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Also in Election 2008
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AlterNet asked dozens of writers, experts and activists on key issues to write about where the country needs to go, and the priorities for Barack Obama's early days in office. This is the third collection of suggestions Read the first one here and the second here.
Gerry Hudson is an executive vice president of SEIU, where he leads the union's Long Term Care Division.
SEIU's members, including nurses, LPNs, doctors, lab technicians, nursing home workers and home care workers, work in all sectors of health care. They live the problems of the system, and they know how much change can impact their working lives and the lives of their patients.
Health care costs are rising at almost double the rate of wage increases for the average American worker. Less than half of small businesses can afford to offer insurance. We can have an impact that will benefit Americans and our economy. Here are some tangible ideas.
Prevent and manage chronic diseases: Let's help millions of uninsured children and adults enroll in meaningful coverage and engage in their care. This will help prevent, bring down the costs of, and eliminate income and racial disparities in the incidence of chronic disease.
Fix the insurance markets: Small businesses, uninsured workers, students and others may need to receive financial assistance or get enrolled in a public program that meets their needs and circumstances. We can't just build a system and expect insurers to participate without ensuring a stable risk pool.
Make government purchasing more effective: The government is the largest purchaser of health care, so a comprehensive approach should create a framework that allows the federal government to become a smarter, more effective buyer. It should set standards for health information technology and sponsor and disseminate research on which treatments work best for which patients. Let's reward providers who can report measures of quality and outcomes and show improvement over time.
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Paul Armentano, deputy director, NORML
Though it's primarily Congress, not the president, who is responsible for crafting America's oppressive federal anti-drug strategies, Barack Obama has ample opportunities to use the power of the executive office to shape a new direction in U.S. drug policy. First, he can uphold his campaign promise to cease the federal arrest and prosecution of (state) law-abiding medical cannabis patients and dispensaries by appointing leaders at the U.S. Drug Enforcement Administration, the U.S. Department of Justice and the U.S. attorney general's office who will respect the will of the voters in the 13 states that have legalized the physician-supervised use of medicinal marijuana.
As president, Obama can also support scientific, clinical research into the medical properties of cannabis by encouraging the DEA to abide by the February 2007 ruling of the agency's own administrative law judge, which found that it would be "in the public interest" to allow private entities to grow medical-grade cannabis for FDA-approved trials. Obama can also use his executive authority to encourage the DEA and the U.S. Department of Health and Human Services to review an administrative petition that is currently before both agencies regarding the rescheduling of cannabis from a Schedule I prohibited drug to a more liberal classification that would allow for its medical use by prescription. Finally, Obama can support the autonomy and health of Washington, D.C., voters by encouraging Congress to lift the so-called "Barr amendment" (passed by Congress in 1998 and reinstated every year since then), which prohibits the District of Columbia from implementing a 1998 voter-approved ballot initiative legalizing the use of marijuana by authorized patients.
One hopes that as president, Obama will use the power of the bully pulpit to reframe the drug policy debate from one of criminal policy to one of public health. Obama can stimulate this change by appointing directors to the Office of National Drug Control Policy (the so-called drug czar's office) who possess professional backgrounds in public health, addiction and treatment rather than in law enforcement.
Obama should also encourage Congress to undo some of the more egregious aspects of the 1986 and 1988 anti-drug abuse acts, such as the imposition of mandatory minimum sentencing and the racially biased 100-to-1 sentencing disparity for the possession of crack versus powder cocaine, many of which were once endorsed but are now opposed by various high-ranking Democrats, including Vice President-elect Joe Biden.
Finally, Obama should follow up on statements he made earlier in his career in favor of the decriminalization of marijuana by adults (replacing criminal penalties with a fine only) by calling for the creation of a bipartisan presidential commission to review the budgetary, social and health costs associated with federal marijuana prohibition, and to make progressive recommendations for future policy changes. Last, Obama can join with leading Democrats like House Speaker Nancy Pelosi and Massachusetts Congressman Barney Frank to offer his support for legislative efforts in Congress that call for ending federal penalties regarding the use of cannabis -- both medically and otherwise -- by adults.
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