Time To Repeal And Replace The Not-So-Great Health Care Debate

Getting to 50 votes should be a means not an end. The end should be an improved health care bill that benefits all Americans.
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Bryan Woolston / Reuters

Donald J. Trump, after watching Senator Ben Sasse (R-NE) make a similar recommendation on Fox News Friday morning, June 30, tweeted , “If Republican Senators are unable to pass what they are working on now, they should immediately REPEAL, and then REPLACE at a later date.”

While President Trump didn’t put it this way, the real intent behind this proposal appears to be to repeal and erase Obamacare. That’s so because the chances of getting a new health care bill of any meaningful significance passed after the Affordable Care Act (aka Obmacare) is no longer law would be slim and none.

The hard truth is that the initial version of the Senate’s health care bill that was pulled and not voted upon was less about improving health care for the majority of Americans and was much more about:

  • Reducing the nation’s budget deficit

  • Giving large tax breaks to the wealthy

  • Elevating state governments’ rights over the federal government’s

The Senate is now trying to craft a different version of its health care bill that would be passable. Senate Majority Leader Mitch McConnell (R- KY) compared the Senate’s negotiations to a Rubik’s Cube, stating he is “trying to figure out how to twist the dials to get to 50 to replace this with something better than this.”

Pardon us for saying so but twisting “the dials to get to 50” is not the way to get to “something better than Obamacare.” Getting to 50 should be a means not an end. The end should be an improved health care bill that benefits all Americans.

By the way, in the good old days of the Senate, the “dials” needed to be twisted to get to 60. Sadly, those days seem to be long gone.

Given all of this, we believe that unless the leadership can come to its senses and return the Senate to being the deliberative and collaborative body it has been historically, it is not time to repeal and replace Obamacare. Instead, it is time to repeal and replace this not-so-great health care debate.

Shortly after President Trump summoned the Republican members of the House to the White House’s Rose Garden to celebrate the passage of their version of the health care bill, he labeled it “mean.” The Senate version is not only mean. It is mean-spirited.

That’s because it was created by a cabal in a closet. And, once it came out of the closet, even several Republican senators did not want to salute it.

Those in charge of crafting the legislation probably thought they could sell it to their constituents and Trump supporters. But, after the President came out as lukewarm on the Senate bill and the Congressional Budget Office (CB0) scored it, that delusion was over.

The CBO does not assign grades to draft legislation it reviews. But, if it did, the Senate health care bill would have received a big, fat “F”. That F would have stood not for failure but for “farcical” and “foolish”.

The CBO said that 22 million Americans would lose their health care coverage over the next year under the proposed legislation. If that is making health care better for all Americans tell and show us how.

It’s said that you can fool some of the people some of the time. And, polls after the CBO assessment attested to that as any where from 12% to 17% of those surveyed approved of the Senate bill. The majority of Americans disapproved, however, and that speaks volumes.

It is time to stop and take a long, hard and serious look at what the totally one-sided and partisan bickering on health care says to:

  • Those growing old in the United States

  • The character of this country

  • The future of our democracy

Ron Lieber, in a powerful article in the New York Times describes the devastating effects that proposed changes to Medicaid will have on the elderly. Lieber notes that one in three people over 65 end up in a nursing home and that according to the Kaiser Family Foundation 62% of those living in nursing homes today cannot afford to pay their bills on their own.

He observes that many of the states currently spend anywhere from two-thirds to 40 percent of their budgets to cover home and community based care for seniors. Both the Senate and House versions of the Republican health care bill provide less for Medicaid.

So, Lieber duly notes that “If state Medicaid administrators have much less money to work with in future years, they will face some unpleasant choices.” He surmises that “home care for elderly will probably be cut first, given that Medicaid isn’t required to pay for that but is required to pay for nursing home care.”

U.S. representative Joe Kennedy (D-MA) comes at it from a moral angle looking at what the health care cuts and other domestic initiatives of the Administration say about the character of our country. In a speech delivered at The Summit, Sojourners’ annual gathering of faith and justice leaders, Rep. Kennedy said:

“Our noble country sees potential not only when we are at our best but when we are at our worst. When we are broken or inadequate or insufficient. When we fall short or do wrong or don’t measure up.

When we suffer not because we are failures but because we are human. And because there is nothing more universal to our brief experience here on Earth than the fact that each of us will feel the sky fall. We offer mercy because at some point we will need it too.

For generations this has been a higher calling that has united Americans across the aisle. It was the patriotic edict laid out by President George W. Bush in his first inaugural address saying,

‘I can pledge our nation to a goal: when we see that wounded traveler on the road to Jericho, we will not pass to the other side.’

But today I tell you in no uncertain terms that this collective commitment to dignity is at risk.

We cannot write it off, we cannot pretend it’s otherwise, we cannot relegate it to “politics” with an eye roll or a sign because it is infiltrating every inch of American life, and we know that. You and I feel it. Deep within us and all around us.

This new guard in Washington isn’t just targeting the laws that protect us – they are targeting the very idea that we are all worth protecting.”

Finally, what does this health care debate and other things contributing to our nation’s current apocalyptic state say about the future of our democracy? Our democratic republic, the United States of America, is a fragile crucible and has been since its establishment in 1776.

Today, in this 21st century, the United States is devolving into the Island States of America. We will have more commentary about this sorry condition in our next blog. For now, suffice it to say, as Thomas Paine did, “These are the times that try men’s souls.”

And, this endless health care debate with the House voting more than 50 times to repeal and replace Obamacare after it was passed in 2009, and the new House and Senate bills of 2017 which really don’t provide positive alternatives or constructive improvements on Obamacare have been among the most trying of these times.

We write this, not as unabashed supporters of Obamacare, but as early critics of its limitations. After presenting our analysis of the health care bill, in our book: Renewing the American Dream: A Citizen’s Guide for Restoring Our Competitive Advantage, published in 2010, we wrote,

So, in our opinion, when it comes to health care reform – the song, “We’ve Only Just Begun” comes to mind. Real reform will come only when we bend the cost curve down and the quality curve up. That’s what the business case for the remainder of this decade – now that there is something to build on – must be all about.

Unfortunately, that’s not what it has been about. Forget the business case and across-the-aisle rational negotiation and decision-making.

Obamacare became and continues to be a political football. This not so-great health care debate in the year 2017 proves that to a fare thee well.

That’s why we say let’s put an end to that debate. Do no more harm.

Put the politicking aside and put the interests of the people first. After that is done, the real healing can begin.

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