If anyone has not heard at least this phrase, 'health care reform', then they've been living under a rock in the middle of a remote desert. Typically I live under a rock in probably a more remote place when anything related to a) government b) partisan politics or c) war of any kind anywhere is mentioned. These three things can raise my blood pressure to a dangerous level, and cause the heart of my motherhood to cry out with frustration over the incredible slowness of humanity's progress towards handling differences without bloodshed and our children's lives.

But I digress, sort of. Even my own hiding rock has become too confined from ignoring what is definitely a polarizing issue that has brought out the worst in some of us Americans who kind of sit on the sidelines. Seems we're in a bit of a conflict in our own country around something as simple as taking good care, for ourselves and for our neighbors. For our health. We are all in a big fuss, an argumentative war over who's going to control this aspect of our lives. And rightly so.

I know I am. At first I began thinking about what I would consider to be the ones to point the finger at in all this fuss, ones closest to my own experience as a medical biller. Private health insurance companies. Dealing with these seeming devils of the insurance industry has got to be one of the most difficult jobs I've ever had. Please forgive this graphic thought, but I would rather be scooping up dog excrement all day than facing yet another facet of the insurance industry. The contradictions, the management inefficiencies, not to mention the hollow and deceptive insurance plans I experience on a weekly basis, I feel I have the insurance poop slung all over me at the end of my working day. And to make matters worse for myself, I've researched information and articles written about our insurance industry, have silently mused over insurance plan dilemmas while outwardly trying to stay present with family, friends and patients. And after experiencing, musing and reading I must admit, the obsession of pointing fingers has become all-consuming to the point of dare I say it, hatred.

Ick. Please save me someone, from myself. And, shortly after I say this to myself, the silent thought is answered by an older gentleman patient in our office. Nosily I'm looking over his shoulder at a picture on his techy new phone while walking him to a treatment room. 'Black Swans', he says, as he notices my peeking. I blush as he goes on politely to tell me the story behind the swans. 'Were you aware of black swans, he says to me. No, I say. He says, 'nobody else thought they existed either, until they did.' Um, ok. And then he went on to explain the significance. He says, 'It's something that reminds me that nothing is really impossible. When you think something cannot happen, or doesn't exist, isn't possible,(yada yada), it doesn't necessarily mean it can't.

Ahhh. But here's the kicker. Before he was ready to leave from his appointment, we talked at length and ad nauseum, about the health care reform and other sundry American problems. 'Here's how I see it,' he begins pointedly. 'I'm a CFO of a bank (and so he is), and everyone's pointing fingers at us about the current problems with the banking industry. Unfortunately what they do not see is that their own desire and want for a product was the flip side of that coin. There aren't many victims played out here. We've all got some level of responsibility.'

And at that moment my thinking started to take a turn, not so quickly at first, but quiet and almost unconscious. Ok, here's a new thought. Maybe, just maybe, people, you and me, play some part in this insurance brewhaha. Maybe. Let me think on that one.

Ok, let's take understanding what we're getting into when we sign up for an insurance plan. With some stretch of the imagination I can say that insurance companies are not completely at fault here. For goodness sakes, shouldn't patients know exactly what they will face, as far as illness, disease and trauma is concerned, and therefore know exactly which and how many procedures will be necessary, and then know all the specific details on whether and how a procedure is covered? And, whether it is just experimental and not covered at all? Shouldn't the patient know to ask all of these questions when comparing plans and signing up with their choice of insurance, aware that they will not be dropped due to the asking of these questions related to possible problems without having them be considered a pre-existing condition? Shouldn't patients know how to ask the myriad questions that a trained medical biller, who has gone to school and with reasonable experience, is able to ask? That's what taking personal responsibility is all about, right?

It took me a little under three years just to sift through and understand what to ask for myself. Ok, I admit I'm a little slow and possibly burnt out enough with that subject as to leave it to the bottom of my to-do list. But please. People having some responsibility here? Ah (big sigh here), not as far as I see, in this arena of the people vs. the insurance plan and therefore the insurance industry.

Ok, so another thought here. If we're a little duped on the process of understanding our insurance plan at the starting gates, why are we continually banging our heads against the same insurance plan, as it starts to show it's true colors, when we should be questioning the industry and demanding better from them and our employers? Aha! Yes! I think I've found the million dollar question that's been wrangling at me for the last several weeks.

If we're not happy with the way things currently are run, why are we not questioning the very folks who put these plans, these industry products together? Why, oh why, my goodness, are we crying out (and almost whining) to our government to stop their own attempt at health care reform, which I might add, IS taking into consideration the private insurance issue of increasing costs for us as consumers by creating some honest to goodness democratic competition? Shouldn't we REALLY be using our 'power of the people' to call out the insurance companies ourselves? To demand better products? To ask even simple questions like, why has my deductible doubled from the year before? Why am I receiving less while spending more? Why is my doctor no longer part of my insurance network?

Why are we getting caught up, and locking our horns with government when all we really need to do is say 'we don't really want your help this time, we'll do it ourselves'? Do we really need to have our voice expressed through this government legislative process? Apparently it's become our habit. And don't we do need a little government right now to help us with our big problem that's gotten out of hand because we didn't DO anything in the first place!

So if we really want less government in our healthcare, if we truly understand our American democracy, isn't it about making some change ourselves and not clamoring against efforts by our government? And this is the question I'm asking myself, what it has all boiled down to for me. After listening to a very poignant interview with a philosopher, Jacob Needleman, on the subject of our American democracy, two things are very clear.

Government was created simply to be a mechanism, in the most limited of circumstances, to 'restrain our human vices' when necessary, and, that people, then, are given the freedom to fully develop their own powers, collectively and individually to be 'full grown up men and women' as Walt Whitman wrote on American democracy. This includes understanding that with our freedom of rights means a responsibility to be respectful of the rights of others, even if they're separate from our own. And eventually we become a society that communes together in the most beneficial way for all.

This is what is unique about America. That the structure is set up to allow us the free will to grow up and be full grown up human beings. Not oppressed, not the oppressor, but a humanity that raises up ourselves and others with abundance for all and not a few. If we do it for ourselves, government won't need to step in-as much.

Where it gets tricky is that we're not all that grown up yet, from my point of view. Having experienced the injustices that have occurred in our American past, as well as the lack of respect toward differing opinions and lifestyles, there seems to be a need for government to at least have a hand in 'restraining our vices' as Thomas Paine, one of the founders of our constitution, has written. It reminds me of something I learned about the importance of boundaries when raising a child. Boundaries are important to protect, but the key is in knowing when to stretch the boundaries to allow for the growth of independence. It takes wisdom to know when to restrain and also when to let go. To keep this thought in mind as 'we the people' and our government struggle through the health care debate seems key in forging a path that seeks both to allow for a continuing growing independence and interdependence while keeping the vices at bay. This is hardly an easy task, as anyone who has ever been a parent knows, especially when it comes to instilling internal values such as responsibility and respect towards the wider community. And this is the task of our government, what our founders created and hoped for, and what 'we the people' felt strongly about then and continue to take pride in now as uniquely American.

That blend sounds like a good democracy to me, and what will help me in taking charge of my anger, transforming it into more of a depth of purpose for supporting my self and my country. I'll keep in mind the rights and feelings of others, caring deeply for others' needs as much as my own, and continuing to uncover the real culprits that keep us from this purpose, and that includes realizing our own power as people to make change. For healthcare reform, does this mean that I consider giving a little of my income to support others' needs out of human decency without judging why? I think so. Does this also mean that I can simultaneously question whether aspects of healthcare reform by my government is financially and morally sound? Of course! Can I also demand better products from our insurance providers, individually and/or through our government? Why not? Black swans are for real.