What the Better Care Reconciliation Act says about America


The Senate version of the Republican health care bill lays bare the priorities of America’s current political leadership. It is not pretty. The new bill demonstrates the Republicans’ entirely unbalanced view of government and fiscal policy, where monetary value trumps all other values, and where only the wealthy are worthy of a helping hand.

These are the new values of the Republican leadership as evidenced by the new bill. We once valued openness in the American political process. This bill was prepared in secrecy. We considered our government one that was by and for its people. By report, the first ones shown this bill were lobbyists for the health insurance and pharmaceutical industries. And our widely shared values in the past placed a strong emphasis on help for those in need. This plan gives a huge amount of money to the wealthy and takes it away from most everyone else.

Most importantly, the new bill does not in any way attempt to fix what is wrong with the American health care system. It is hard to believe, but under the new plan, fewer people will have access to care, not more. And for many, health care will cost more, not less. And the bill in no way addresses the quality of the care that patients will receive. Such things are not a priority to the Republican leadership. Prior to Obamacare, 45,000 people died annually because they did not have health insurance. Under this new plan, things may be worse! Health care will continue to be our national disgrace.

But it perfectly reflects the unbalanced way that the current Republican leadership sees the world. They sell the notion that we cannot have both a strong, effective government and a strong economy — it is one or the other. They believe that we can’t have both healthy companies and healthy people. So they invest in the former, and abandon the latter. It is an unhealthy, unsustainable view of the world, and a bad philosophy with which to govern.

More and more, we see the end results of this divisive political philosophy playing out in society. They want us to believe that there is not enough money to go around. It is a zero sum game where only a select few can get the meat. The rest are left to fight over the bones.

One older patient told me that we should each just take responsibility for ourselves. He decried the fact that he should have to help pay for the health care of someone who rides a motorcycle without a helmet and suffers a head injury. I pointed out to the patient that he had type 2 diabetes, which was, at least in part, due to his unhealthy lifestyle choices, and that his Medicare insurance was funded by our tax dollars. He was only slightly chastened.

But the new health bill tells us about more than just the Republican leadership. The Democratic response is just as revealing. I asked one patient what he thought of the new bill and the efforts of the new president (for whom he voted) so far. I am paraphrasing, but his response was, “I don’t like any of it, but what other choice do we have?” In other words, he doesn’t feel as if the Democrats have proposed anything of substance that would be better, so he sides with the Republicans — whom he considers to be the lesser of the evils. So the failure of the Democratic leadership to present any better ideas provides the pretext for the Republicans to do as they please.

The current leadership cares for profits over people, CEOs over children, and the wealthy over the poor or the sick. We have reached a tipping point where many Americans lose their financial futures, and even their lives, for lack of medical care — when that care is readily available — because of such choices.

Abraham Lincoln was credited with the following lines, “The legitimate object of government is to do for a community of people whatever they need to have done, but cannot do at all, or cannot so well do, for themselves – in their separate, and individual capacities.” But the Republican leadership is scornful of the very notion that government can or should help, and holds those who “cannot do at all, or cannot so well do” in disdain. In its wake, the Democratic leadership offers little that is perceived to be better.

Good government strives for the proper balance amongst competing interests. It is not an easy thing to get right. Global budgetary interests must balance with human needs, and public interests must be balanced against private ones. We achieved such a balance in this country successfully in the post-World War II era and through the 1980s. The result was what we called the American Dream. That dream is gone for too many Americans now.

We can have effective government alongside a healthy, sustainable economy, strong companies, high-quality, affordable health care and education, a clean and safe environment, and plentiful jobs with good salaries. We can have a country and personal lives that effectively balance money with other things we value. But we will not achieve those things with the unbalanced priorities of our current political leadership. It will take a new generation of leaders, with re-ordered priorities, to get that done.

Matthew Hahn is a family physician who blogs at his self-titled site, Matthew Hahn, MD.  He is the author of Distracted: How Regulations Are Destroying the Practice of Medicine and Preventing True Health-Care Reform.

Image credit: Shutterstock.com


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