May 7, 2017

Editorial: On health care, a sickening display

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The Capitol building -- looks good from afar, but it's a mess in there, Mariano says.

Republicans’ years-long, devil-may-care and glaringly unprepared push to repeal and replace Obamacare has households across the country today confused and scared, and rightfully so.

Last week, the national sickness that is politics took a turn for the worse.

The U.S. House barely passed its atrocious healthcare legislation, then gathered in all-Republican force at the White House Rose Garden as if in triumph.

It’s not, first of all, a triumph in the furious quest to overturn Obamacare just yet. This dishearteningly flawed bill, the House’s second try at writing a healthcare measure since President Trump took office, must next face the Senate, where the knee-jerk “repeal” reflex is less pronounced.

Some Republican senators have already signaled a more cautious approach to this serious and complex matter. And in terms of party representation, the Senate makeup leaves them less margin for error.

We will surely get better from that chamber. The hope, now, is that Americans in need of universal, high-quality health care will get far better treatment than received from the House.

Irresponsibly, Thursday’s vote was rushed in many ways. The Congressional Budget Office had not completed its assessment of the financial aspects of the healthcare rule changes. And there were no hearings held — despite this being legislation that would affect everyone and tremendously impact the economy, and which generated confusion on key points right up to and following the vote.

Several groups stand to come out on the short end of Trumpcare, many of them among the poor, elderly and disabled who recently, under Obama, were able to enroll in Medicaid. States worst-hit by the opiate crisis — Massachusetts among them — would have all federal funding removed under the House’s latest bill.

Another case in point is coverage for pre-existing conditions

Flickr / Evan Guest

President Trump

Republicans’ years-long, devil-may-care and glaringly unprepared push to repeal and replace Obamacare has households across the country today confused and scared, and rightfully so. Despite Trump’s assurances that coverage for pre-existing conditions would be guaranteed under the bill, what the House passed would allow states to gain waivers bypassing insurance rules. Pre-existing conditions, in short, could mean sky-high premiums for some.

An $8 billion last-minute tack-on to pretend to ease this pain is, essentially, meaningless. It’s a trickle given the vast amounts of dollars involved in the proposed legislation. And Republicans have pulled other tricks. Corporations and the wealthy stand to benefit from billions of dollars’ worth of tax cuts, the curative power of which — if any — has not been explained to the millions of mortals directly impacted, for better or worse, by Washington’s healthcare decisions.

The proposed legislation also removes the cornerstone of Obamacare requiring the purchase of health insurance. Though certainly that issue is an interesting debate, abolishing that mandate crumbles the current healthcare structure in ways demanding exploration. Similarly concerning is that the House measure would allow states to opt out of providing health benefits such as maternity leave and mental health services.

Analysts say millions of Americans stand to lose coverage with health care in Republican hands.

In that light, a breather is in order.

Nothing’s enacted yet. If the Affordable Care Act is to be yanked off the books, rather than thoughtfully operated on as this patient deserves, there are several steps ahead that should mitigate the damage.

A moderated Senate version of the Republicans’ American Health Care Act, once it passes, would need further congressional reworking and approvals before reaching Trump’s desk.

Is it too much to hope that the U.S. Senate will sit down with industry experts and political veterans from both parties on health care, and carefully craft new legislation or ACA revisions worthy of the issue and of ourselves?

Given the strength of the U.S. Constitution and America’s receding but still strong stature as a global leader, mindless expediency, reckless unfairness and deafness to excellence are not really in our pedigree.

Our region’s representative in Washington, D.C., U.S. Rep. James P. McGovern, understands this.

Office of Congressman Jim McGovern

U.S. Rep. Jim McGovern

He upheld our system’s ideals — and did Worcester proud — by speaking calmly and passionately last week on behalf of constituents. On Wednesday, during a Rules Committee meeting, McGovern reacted forcefully not to the substance of the bill — which he certainly disagrees with — but on the process employed to get it passed.

Wherever one stands on our country’s protracted healthcare debate, his remarks to that committee deserve a listen. “I think health care is a very personal issue. It’s very important, and people want us to get it right,” he told his House colleagues. “And I don’t think anybody here believes that we’re getting this right, even those of us with different opinions in the process that we’re utilizing here.

“I gotta be honest with you, this process, to put it bluntly, is a goddamn mess. I mean, it really is,” he continued. “I don’t know how anybody can defend it. Fixes upon fixes to fix the fixes to fix the fixes. And it’s going to be brought to the floor tomorrow, and … that’s how we’re going to serve our constituents? … I think the whole process and the way it’s being handled is an insult to this institution, and, more importantly, it’s an insult to the American people.”

The House hurriedly held its vote once it realized it had enough supporters to succeed. It garnered those final Republican supporters by adding last-gasp changes to appease party centrists and extremists. The House’s resuscitated bill — this was its second attempt to write healthcare legislation since Trump took office — squeaked by, 217-213.

With 20 Republicans joining all of the House’s 193 Democrats in voting no, the result was one vote more than the 216 majority needed.

Massachusetts, a leader in healthcare reform, is fortunate to have Gov. Charlie Baker steady at the helm while Washington wrestles with the issue amid Obamacare-overthrow fervor.

“A very difficult pill for the commonwealth to swallow,” is how Baker described the legislation. It would be a costly pill of at least $1 billion, he estimated. The governor, a Republican, also said: “I certainly think there are plenty of things we can do to fix the Affordable Care Act.”

Crafting healthcare legislation should be a delicate operation, not a hack job in which privileged people serve special interests at the expense of the rest of us.

We fervently hope the healthcare debate in America hit bottom on Thursday.

The singsong taunts of some House Democrats in response to the vote were an embarrassment; though not nearly so as the fact that 217 of their colleagues had just accepted — and then took a bus ride to the White House to celebrate — such a deeply flawed and cynical bill.

As the Hippocratic Oath stresses, first, do no harm. That principle in medicine should guide healthcare legislation just as much.

Health care is about people, not politics. And since sickness doesn’t take sides, health care is a topic that ought to lend itself to togetherness.

This moment in American history is an opportunity. It’s time for deliberation, negotiation and wisdom to come to bear to make the Democrats’ signature achievement under the Obama administration better — whether it’s tweaked, or switched out for a Republican version.

We urge our political leaders to proceed slowly from here. Time, study and negotiation are needed. This issue is too central to too many lives to be choked by chronic partisanship. “Care” should be the leading word as our eyes and hopes turn to the Senate.

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