changes in the delivery system, how and where people access care.
Across American History there are scores of examples punctuating the fact that monumental efforts to bring about social change nationally have always been sustained by local efforts. Women were allowed to vote in local and state elections before they were granted the right to vote in Federal elections. In both cases, these groups were granted the right to fully engage in the American experience only after Congress passed constitutional amendments. Those amendments needed to be ratified by State legislatures. Local action created the consensus to ratify those rights. When and where the grassroots, political consensus does not exist at a local or state level — lofty ideals fall flat.
We may look at this moment in time and conclude that making “chronic illnesses and genetic predispositions” a “protected class’ is the prudent thing to do politically. Or more boldly, perhaps; we should seek a Constitutional Amendment to protect people who are chronically ill. That said however, change is evolutionary not revolutionary. Sustaining change requires each of us to double down and commit to acting locally to cement gains nationally. Only through coordinated local efforts can we begin to act together, in pursuit of the greater good.