It’s time for the members of Congress and millions of Americans who oppose health care reform to stop hoping it will go away and begin to make sure it works as well as possible.
It’s not going away because the first opportunity for repeal is 2017, and even that possibility assumes that a solid conservative majority in each chamber and a conservative president will emerge from the 2016 elections. Without a conservative president, both houses would have to be veto-proof, a situation that has occurred fewer than 10 times.
By 2017, the 20 percent of the economy that is health care will have undergone enormous changes: Many medical practices will be rearranged; millions of previously uninsured people will be benefiting from coverage; the medical-outcomes database will be taking useful shape; health care markets will be running; many of the outsized fears about the act’s impact will have dissolved and some of its flaws will have been exposed.
That last fact is the one most in need of our concerted attention.
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As things now stand in the House of Representatives, obvious problems in the complex law are not being addressed by Congress because the most ardent opponents cannot bring themselves to vote for anything except repeal – 37 fruitless times so far – and supporters are reluctant to push for changes either because they are fearful of Pandora’s-box syndrome or have recognized the futility of it all.
Any massive new program – whether governmental, commercial or scientific – needs adjustments along the way. That was true of Social Security in the 1930s, Medicare in the 1960s and immigration in the 1980s. Though none of those is perfect, the American people are far better off with them than we would be without them.
The administrations and Congresses of those years found ways to make needed changes without either blowing up the programs or letting avoidable bad things happen to people.
It should be no different with health care, but so far there’s little sign that the political will exists to work at improvements.
Instead some states, including Kansas, and some congressmen, including our Rep. Tim Huelskamp, R-Fowler, are willing to let bad things happen to people in order to thwart reform out of what generously can be defined as ideological stubbornness.
Fortunately, as with the entire nation, the large majority of Kansans who are covered by employer or Medicare policies will see little change despite state foot-dragging, and those who aren’t currently covered, along with millions of other Americans, will have newfound security.
How fascinating it would be to peek into the spring of 2017 under the assumption of a conservative sweep. As promised during the campaigns, the new Congress passes total repeal and the president signs it, igniting the most sweeping government takeaway in the nation’s history:
• Millions of people stripped of insurance.
• Medical practitioners forced to reorganize once again.
• Insurance companies surrender hundreds of millions in newly found premiums.
• Small businesses face rewriting compensation plans and large businesses renegotiating their union contracts.
• At least 37 states must retool Medicaid plans.
And everyone will face years of uncertainty until the second – and most difficult – part of “repeal and replace” is thrashed out, likely over several years.
All of that is avoidable by our representatives rediscovering political will and moral courage.