Health care redux: Can’t we learn?

In the midst of Republicans’ endless health care victory laps last week, Rep. Joe Barton, R-Texas, offered this bipolar view of the meaning of Thursday’s vote: “You either believe in government or you believe in markets. I believe in markets.”

Thus he joined 216 other House Republicans in passing along to the Senate the American Health Care Act, revoking the most critical parts of the Affordable Care Act, which they had derisively labeled “Obamacare” seven years ago and refused thereafter to try to improve.

But last week’s Republican victory laps were taken holding aloft only a glittery participation trophy, and a tenuous one at that. The reckless proposal they cobbled together as soon as they controlled the White House reflected no fresh thinking about the considerable problems of America’s health care system, the world’s most expensive and, among developed nations, one of the least effective except for the very wealthy.

After their seven years of promising the impossible, their “repeal and replace” vehicle is headed for either major remodeling or total junking in the Senate. But for now, House members can rush home to show Mom and Dad their participation trophy. Unfortunately for the members, many moms and dads know the difference between just doing something and doing it successfully; the difference between satisfying artificial political needs and solving a large public problem.

It was the crimped attitudes of people like Barton and his advisers and financial supporters that put the GOP in a bad place on the health care issue seven years ago with glib, divisive sound bites such as the one about the alleged incompatibility of government and markets.

American politics too often becomes stuck and American progress thwarted by reliance on such absolutist framing of choices. Just as most moms and dads know in their minds if not their hearts the difference between a participation trophy and an earned one, attentive citizens know a false dichotomy when they hear it.

And the more they are presented only two sides of such complex questions as abortion, health care or taxation, the more they are repelled by politics and the politicians who create the either/or framings. Their personal experience tells them the universe of ideas is not two dimensional; that ambivalence is everywhere, unavoidably baked into democratic self-determination. When the discussion of political issues is framed only at the polar extremes, most citizens are excluded; they don’t hear their nuanced beliefs included in a contrived discussion. So they turn away.

Yet to survive, politicians must persuade people to make one-dimensional choices between candidates; there’s no room for ambivalence in a voting booth. So politicians deliberately, and often artificially, create larger and larger gaps between their beliefs. And that’s not going to change until more voters consciously and publicly add reasonableness and willingness to compromise as the price of their votes.

If ever the nation had an issue capable of driving such a useful political evolution, it is health care. One sixth of the U.S. economy is directly involved; lives are quite literally at stake; the mental and physical well-being of future generations hang in the balance. It begs for bipartisanship.

And yet last week Democrats were vengefully and cynically labeling the new legislation “Trumpcare” and predicting disaster even while ensuring it by making no real effort to intervene.

When will we learn?

This story was originally published May 9, 2017 at 5:03 AM with the headline "Health care redux: Can’t we learn?."