So, here's the thing. The AHCA bill that was passed today is not actually going to become law; it has to go through the Senate and will, at worst, be tempered. Probably.
But, this whole fiasco has opened up some really ugly questions that I feel we as a nation need to, at a minimum, recognize. Ideally, talk about and solve.
First, the House voted on a bill before it could be analyzed and scored by the Congressional Budget Office (CBO, the non-partisan organization that provides analysis to Congress). Basically, they voted on and passed this without any idea about the effect of the bill, without doing any sort of cost-benefit analysis.
Now, "cost-benefit analysis" sounds a lot like intellectual-elite business-school jargon, but it's really not. Funny story: when my son was about 10 years old, he asked me when he could curse in front of me. My answer was, "When you're ready for my reaction." What I meant, of course, was that the older he got the less I would react, and the less he would care; when those two slopes crossed, he could curse! But what I was actually teaching him was how to do a cost-benefit analysis: when does the benefit (the release of cursing) outweigh the cost (Mom's reaction). And we all do these every single day, when we decide to have the Snickers bar, or to keep our mouths shut about our spouses hair, or whatever. It's not only a fairly simple concept, it's also an important one, particularly if we want to stay happily married. But the House didn't feel it was necessary.
So, first question: have we really elected a body of Representatives who are so insistent on doing, or in this case undoing, something that they simply don't care what the cost is? And if so, what does that say about us as a country? Will we hold them accountable? Or do we not care about the cost either?
Next, the House created and passed a bill that allows for the dismantling of the 10 essential health benefits guaranteed by the Affordable Care Act (ACA, or Obamacare); protections for women, for those with disabilities, for those with pre-existing conditions, wellness visits, chronic condition management, and so on.Poll after poll after poll shows that the majority of Americans actually like these benefits. So, why on earth would the House pass this bill? My own cynical view is that they did because they knew the Senate would not, and this allows them the best of both worlds; they can claim to have dismantled Obamacare, without having to actually deal with their constituents' resulting loss of coverage. But, if they, and by extension America, are not actually opposed to the provisions in Obamacare, then what is it they are opposed to? Well, again, there are a number of polls, both before and after the 2016 election, that indicate that when called the Affordable Care Act, people reacted positively towards the provisions. When called Obamacare, they reacted negatively.
It seems that what those who opposed it don't like is the fact that Obama created it.
Now, we can argue and discuss all day about whether this was because he's a Democrat, or because he's black. I certainly have my opinion, I'm sure you have yours. Honestly, they're probably both true, to an extent and in certain circumstances. But is either any better than the other?
So, second group of questions: have we become a country that is so partisan that if the other side has a good idea, we'll attack it simply because someone else came up with it? Are we still so racist, consciously or unconsciously, that we can't allow a black man to be successful, even if sabotaging him hurts us? Or are we so determined to pretend that racism is only in the past that we won't call out those who are racist?
Finally, the actual effect that this bill, were it to be passed by the Senate as is, would have. There are a couple of ways to look at this. Some people would simply die. Not because they have incurable diseases, not because they live somewhere without adequate health care. They would die because they couldn't afford to pay for treatment. Others would struggle with conditions that could be easily managed...if they had the insurance to cover it. But they don't, so they wind up going to Emergency Rooms when they're in acute distress. In the latter situation, we all wind up bearing the cost, because of increased overall healthcare costs; in the former...well, someone dies who doesn't need to.
So, my final set of questions. Are we really that crass? Are we really that uncaring? Are we really willing to see costs rise overall because we won't ensure that all can be insured? Are we really OK with people dying? Could you really look a parent in the eye and tell them that their child can't be treated? Could you tell a child that their parent has to die?
These are not easy questions. They'll make us squirm. They'll make us confront and think about some very ugly possibilities. This is not storming the beaches at Normandy, or racing to the moon. This is petty, and crass, and ugly. This is every mean-spirited thought we've ever had, taken to the Nth degree.
But, just to go all Dumbledore on you, while it may take courage to stand up to our enemies, it takes even more to stand up to our friends. And, I would hold, it takes the most courage to stand up and admit our own failings.
I believe are better than this. I believe than many of us in this country do have the courage to think about these questions, and to wrestle with them. Even when it's hard. Even when it makes us guilty, or uncomfortable. Even when it's scary.
I hope I'm right. Because if I'm wrong, I fear that this country will not survive.