Pundit Wire

America Still Needs a Serious Health Care Debate

In three years of street brawl over America’s health care system and the Affordable Care Act, there’s one thing the country still hasn’t had: a serious debate over America’s health care system and the Affordable Care Act.

We have been subjected to everything from snarky bs to thermonuclear rhetoric. We’ve heard well-crafted talking points and been told that Obamacare would end Western civilization as we know it. We’ve been the targets of a propaganda campaign that would make Herr Goebbels beam with pride. But, what we’ve never heard from our elected leaders is an honest, straight-up, fact-based discussion about health care in the United States; what the problems are; what happens in the future if something isn’t done; and of course, the best way to fix it.

We know health care costs in the U.S. are by far the highest in the world. We know the U.S. spends more on health care per person than any other country on the planet. So, we’re paying for the best health care system, right? Wrong.

According to the World Health Organization (WHO), the U.S. ranks 37th out of 191 countries in health care quality. We lead the world in preventable deaths. We’re 42nd in life expectancy. Our infant mortality rate is much higher than other industrialized nations. A night in a U.S. hospital costs 5.6 times more than in Japan. In the last few years, health care costs have been listed as a major factor in more than 60 percent of personal bankruptcy filings. Clearly, we’re paying a lot more and getting a lot less. Yet we still haven’t had a serious debate over our health care system and the Affordable Care Act.

I mentioned that we’ve been the targets of a propaganda campaign and I meant that quite literally. The Republican establishment, their representatives in Congress and the interests behind them have conducted a campaign against ‘Obamacare’ using textbook propaganda techniques. But what they’ve never done is propose an alternative. What they’ve never done is tell the public what they’d do. Beyond wanting to cap the amount you can recover in a lawsuit against a doctor who commits medical malpractice, they really don’t have a plan. All they’ve ever talked about is killing Obamacare. They’ve never really tried to find a solution.

I read in another post on this site that “Democrats railroaded the ACA through Congress without a single Republican vote.” We’ve heard that accusation a thousand times, and it’s still dishonest. Anyone who was working in Congress in 2009 saw and heard and followed the endless committee, subcommittee and Gang of Six meetings as Democrats tried desperately to bring Republicans on board. Senate Finance Chairman Max Baucus spent months trying fecklessly to win over Olympia Snowe of Maine, at one point, I think, promising her all the land west of the Mississippi. But to no avail. And yet, Republicans claim they’d been left completely out of the process. As it turned out, 216 amendments to the legislation offered by Republicans were considered, and 161 of those Republican amendments are actually in the Patient Protection and Affordable Care Act. Not minor amendments either, but language from Republican legislation that addresses some of their major issues:

  • Allowing individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, just as large corporations and labor unions do;
  • Giving states the tools to create their own innovative reforms to lower health care costs;
  • Cracking down on junk lawsuits by providing grants to States to evaluate promising medical liability reform ideas that put patient safety first, prevent medical errors and reduce liability insurance premiums;
  • Letting families and businesses buy health insurance across state lines;
  • Extending dependent coverage to age 26 and give young adults new options;
  • Allowing automatic enrollment by employers in health insurance and allowing employees to opt-out;
  • Providing mechanisms to improve healthcare quality; and
  • Promoting Community Mental Health Centers to provide access to comprehensive mental health services in a community setting, but ensuring that such facilities provide appropriate care and do not take advantage of Medicare patients or taxpayers.

Not bad for a group that claims they were completely left out of the process. The fact that they turned around and voted lock step against the legislation says a lot more about them than it does the legislation or the process.

We still need a serious debate out our health care system and the Affordable Care Act. It can be an argument  It can be loud and rancorous. People can yell at one another. But they have to tell the truth. They can’t just make stuff up.

The issue has been in the news nearly every day for three years. Now the Supreme Court has dived into the middle of it and there is absolutely no telling where their deliberations may lead. It could be an enlightened decision reflecting a thoughtful attempt to interpret the Commerce Clause of the Constitution and its application to a 21st Century society on an issue that directly affects the lives of millions of citizens. Or it could be a politically-driven stink bomb like Bush vs. Gore.

In the meantime, we’ve still never had a serious debate about our health care system and the Affordable Care Act. There’s still time. The matter certainly deserves it. So do we.

Dave HelfertDave Helfert has been a political and governmental communicator for more than 30 years, writing speeches for elected officials and candidates, creating media in more than 200 political campaigns, working for six years as a Communications Director in the Clinton Administration and then nine years in the U.S. House.

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  • Olya Thompson

    Yes, as you point out, I too have been waiting to hear a discussion/debate about the serious issues that confront health care in this nation, and have yet to hear it. Is this because the influence of special interests and lobbyists (who have a stake in the current system that is clearly broken) is so strong?

  • http://twitter.com/jimjaf @jimjaf

    well, its hard to see how you can have a serious debate about a bill when no one understands precisely how it will work. or why such a debate would help. time will tell. at the moment, each side has a vision of how things will play out. the democrats think we'll make care more efficiently allowing us to be healthier while moderating costs. the republicans think this goal can only be achieved by cookbook medicine where washington bureaucrats impose templates on physician performance. either is a possbility. how constructive a debate on whether my possibility or yours is more likely is a mystery to me.

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