"This amendment starts from the premise that health care is a human right, and that every citizen, rich or poor, should have access to health care, just as every citizen has access to the fire department, the police or public schools."

And for a moment last week the fog of jargon and compromise lifted on the Senate floor and a vision of what's possible hovered over the Capitol. We could do this. We could build this kind of society, not just talk about it. We could begin moving beyond the stuck, scared place that keeps us at odds and fighting one another (and much of the world). We could return to the task of creating what economist Riane Eisler calls "the caring economy."

But the vision Bernie Sanders articulated in his amendment, which would have transformed HR 3590, Congress' twisted parody of health-care reform, into life-saving legislation, will remain just a vision for now.

It's the best we'll get from our elected reps in this grim holiday season, as the economy continues to fissure and the dreams and security of more and more of us buckle and break, and decent medical coverage becomes increasingly a matter of luxury or luck (really a shame about that pre-existing condition). Things aren't bad enough for real change yet, or maybe the demand for it still remains pale in comparison to the lobbying pressures of Big Insurance and the prevailing free-market dogma among establishment politicians.

But for-profit health care guarantees that many people will not be able to get coverage. There's no escaping this. As a result, basic health care for all Americans — however cost-effective and spiritually healthy it would be for the nation — does not yet have the status of, for instance, gun ownership: It is not a right.

Summing up the statistical argument Sanders makes in support of a single-payer universal health care plan, John Nichols writes in the Nation: "The 1,300 profit-making private insurance companies administer thousands of separate plans and waste about $400 billion a year on administrative costs, profiteering, high CEO compensation packages, and advertising. Health care providers spend another $210 billion on administrative costs, mostly to deal with insurance paperwork. As a result, the United States spends $7,129 per person on health care, almost double the amount spent by nearly any other industrialized country."

Yet, as Sanders points out, 46 million Americans do not have any health insurance, and for millions more the coverage is inadequate but budget-breaking. And as a result, the U.S. "ranks among the lowest of developed countries," according to Sanders, in both general health and life expectancy. In other words, the efficiency of the free market — the efficiency of greed — is a myth and a scam when it comes to health care. Big Insurance mostly takes care of itself, because that's the whole point.

What's missing in the national debate over health care is an overarching value or gestalt — a sense of national wholeness — beyond pseudo-Darwinism and the "law of the jungle" we affect to believe in. To embrace such a "law," to put it at the center of a moral philosophy or code of ethics, is to go through life scared, armed and unaware, in effect believing in nothing at all except our individual isolation.

The short-lived Sanders-Brown-Burris Amendment To Create a Universal, Single Payer Health Insurance System dared first of all to stand in a vision of national wholeness. To assert that everyone has a right to adequate health care — to make that the uncompromised starting value — changes the game that's played in Washington, and the amendment, predictably, was buried under a point of procedure by the Republicans. Sanders finally withdrew the amendment and gave a 30-minute speech instead, staking a claim not in today but in tomorrow: in the future so many people are yearning for.

"It is in our power to imagine the world we want for ourselves and our children," writes Eisler in The Real Wealth of Nations. "For most of us, this is a world where our basic needs for food, shelter and safety, as well as our yearning for nurturing and love, for justice and peace, and for a sense that what we do has meaning and helps others as well as ourselves, are fulfilled. Above all, it is a world where our children survive and thrive.

"It is up to us to help create the conditions that support this vision."

What I see is that, as law-of-the-jungle conditions, which have always been the default setting for the poor, begin applying to an ever greater segment of the U.S. middle class, demands for structural change — and for a more intelligent media to understand and report on those demands — will intensify. We can either pursue distractions or we can pursue a cohering vision of social justice, mutual support and healing. The time to choose is now. We're not in this alone.

Robert Koehler is an award-winning, Chicago-based journalist and nationally syndicated writer. You can respond to this column at or visit his Web site at © 2009 Tribune Media Services, Inc.