Oh, What a Week It’s Been: Thoughts on the Health Care Earthquake

Keizer, Oregon :: I watched with fascination and concern this week as shockwaves from the health care reform (HCR) law rippled through the national conversation. Most of the grumbling I heard on talk radio the day after the bill passed was about how insurance companies could no longer deny coverage to individuals with pre-existing conditions. Callers complained to the hosts that the federal government was using their tax dollars to subsidize insurance for people who hadn’t taken good care of themselves in the first place. There was a lot of talk about “personal responsibility.” But this is a failure of imagination, the kind of argument made by people lucky enough not to be touched by a pre-existing condition. Yet. Pre-existing conditions include not just the emphysema of the lifelong chain smoker, but diseases like diabetes, asthma, and cancer that alight on individuals seemingly at random or by accident of birth.

On Tuesday, some of my Christian friends expressed serious and sincere concern that the new law will use their tax dollars to pay for abortions. I didn’t understand this either since the legislation unequivocally upholds longstanding restrictions on federal funding of abortions. The President even signed an executive order on Wednesday reiterating that every nook and cranny of HCR is subject to current restrictions on abortion funding. (An executive order carries the full force of law.) National Right to Life hated the bill anyway. But at least one pro-life group, Catholics in Alliance for the Common Good, supported the bill, and issued a letter listing page-by-page the law’s anti-abortion safeguards. A number of prominent evangelicals, including Joel Hunter and Ron Sider, also supported HCR. And yet, when Rep. Bart Stupak, the pro-life Democrat whose support for the bill ultimately ensured its passage, was speaking on the House floor, a Republican colleague felt compelled to shout “baby killer.”

Today I’ve been reading about the bill’s supposed double-standards. Senate Minority Leader John Boehner and conservative media outlets accuse President Obama and Congress of exempting themselves from certain portions of the law. The truth, as usual, turns out to be more complicated.

HCR mandates that an individual who is not insured – not covered, for example, under an employer’s plan – buy insurance through one of the state health care exchanges. However, the new law requires Congress members and their staff to drop their current plan and buy insurance through state exchanges. It’s a solidarity thing, though I doubt the Republicans who introduced the proviso meant it as such. It’s like the old saying about how the President and Congress send other people’s kids to war, but not their own. Requiring lawmakers to buy insurance from state exchanges means they have skin in the game now too.

This is where it gets tricky. Two amendments were originally proposed with Congressional mandates. (I believe neither mentioned the President.*) The amendment that failed to pass applied to all Congress members and all their staff. The language that made it into the final bill is narrower; it applies to all the senators and representatives, and most, but not all, staff. For example, an aide working for Nancy Pelosi, the representative for California’s 8th Congressional District, must buy insurance from state exchanges. But an aide working for Nancy Pelosi, the Speaker of the House, does not seem to be required to buy from the state exchanges. HCR doesn’t specifically exempt leadership and committee staff; they just don’t fit neatly into the language of the law. Democrats claim they rejected the broader language because it would have applied to many non-political positions on the Hill, such as the Capitol Architect.

The most troubling – and somehow most predictable – development of the last week has been the violence. This is from the Associated Press:

More than 10 lawmakers in the House said they had received threats or worse as a consequence of the health care debate, most of them Democrats who voted in favor of the legislation. There were reports of bricks through windows…and numerous obscene and threatening phone calls and faxes. An undisclosed number of lawmakers were under increased police protection.

A tea party activist posted on his blog the address of a house he believed belonged to Virginia Democrat Tom Perriello and encouraged readers to “drop by” to articulate their anger over Perriello’s support of the health care bill. Someone cut a gas line at the house, which was actually the home of Perriello’s brother and sister-in-law and their four children. Threats have even been made against the Senate Parliamentarian, whose job it is to provide non-partisan “advice and assistance [on the Senate’s] legislative rule, precedents, and practices.”

If health care reform was an earthquake that altered the American landscape, the violent protesters are looters, rebelling against a society they believe has let them down, angry at a higher power (so to speak) whose authority they no longer recognize. But this comparison almost legitimizes them. They are, in reality, vandals, sore losers, and maybe even domestic terrorists, taking advantage of the upheaval to advance an anti-democratic agenda. Republicans and Democrats alike have condemned the violence. Still, I can’t help but think that the violent agitation on the margins is being inflamed by the pervasive use of war metaphors in the center of our political rhetoric – talk of culture wars, battleground states, Sarah Palin’s Tuesday morning tweet “Don’t Retreat, Instead-RELOAD!”, etc.

I am ambivalent about the health care reform law. I think it is a step in a better direction, but not necessarily the right direction. It will extend health coverage to 32 million more people, but it seems like a giveaway to the insurance companies. Make no mistake, Wall Street reacted favorably to the bill’s passage, and at least one large insurance company, Cigna, is saying it won’t join efforts to repeal the legislation. Why would they, with millions of new customers up for grabs? My preference is still for a single payer plan. If comprehensive campaign finance reform is the best thing we can do to save our democracy, single payer health care may be the best thing we can do to improve the lives of millions of Americans, while spurring economic growth, innovation, and entrepreneurship.

Michael Steele, the Chairman of the Republican National Committee, said on Sunday the health care bill is “the end of representative government.” But I think if we can come together as a country at the end of this long and bitter debate, if we can focus more on what unites us than on what divides us, if we can channel our hopes and frustrations toward positive and peaceful ends, and if we can restore civility and nuance to our public discourse – we may actually witness a triumph of representative government. It remains to be seen. What I know for sure is that health care reform won’t be the last difficult thing we have to do together, so we should try to end this well.

*This part of the law does not go into effect until 2014. FOX News is reporting that President Obama will voluntarily participate in the state exchanges if he is still president.

4 comments on “Oh, What a Week It’s Been: Thoughts on the Health Care Earthquake

  1. Nicely done John. Your comments about ‘single payer’ insurance and finance reform are right on target. Thanks, UM

  2. Great post, John.

  3. Well done. I’ve also heard about the threats and looting…it’s kinda scary. The biggest gripe I’ve been reading about is the fine for those who choose not to buy insurance (about $95)…still not sure how I feel about this either.

    I still have mixed feelings to (I also like the single payer plan), but it’s better than what we had.

  4. Thanks for the comments. Hanging over all this is the very real possibility that major components of the bill – most notably, the mandate – will be ruled unconstitutional by a Supreme Court that has shown in the last couple months that it has no problem reversing decades-old precedents. I think this is sometimes called judicial activism.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: