This past week, a good friend of mine died as a result of multiple brain tumors. The diagnosis was in August and she passed away in less than three months.

Despite the fact that the odds were against her, she was determined to fight for her life. In the last communication I had with her, true to form, she looked optimistically at her situation and commented that she was fortunate to have had health insurance. She could not have imagined carrying on this struggle without it. In that sense, she said, she was more fortunate than the nearly fifty million people living without any health insurance.

When word of my friend’s death came, I found myself thinking about her comments, offered this summer in the midst of right-wing disruptions of the healthcare town halls. While health insurance did not save my friend’s life, it offered her a chance that she would not have otherwise had. In fact, lacking insurance, she would have passed away without dignity.

Why is the debate over healthcare reform not framed in these terms? This is the question that I keep asking. We hear about the raw numbers of people who lack healthcare and we also hear (or know) of those who hold onto jobs only because of healthcare. We hear a debate about a public option - governmental involvement to guarantee some level of healthcare for all citizens - and we may even hear the call for Medicare for All!

But too little attention goes to the realities for people such as my friend, not to mention people who have less severe ailments. We do not stop and ask, nor have the question posed, what happens to that person who awakens one morning, lacking health insurance and discovers that they have a brain tumor, leukemia, lupus, sickle cell anemia, tuberculosis, lung cancer, or any number of other chronic, and in some cases, fatal illnesses? In fact, when the right-wing was chanting its insanity this past summer, I heard precious few responses that focused on a simple question: what are people supposed to do if they lack healthcare insurance or cannot afford it?

From the standpoint of the political Right the answer is simple: they should die. For progressives, we unfortunately respond all too often at a level of abstraction. We allow ourselves to get pulled into discussions about the federal deficit and how healthcare insurance will be paid for, rather than focusing on at least two realities: the cost of healthcare insurance continues to sky-rocket, and, second, nearly fifty million people have absolutely no care and, as a result, are throwing the dice every morning when they get up, hoping and praying that they do not get ill or have an accident.

Lying beneath the healthcare reform debate is actually a more general but critical question: what is the role for government? The political Right, particularly since the age of Reagan, has suggested that government has no social role and is rather nothing more than a guarantor of the peace (usually through the military, prisons, and the police). The implications of this notion truly are that everyone in this society is on their own to survive as best they can and to expect nothing.

To win the battle on healthcare reform, or even to ensure that there is a public option (which I do not consider winning, but a slightly positive change) progressives must put the issue of healthcare in stark and personal terms. We must force the opponents to come out and admit that they comfortable with allowing people to become ill and die rather than have the government involve itself in a pro-active manner in addressing public health.

My friend did not survive; that is true. At the same time, even with the odds against her, she felt that she had a chance at life because the one thing that she did NOT have to worry about was whether she could receive quality healthcare.

Nearly fifty million other people, if confronted with the same horror, will not even have a chance.

BlackCommentator.com Executive Editor, Bill Fletcher, Jr., is a Senior Scholar with the Institute for Policy Studies, the immediate past president of TransAfrica Forum and co-author of, Solidarity Divided: The Crisis in Organized Labor and a New Path toward Social Justice (University of California Press), which examines the crisis of organized labor in the USA. Click here to contact Mr. Fletcher.