As the nation continues to stumble and bumble along a path that might lead to a reasonable, manageable health-care system, the issue is consistently dominated by political considerations rather than legitimate concerns about affordable and accessible medical care.
The subject of medical care brings to mind the Hippocratic Oath, historically sworn by physicians entering the profession, pledging to uphold high ethical standards and do no harm.
What we have seen with all the squabbling, blaming and secret conclaves over health-care legislation, and in political action in general, suggests there might be a "Hypocritic Oath" as hypocrisy appears to be the prevailing mode of political behavior.
At this point the fate of health-care legislation is unclear. What is clear is it is more a political issue than a policy issue, even though there are highly important policy issues involved. It exemplifies the sad state of our politicized and polarized public affairs.
Eight years ago, I wrote that if debate and decision-making on overhauling the health-care system could be conducted in a vacuum we might see some real progress. But as long as we treated it as a political issue, meaningful advancement would be difficult. Making that prognosis didn't require rare insight but recognized the complex knots and hardened positions in both parties.
While President Obama was still in office, the House of Representatives regularly voted to repeal and replace Obamacare, knowing, of course, that Obama would never sign such legislation. As candidate and president, Donald Trump repeatedly said ít would be "so easy" to repeal and replace on Day One. However, once Congress was actually dealing with the issue, he conceded that it would be "very tough."
Although the ACA won congressional approval without a single Republican vote in 2010, contrary to public perception the bill contained numerous Republican ideas and amendments.
This year, when congressional Republicans began to consider the substance of legislation, it became apparent that even with a Republican as president, they weren't really prepared -- despite those years of presumed preparation while Obama was in the Oval Office.
The nonpartisan Congressional Budget Office estimates the revised Senate Republican health-care bill would increase the number of uninsured people by 22 million people over the next 10 years if it passed.
Even though Trump derided the bill passed by the House as "mean," he orchestrated a big celebration at the White House. However, it raised more questions than answered, and when a small group of Senate Republicans headed by Majority Leader Mitch McConnell met behind closed doors (so much for transparency) the resulting proposal did not satisfy all those on the Republican side.
A good example is West Virginia Republican Sen. Shelley Moore Capito, who said, "I didn't come to Washington to hurt people," explaining her stand against her party's proposal to repeal Obamacare without a replacement plan. She noted that her state had significantly expanded Medicaid under Obamacare (as has Arkansas and 30 other states). Arkansas Republican Gov. Asa Hutchinson said, with more than 300,000 in the state on the expanded Medicaid program, the Senate bill would shift too much cost to states. He suggested a bipartisan approach is needed. However, hard-liners in both parties have shown no interest in finding common ground.
At one point, Trump said, "We'll let Obamacare fail, and then the Democrats are going to come to us."
Arkansas Republican Sen. Tom Cotton said, "Obamacare is hurting lots of Arkansans" and continues to favor repeal and replace. National polls, however, indicate declining support for doing that. While Trump undoubtedly has strong support in Arkansas, according to the latest Talk Business & Politics-Hendrix College survey his job-approval rating in Arkansas has gone from a 60 percent-35 percent approval-disapproval rating in February to just 50-47 currently.
Trump has sent mixed signals on the legislation, but after the bill failed in the Senate, he wanted to make clear that "I'm not going to own it." Unlike Harry Truman, he didn't assert that "The buck stops here." He tweeted, "We were let down by all of the Democrats and a few Republicans."
Regardless of where you assign the responsibility, the episode demonstrates again the polarized and politicized atmosphere that pervades Washington.
Trump boasts that he has compiled an extraordinary legislative record, surpassing those his predecessors in the opening months in office. However, the legislative record is actually very thin, mostly routine matters. He has signed high-profile executive orders, including withdrawal from the Trans-Pacific Partnership, and, importantly, his Supreme Court nominee won Senate approval, although it required McConnell changing Senate rules to lower the threshold for advancing Supreme Court nominees from 60 votes to a simple majority -- the "nuclear option."
"There is such a profound lack of trust between the two parties," said Maine Republican Sen. Susan Collins. "It's hard to know whether the polarization in the Senate reflects the country or whether the polarization and divisiveness affects the country."
There are more potential confrontations coming soon, including raising the debt ceiling. And the air is filled with charges and counter-charges about recusals, collusion, pardons, staff shakeups, sanctions and leaks.
What we need to see is more of a Hippocratic "do no harm" approach rather than continued Hypocritic politicization.
Commentary on 07/26/2017