Monday, May 8, 2017

Republicans Take the Hypocritical Oath on Healthcare

When out of power, Republicans were the “Party of No.” Now that they hold power, they have simply become the “Party of Undo.”  Here is Steve’s take on Republican healthcare… and governing philosophy.

When historians look to mark the day that everything went off the rails in the United States of America, a very reasonable pick is October 23, 2010. That was the day that Senate Minority Leader Mitch McConnell of Kentucky said in an interview that The single most important thing we want to achieve is for President Obama to be a one-term president.”

There is no record of McConnell hastening to qualify this statement by noting that “of course I meant to say that this objective comes after ensuring the defense and safety of our nation, serving the needs of my constituency, and supporting and defending the Constitution, as I swore to do when I took the oath of office of the United States Senate.” No, job #1 for the Senator from Tennessee was to focus every fiber of his being on obstructing, fighting, and undermining the freely elected leader of his own country.

McConnell was true to his word, leading his party on a kamikaze raid on the Obama White House, triggering the mutually assured destruction of the daily civility, bipartisan cooperation, tough but open-minded negotiation, and endless horse trading that had miraculously enabled Congress to function more or less as the founding fathers had intended for more than 200 years. McConnell’s philosophy metastasized and became Patient Zero in the death spiral of dysfunction that gridlocks our government today.  In his signature act, McConnell was able to deny a sitting president his right to fill a vacancy in the Supreme Court with a brazen middle-finger salute to the obvious intent of the framers of the Constitution.

It was Mitch McConnell who mainstreamed the notion that being a Republican was more important than being an American, and who turned us from a nation of patriots into a nation of partisans.

In what must be considered plutonium-grade irony, the electile dysfunction in Washington, D.C. borne of McConnell’s mission of obstruction caused many Americans to lose patience with government, enabling Donald Trump to storm to the presidency by railing against the ineffectiveness, inaction, and swamp of self-interest in Washington, D.C.  That is to say: the Republican candidate for president campaigned directly against the Republican Party philosophy as articulated by one Mitch McConnell.

Of course, Mitch McConnell did not succeed in achieving the central organizing mission of his life’s work. Barack Obama won a second term, and, indeed, emerged at the end of his eight years in office as one of the most popular presidents in decades.

But the metastasized cancer of McConnell’s core objective did not wither and die as Obama prevailed and served successfully. Rather, cancers lie hidden and dormant as they tinker with mutations that enable them to roar back with murderous rage. When McConnell failed to terminate Barack Obama’s full terms in office, the cancer mutated and took on a different objective: to obliterate, after the fact, each and every accomplishment of the Obama administration.

This, in good measure, explains the unending and relentless assault that the Republican Party has mounted in order to be able to claim that it has delivered on its promise to “repeal and replace ObamaCare.”

Last week, a confluence of forces – Donald Trump’s increasingly desperate need for a single legislative triumph, the Republican Party’s desperate need to claim fulfillment of at least one campaign promise, Paul Ryan’s desperate need to restore his credibility as House Speaker, and the Republican Party’s need to eradicate the Obama legacy, came together to produce a Rube Goldberg construct that barely passed in the House of Representatives. The bill remains so flawed that there is talk of simply having the Senate rip it up and start over. ObamaCare is still the law of the land, and there are many hurdles ahead before the Republicans can achieve their goal. But to a party and a president consumed with optics, sound-bytes, and symbolism, the mere passage of the bill in the House was ample reason to celebrate.

The reason the bill is such a monstrosity is that it was conceived with no specific objective other than to enable Republicans to claim that they repealed Obamacare. In practical terms, this meant that this was no criteria for success other than passage in the U.S. House. The Republican goal was not to create something that was better than ObamaCare, it was to create something that could pass in the House of Representatives.

The reason it took three tries to even meet that standard is that Republicans themselves were in split in diametrically opposite positions about Obamacare. The right-wing Freedom Caucus essentially views any form of state-sponsored guaranteed health coverage as creeping socialism and wants to take the federal government out of regulating healthcare to the full extent possible. Centrist Republicans in heavily contested congressional districts could clearly see – in countless town hall meetings -- that their constituents found certain aspects of ObamaCare to be very compelling.  The most popular components of ObamaCare were the right to keep children up to age 26 on the parent’s plan, and the language preventing insurance companies from either charging exorbitant premiums to persons with “pre-existing conditions,” or denying coverage entirely. 

Using the criteria of “what can pass?” rather than “what is good?” the Republicans threaded the philosophical needle by abdicating, foisting off the question of whether insurance companies must offer insurance to people with pre-existing conditions to the individual states. The states, in turn, would have the option to allow insurance companies to charge exorbitant premiums, which is exactly where the hypocrisy hits the fan. The state can “require” an insurance company to offer insurance to all persons with pre-existing conditions, but the insurance company can determine the cost. If a cancer patient has to pay $150,000 for health insurance, then it is a sham to pretend that the ObamaCare requirement has been preserved.

This solution provided just enough of a coating over the bullshit to enable both wings of the party to go back to their constituents and say that the new health plan meets all of their requirements. More important, it allowed everyone to say that they had met their promise of voting to repeal ObamaCare.

What lies ahead is the matter of what bill – if any – ultimately emerges from the Senate.

In the short term, Republicans could all claim a desperately needed victory, the photo op, and the pretension of a George Dubya caliber “mission accomplished.” Paul Ryan was no longer flat-lining, Donald Trump’s presidency was temporarily out of the ICU, and Republican Representatives in the House of Representatives could pretend that they had provided their constituents with some vestige of healthcare that barely clears a bar of human decency. 

Sure, if this bill were ever to become law, it would cost poor people more, be more expensive for older people than younger people, result in millions of people losing insurance coverage, and -- because of the failure to provide guaranteed coverage for pre-existing conditions --  those most at risk will be in the most peril of being abandoned. Taxes on the super-rich will be reduced. Once again, the very people who voted Trump into the White House will be sucker-punched.

But hey, the Republicans can say that they actually succeeded in a vote to repeal and replace ObamaCare,so they are content that they have achieved their only real objective.

What might be of interest to Republicans is to look at healthcare from a different point of view, a perspective that is not informed solely and wholly by Mitch McConnell’s singular life goal of eradicating the legacy of Barack Obama.

Perhaps Republicans could look at health care from the perspective of those who provide it.

Interestingly, doctors are also administered an “oath of office." The difference is that doctors, unlike our politicians, actually read the words and take their oath seriously. Most people think that the Hippocratic Oath is centered on the idea of “do no harm.” In fact, those words do not appear at any point in the text.

What does appear, however, are these vows:

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

Yes, doctors are bound to reflect on the humanity of the persons they treat, the potential economic burden of their care, and to be vigilant about how that treatment affects the patient’s life and the lives of all those he or she holds dear. Wouldn’t it be something if our Republican representatives held themselves to such a standard? If they arrived at their decisions based on the impact on the constituents rather than on the donations of those who fund their re-election campaigns?

Our Republican members of Congress might be wise to reflect on the vows that physicians make, as well as on the oath that they themselves took upon taking office.

If their only goal in life is destroy the opposition party, they have lost sight of their vow to protect and defend the Constitution.

They are not serving their constituents if they are content to draft weasel language that protects their own jobs at the expense of the health of the people they serve.

The only creed that they are living by is the natural extension of the oath first uttered by Mitch McDonnell: The single most important thing we want to achieve is for President Obama to be a one-term president.” When out of power, the Republican Party became “the Party of No.” Now that the Republicans have a hold on every branch of government, they have simply become “the Party of Undo.”

We still have little idea of what Republicans actually seek to achieve, only what they seek to destroy.

And their oath of fealty to McConnell’s  commitment stands in precise and direct opposition to the very oath they took when they entered Congress.

Leave it to this Republican administration of fake news, lies, deception, and distraction to try to solve healthcare with a hypocritical oath.

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