Sunday! Sunday! Sunday! No, not a monster truck rally, but something almost as brutal and smashing. Last Sunday provided Democratic presidential candidate front runners Hillary Clinton and Bernie Sanders the platform to differentiate their positions on those issues most important to their base. (Martin O’Malley was there, too, but barely; one was reminded of his presence only through his plaintive pleas for speaking time.)
It’s no surprise that gun control was the first topic of debate. Clinton and Sanders pointed out the inconsistencies in each other’s positions, while O’Malley stated that both are right about the flip-flopping of the other. From gun control, the debate turned to questions of justice and related reform. Sanders expressed frustration that Wall Street big shots escaped criminal liability for their role in the mortgage crisis, while young people are regularly imprisoned for marijuana possession.
From there, the issue of opioid addiction arose again. And again, candidates refused to acknowledge that opioids, when used as prescribed, serve a valid and critical treatment role for individuals experiencing severe, sometimes chronic, pain. Instead, Sanders went so far as to suggest that “there is a responsibility on the part of the pharmaceutical industry and the drug companies who are producing all of these drugs and not looking at the consequence of it.” Pressure from the DEA and SAMSHA has already scared States into making it increasingly difficult for patients to obtain legitimate analgesic prescriptions. Is it really necessary to exert pressure on manufacturers, too, potentially limiting the supply of these drugs? I think not.
Fortunately, candidates did use drug addiction to shift the conversation to mental health treatment. In particular, Clinton mentioned needing “to divert people from the criminal justice system into drug courts, into treatment, and recovery.” Sanders called for “a revolution,” such that Americans “should be able to get treatment that they need when they need it…” Yet rather than pressing the candidates on the specifics of mental health treatment reform, moderator Lester Holt opted for a commercial break.
Upon the debate’s return, moderator Andrea Mitchell pitted the candidates against one another in regard to general healthcare reform, explicitly asking Clinton whether “Sanders wants to kill Obamacare.” Aligning herself more closely with Obama than in previous debates – perhaps because this debate was cosponsored by the Congressional Black Caucus Institute – Clinton fawned over what she considers the accomplishments of the Affordable Care Act. Rather than repeal and replace the existing healthcare payment infrastructure, Clinton wants to “improve it.”
Sanders, despite serving “on the committee that wrote the Affordable Care Act,” proclaimed that his latest healthcare proposal would “provide health care to all people, get private insurance out of health insurance, [and] lower the cost of healthcare for middle-class families by 5000 bucks.” Channeling Trump – perhaps further alluding to the idea that Clinton is part of the ho-hum establishment – Sanders said that he can succeed in implementing his healthcare vision if “we have the guts to stand up to the private insurance companies and all of their money, and the pharmaceutical industry.”
Rather than ask for specifics, the debate moderators once more changed subjects, this time to ideas for bringing the country together. Unfortunately, it’s the specifics that the country needs to come together enact substantive progress. Singing kumbayah under the Capital Dome isn’t going to bring down the cost of insurance premiums, permit people with disabilities and senior citizens to remain in their homes, or increase the availability of outpatient mental health treatment. Nevertheless, these are all end goals that both parties should be motivated to achieve. The particular means of success are the areas for disagreement.
As people with disabilities, I think we need to be involved not only in pushing for the specifics, but also offering them to candidates. For example, would Sanders’ Medicaid-for-all vision mandate the provision of home- and community-based care? How would this expensive care be protected, even as millions more crowd into the system? What about a consumer-directed delivery model? Alternatively, would Clinton’s more pragmatic approach abandon all previous proposals that failed to pass Congress? Including the CLASS provisions? Would she support long-term care provisions elsewhere?
My suspicion is that the candidates themselves don’t have specific ideas at this point. While the community itself may not have all of the answers, it must be vocal in sharing its collective experience regarding the operational status quo. Or, once again, we will be left out of the debate.
Contact: Emily Munson