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Last week marked the unraveling of the Republicans’ American Health Care Act, which was a major blow to President Trump in his first 100 days in office. In January, Trump promised, “We’re going to have insurance for everybody,” and that with his plan Americans could “expect to have great health care. It will be in a much simplified form. Much less expensive and much better.”

A month and a half later, Trump had come down from the clouds. “Nobody knew that health care could be so complicated,” he lamented to a gathering of the nation’s governors.

Actually, there were lots of Americans who knew just how complicated health care was. Just ask anyone who is self-employed, or who works for a small business that doesn’t offer health insurance – in other words, most of rural America. Rural Americans, who voted for Trump in record numbers, know better than anyone else the difficulties of the private insurance market. If president Trump’s 36 percent approval rating is any indication, many of those who voted for Trump are feeling burned by his failure to deliver on his grandiose health care promises.

In Trump’s defense, he is articulating a fundamental truth about the American health care system. It is unbelievably complicated. We want, in the president’s words, “insurance for everybody,” but Republicans and Democrats alike have tried to deliver that service via for-profit insurance companies, whose main goal is NOT to insure the sickest among us. Any wonder that such an approach doesn’t work? Our healthcare system is practically designed to fail, because we’re trying to achieve universal service through a for-profit delivery mechanism. It’s like putting hay through a round hay baler and hoping for square bales. We’re using the wrong tool for the job. Private markets are good for lots of things, but providing universal coverage is not one of them.

Most people agree that in the most advanced and prosperous nation on earth, we should be able to provide some basic health care to everyone, so that we don’t have an infant mortality rate lower than Slovakia or a life expectancy worse than Slovenia. These basic services that should be available to all are what economists call public goods, and economics 101 points to government, rather than private markets, as the best supplier of public goods. It’s become in vogue in recent years, especially among those on the right, to say that government is “broken,” and therefore we should look to private markets to supply public goods. That’s like saying that the square baler is broken, so we should use the round baler and hope for square bales. There is, of course, another alternative: fix the square baler.

Is government actually broken? Many on the left would say no, limping along with a square baler that tangles the twine more often than not, and mysteriously shuts off for no apparent reason. Like a baler in need of repair, the fundamental malfunction in government today is that we want our elected officials to work for the public good, but their campaigns are bankrolled by private interests. It is obvious enough that elected officials who ignore the desires of their donors will not stay elected for long. The scourge of unlimited campaign spending has resulted in government for hire, that all too often overlooks what is best for the common good. We should not be surprised when elected officials – whose campaigns are supported handsomely by private insurance companies – put forward health care proposals that pan out well for the insurance companies and not so much for average citizens.

So what do we do? First, stand up to Democrats who deny that government is broken. Second, stand up to Republicans who refuse to fix what is broken in government, and instead put forward half-baked privatization schemes that are doomed to fail because they are the wrong tool for the job.

Some will deny that there is a problem with campaign spending, and ignore the increasingly obvious link between dysfunctional health care policy and unlimited campaign donations. Some will throw up their hands in defeat and say that getting big money out of politics is impossible. And then there are those of us who can’t afford to be in denial or despair, because we or our loved ones need health insurance, and neither dysfunctional government nor the for-profit insurance industry is getting the job done.

To those who are ready for something better – please join the effort to fix our broken campaign finance reform system, so that we get health care reform that actually works for We The People.

On Tuesday April 4, residents in nine Wisconsin communities will vote on whether to amend the U.S. Constitution to clarify that only humans should have constitutional rights and that money is not the same as speech and political spending can be limited to allow all Americans to participate in the democratic process. I urge voters in Racine, Monona, Blue Mounds, Fox Crossing and the towns of Neshkoro, Crystal Lake, Caledonia, Blue Mounds and Jordan to vote YES on this ballot resolution.

I also invite all Wisconsinites to call their state Senator and Assembly Representative and urge them to co-sponsor Assembly LRB-176/Senate LRB-1138, which call for a vote to clarify that unions and corporations are not people, and that money is not speech, in order to allow for limits on campaign spending. Let’s fix what is broken, and get health care working for all Americans.

O’Connor lives in Madison and works on behalf of family farmers and rural communities in her role as government relations director for Wisconsin Farmers Union.

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