Congratulations to Sen. Ben Nelson (D-Neb.) and Congressman Bart Stupak (D-Mich.). They have made their point and they have made it very effectively. The Democratic lawmakers, along with others, have utilized health care reform legislation as a vehicle to advance other issues. They have transmitted a very clear message to their constituencies that they will work to advance their agendas and issue platforms at any and every opportunity possible.
But, now it is time for lawmakers on Capitol Hill to get back to the business of achieving health care reform.
As the Senate prepares to vote on final passage of the Senate bill, and both the Senate and House prepare for Conference Committee negotiations to merge the chambers' bills, focus must be placed on ensuring that all Americans have access to affordable, quality, and reliable health insurance and health care.
It is time that the quest to achieve health care reform no longer be used by a handful of lawmakers to pursue their other agendas. Such maneuvering to serve other agendas must now take a back seat, in order to best serve the American people as a whole.
If lawmakers hold up bill after bill until their demands are addressed, nothing will get done and no progress will be made. If we were to continue down this path, our nation would stagnate and our democracy would become completely dysfunctional. While this would make Machiavelli proud, the machinery of society would grind to a halt. Myopic devotion to each thread would cause the fabric of society to unravel.
In the case of the abortion issue, Stupak and Nelson have argued that there is a nexus between our nation's health care system and abortion. But there is a similar nexus between health care and many other issues which other lawmakers have refrained from injecting into the health care reform debate. Although it would be nice - and very opportunistic - to force other issues into health reform legislation, forbearance has been a pragmatic necessity, in order to enable reform to proceed. Advocates for other issues - which are just as related to health care as abortion - appear to recognize the greater imperative of enacting health care reform.
For example, the widespread use of tobacco has profound health consequences, both for tobacco users and others who are in their midst. Tobacco takes a high toll on peoples' lives and on an overall quality of life, not to mention adding significants costs to our nation's health care expenditures. Just as with the Stupak and Nelson abortion provisions, it could be argued that tobacco users assume the risk of health care costs associated with tobacco, and that no Federal funds should be used for anyone whose problems are linked to tobacco. But such an amendment would violate the principle of providing health care for Americans who need it, for whatever reason that they need treatment, and might delay the passage of reform. So, those who advocate against tobacco use have exhibited restraint.
Similarly, certain criminal acts create an increase in use of health care. These include domestic violence, rape, child abuse, and drunk driving. Some would like to increase criminal penalties for these actions, and shift full financial liability for the health and other consequences to the perpetrators of these acts. But, even though increasing criminal and civil penalties would be fully justified, it might be a distraction from the core objectives of health reform. So, again, there has been restraint.
There are still other health-related issues for which some would like to see special treatment. Sen. Barbara Boxer (D-Calif.) pointed out that many Americans would like to exclude coverage of Viagra for men, just as Stupak and Nelson have sought to exclude coverage of abortion for women. Some would like to address carbonated "soft-drinks," laden with sugar and chemicals, which increase incidence of obesity, diabetes, and other health conditions. Others might suggest that golfers should assume the risk of golf injuries, which non-golfers avoid. The same could be said of other sports injuries. Yet, there has been forbearance, so as not to delay or impair health care for all Americans.
Some people seek to dedicate their life's work to a single issue, advance it at every opportunity, and interpret every other issue through that singular lens. They can best make their contribution as the leader of an advocacy group or think tank that is committed to that issue.
But someone who seeks to serve in Congress, representing their constituents on the full panoply of national issues, has the responsibility to balance a broader range of issues, considerations, and impacts. It is irresponsible to act as a single-issue advocate when national sustainability - and the quality of life of all Americans - is at stake.
Any legislator who cares about their constituents' health, providing health care for all Americans, and/or managing the impact of health care costs on the Federal budget should support this historic legislation. This is the moment to enhance the fabric of society, rather than being distracted by a myopic devotion to any single thread.
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