Healthcare: Ask Not

When last night’s vote on H.R. 1628, the Republican healthcare bill, was cancelled, Democrats across the country were overjoyed.  In particular, the minority leaders for the House and Senate, Nancy Pelosi and Chuck Schumer, were delighted to take ownership for the bill’s defeat.  Speaker Ryan was evidently quite disappointed in defeat, and President Trump was quick to cast blame.

On the face of it, that’s the whole story.  Obamacare (the ACA) is the law of the land and likely to remain so for another year at least.  The Republicans tried and failed; the Democrats won an unlikely defensive victory.  And politics as usual moves on to the next thing, whatever that is.

What we’re missing is the same sort of thing we always miss, and we miss it because nobody reports it for us.  Nobody goes through the details, figures out the why and why not, chews up the facts for us, pre-digests them, and spits them in our faces in fifteen-second sound bytes.  After all, it’s not the truth that sells.

Ever notice that, by the way?  The news is always horrific; it’s nasty stuff.  We get a continuous feed of the finer details about disaster after disaster, horror and crime and war and unspeakable wickedness, all made easy to understand by the happy friendly editors and producers of our chosen point-of-view news source, the one that matches our personal biases most of the time.  No matter if we’re conservative, liberal, or a thoughtful moderate, we pick our channel and tune in — and no matter our preference, they never seem to run out of stories for us, do they?  There’s always something that suits our fancy, and it’s never ever good news, because that doesn’t sell any more than the simple truth does.

And the simple truth about the healthcare bill is that we’ve got nothing to celebrate this time either.

Don’t believe me?  Well, let me break it down for you.  Once we’re all at the same place, then we can discuss.

Eight years ago when the Affordable Care Act was first going through Congress, we were told it was the most wonderful thing, that all of America was about to have healthcare and that everyone would be able to afford it.  And who could object to that?  How could anyone possibly find anything wrong?

As things turned out, we didn’t actually get universal healthcare.  To be perfectly fair, it would have been very unwise to make that happen anyway; the economic chaos caused by a massive change in the way we handle health insurance and paid medicine would have caused a panic on Wall Street, and rightly so — recession, even depression, often follows that sort of change.  Instead, the A.C.A. was designed as a first step toward free healthcare, a way to get Americans used to the concept while giving the industry time to prepare.

Because it was designed as a partway plan, there was plenty there for idealists on both sides to object to.  Conservatives opposed the major change; fans of small government didn’t care for the massive tax hike; Libertarians detested the large fines for non-compliance.  The pro-Socialist wing of the Democratic party was no happier; this plan is so far from the single-payer ideal it hardly seems an advance at all.  And so it was enacted with the overwhelming majority of Americans opposed to it, and that was a good thing because, again, it was never designed to be permanent.

But opposition was so strong that, for the next eight years, the Democrats only ever managed to lose political ground over the issue, fighting to defend something so intrinsically flawed it was indefensible.  No plan to extend or improve the present law was likely to get passed, and so none was ever introduced, not until opposition the A.C.A. grew so strong that it brought about a complete shift in the political balance in Washington and the republicans finally had their chance.

Now, when I see a problem, I first look at where things now stand.  Then, I envision the way I want things to be in order to eliminate the problem.  Then I devise a plan to get from here to there as quickly and efficiently as possible. Makes sense, right?

Thing is, when politicians see the same problem, many of them first look to see how it can be best used to gain them more political power, more influence and control, and perhaps even some perks — not bribes per se, but those things that appeal to the venal and corrupt without necessarily enriching them monetarily.

We’ve become used to this; it’s the normal way of things in Washington.  For this bill, however, the game changed somewhat.  Direct campaign donations and PAC assistance were offered in exchange for votes on both sides of the aisle, an unusually obvious quid pro quo that smacks of direct bribery.  That alone should show us how great the stakes really are — and who the stakeholders, apparently not We The People but industry and party, faction and business all intermixed.

The results are quite clear:  Not only do we have no action whatsoever in healthcare, we’re guaranteed to see no more for the rest of the year and possibly not again until the 2018 elections are ended.  The public perception, of course, is that the Republicans cannot (or will not) help us, and that the Democrats like things the way they are.  The truth, however, is that industry lobbyists have delivered a truly major victory for their corporate backers, guaranteeing that American public policy will not move toward a simple and efficient system for years to come.

While this looks like a defeat for Republicans, in reality we must consider that the bill was designed to be what it was, which is completely impossible to pass.  Just like the Democrat-sponsored counterpart, H.R. 676, which purposes to extend Medicare to everyone and outlaw for-profit medicine, it’s designed to be so extreme that it must necessarily fail.  (I’d be entirely in favor, except it’s too sudden; there’s no cushion to prevent catastrophic economic consequences, including two thirds of American hospitals suddenly going bankrupt.)  And the same holds true for each of the dozen other measures before Congressional committees.

Because the truth is, passing these bills is in nobody’s best interest (except, perhaps, the people).  The Republicans benefit in that they are now able to consolidate their ranks, weeding out the ideologically impure in the upcoming elections.  The Democrats, of course, emerge as the champions (however ineffective) of healthcare.  And Wall Street and the massive healthcare businesses can keep on piling up the money.  There is no healthcare debate; it’s an illusion, carefully orchestrated by everyone involved.

And, just like always, two thirds of the electorate are so blinded by propaganda and fear that they are failing to keep track of the present course of government.  Which, when it comes to healthcare, is not in the direction of single-payer or repeal, either one.

This was not a victory.  Instead, it has been yet another loss in a battle between bad and worse, in a long string of such battles.  Nobody wins, least of all the American people, and the wars inside and between parties just goes on and on.

And people who cannot afford healthcare still exist, and live untreated with illness, and die young day after day.

“…any man’s death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bell tolls; it tolls for thee.”
-John Donne, Meditation XVII

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