CHAPEL HILL -- A couple of weeks ago, Dr. Mehmet Oz helped organize what was described as the largest one-day, nondisaster-related, free clinic in American history. Held in Houston's Reliant Center, the operation drew more than 700 volunteers to serve, without fee, 1,784 patients. Oz explained he had chosen Houston because Texas has more people without health insurance than any state in the union.
Reading of the charity effort, I thought it odd that Texas's two senators remain adamant opponents of President Barack Obama's reform proposals. The Census Bureau just documented that an astonishing 24.9 percent of the Lone Start State's residents have no health-care coverage of any kind. Still, Sen. John Cronyn rails against Obama's moves toward "socialized medicine." American health care, he claims, "is the best in the world." People "from all over the world" come here "for health care denied in their socialized systems." Perhaps they wait in line at the Reliant Center.
And the pattern is broader.
Louisiana has 20.1 percent uninsured -- fourth highest in the country. Yet Sen. David Vitter has explained that he is "absolutely against a public option of any kind" or any "big government plan." His constituents are reportedly more interested in tort reform and being able to purchase insurance across state lines. His largest concern is not disrupting "those who already have good health insurance." He doesn't explain how many of them there are.
Mississippi has 19.1 percent uncovered. Its Sen. Roger Wicker considers health reform "a job killer." He emphasizes, instead, the paramount need to protect private insurance companies. Wicker vows stout opposition, without irony, to "Washington-run health-care schemes ... that rely on cuts to Medicare and Medicaid."
Seventeen percent of Oklahomans are uninsured. Their senior senator, Jim Inhofe, proclaims "strong opposition to Obama's health-care proposal" and its embrace of "socialized medicine." His colleague, Tom Coburn, decries Obama's "radical provisions" that "could cause 100 million Americans to lose their private insurance."
Even our own state, with 16.6 percent uninsured and one of the most rapidly rising rates in the nation, is not immune. Gov. Beverly Perdue was one of just six refusing to sign the Democratic Governors Association letter to the congressional leadership that expressed support for reform efforts since "the status quo is no longer an option." And Sen. Richard Burr, famously, months ago accused those seeking a particular expansion of the children's low-income health plan of lining up at the "taxpayer trough" "with the rest of the hogs."
I'm not one for calculations. But given the trend, I did some counting. The Senate is, subject to some interpretation, 60 percent Democratic. In the 10 states with the highest rates of uninsured -- Texas, New Mexico, Florida, Louisiana, Arizona, Mississippi, Nevada, California, Alaska and Georgia -- 60 percent of senators are Republican, standing resolutely against reform's expanded access. In the 10 states with the fewest residents not covered -- Massachusetts, Hawaii, Minnesota, Wisconsin, Maine, Connecticut, Iowa, Pennsylvania, Vermont and Rhode Island -- 85 percent of senators are Democrats, pressing toward reform.
Broadly speaking, the states with the greatest number of constituents standing to gain the most profoundly from reform oppose it. Those with fewer citizens hanging in the unprotected balance, again to generalize, support it. Go figure.
I can't claim to fully comprehend the meaning of such numbers. It is curious, in a democracy, that senators from states having so many locked out of the system would cling tenaciously to the status quo. For me, it follows inexorably from a politics in which those at the bottom, economically, simply don't count. Only then, when 25 percent of a senator's constituents are left in the shadows, can the purported "representative" claim steely indifference to the result.
Of course, the uninsured by definition don't make much money. They have neither the time, nor the energy, nor the organizational capacities to publicly press their claims. They don't vote in great numbers. They don't run political action committees or finance campaigns. They don't manage large corporations that allow them to purchase loyalty and largess from their politicians. They are, disproportionately, persons of color. They believe they have little to gain from our electoral politics. We consistently prove them right. To most political leaders in their heavily uninsured states, they are invisible. They always have been.
The irony is, in ignoring the strained and desperate plight of these our fellows, we turn our backs on the promise of America.
Gene R. Nichol is a professor of law and director of the Center on Poverty, Work and Opportunity at UNC-Chapel Hill.
