Alone among developed nations, the United States’ approach to health care is a hodge-podge. There is Medicare for our elderly and Medicaid for the very young, the poor and the disabled. The Veteran’s Administration serves our nation’s finest and the Indian Health Service does the same for our native American brothers and sisters. For the vast majority of workers, the model we settled on after World War II relied upon employer-provided health insurance.
By the turn of the 21st century, changes in society were straining that model to its breaking point, especially for workers in the private sector. Lifetime employment with one company was no longer realistic, yet changing jobs and insurance could expose families to devastating losses of coverage. Medical bills became the leading cause of personal bankruptcy in the US as the number of Americans without coverage rose. Emergency room visits by the uninsured increased and those costs were being shifted, in a manner both costly and inefficient, back to those who still had policies. Two classes of Americans were developing: those insured and those not.
In 2006 then-Gov. Mitt Romney, with his Bain Capital market-driven instincts, teamed up with the Heritage Foundation (often called Ronald Reagan’s think tank) and the Massachusetts Legislature to enact a law designed to cover all of that state’s population with health insurance. Soon afterwards, policy makers in other states including Alaska began to craft versions of that bill to fit the needs of their citizens.
The central idea of what was then called RomneyCare was rooted in a classically conservative principle: each person should be financially responsible for his or her own health care. The role of government was to try to level the health insurance playing field through reforms, and to make private health insurance available to those without it at a reasonable cost. I’m not saying the idea was perfect; but it solved several problems at once and delivered measurable improvements.
The elections of 2008 led to the introduction of a RomneyCare-type bill in the U.S. Congress. That bill’s passage in March 2010 as the Affordable Care Act, a/k/a ObamaCare, led us to where we are today. You can debate ObamaCare all you want, but its conservative nature is a matter of history. Knowing this open secret of the pedigree of our current health care law helps make clearer the dilemma faced by Paul Ryan and Mitch McConnell in 2017. They couldn’t accept ObamaCare because of the last seven years of nasty politics, but there is no further room to move as you go further to the right on the health care spectrum and not be simply throwing people to the wolves.
Which is exactly what the bill before the Senate does. Put simply, the question before our highest elected leaders is whether to tell millions of Americans to fend for themselves in the health care wilderness.
That’s wrong. It does not have to be this way. Health care may not be a right, in the same way as free speech or the right to bear arms, but most people would agree that health care is inextricably woven into our human existence. Not as important, perhaps, as air, water and food, but still very very important. And just as we work to make clean air and clean water available to all, the nature of health care seems to call out for a similar approach: collective action to protect a collective good.
The bill before our US Senators, Lisa Murkowski and Dan Sullivan, does not advance the public interest in health care. It takes fifty years of slow incremental progress for millions of people and trades it for a big tax cut for a small group of wealthy Americans. I can’t sit by and let that happen without raising an alarm.
This is the week for action on this issue. Write Senators Murkowski and Sullivan. Call them, email them, or speak to them in civil tones if you see them out in public. Plead for them to say ‘no’ to this latest idea. No. No. No. Tell them to go back to the drawing board and start again.