Commenting on the Senate health care bill currently being debated, conservative pundit Marc Thiessen writes, “Here is the summary of the bill that Democrats will take to the American people in 2018: Republicans voted to cut $701 billion in taxes for corporations and the wealthy, and pay for it with $772 billion taken from Medicaid for the poor — all while pushing 22 million Americans off health care. And Senate Republicans are writing the script for them. Have they lost their minds?” He concludes, “Paying for a massive tax cut for the wealthy with cuts to health care for the most vulnerable Americans is morally reprehensible.”
And it is. And, yes, congressional Republicans have lost their minds. And, in so far as any of them claim to be conservatives, they also have lost their moral and philosophical bearings.
Now stay with me for a few minutes because I will ask you to remove yourself from politics and place yourself in the position of having to care for the poor without creating or adding to welfare dependency. And what I am asking you to do is not easy. The entire Senate health care bill debate has so many layers of politics involved now that it is almost impossible to discern good policy from bad.
For instance, both sides have a penchant for basing their arguments on evidence-based data. The political problem with this exercise is that partisans do not look at studies to actually learn from them. They look at studies to use as weapons against opponents. So, we get a study like the Oregon Medicaid Experiment and both sides claim it proves conclusively that their side is correct. But, in truth, if you read the results of the study, you would see that both sides have a point and, more importantly, the conclusions serve neither side’s interests.
So, as you listen to all of the arguments over the Senate health care bill, please keep in mind that almost all that you hear is political prattle aimed at one upmanship with the only goal being a legislative win at any cost. In other words, these elected officials do not care about the poor; they care only about partisan politics – and that behavior really is morally reprehensible.
The question I pose to you is this: Do you really care about the poor?
Be careful if you answer yes. Because now you will have to actually know the poor, not just think about them. After all, how can you help someone you only think you know? If you try, you are bound to get it all wrong. You will only get it right if you actually know them. And, as the old saying goes, to know them is to love them.
With you in charge of providing health care for the poor, and after you got to actually know them and love them, my guess is you would look at the life and circumstances of the poor one by one. You would create processes that afford them dignity and solutions designed to uniquely meet their needs. You would balance their individualism with the common good of society, regardless of whether or not assistance is provided publicly or privately. After all, your goal is to care for them, heal them and uplift them – that is, if you seek to really know them and love them.
No doubt you would quickly conclude that the best medical care you can provide is the service closest to them – from their own families, communities, associations and, if governmental, from state and local sources. You will want to be as close to the poor as possible, even intimate in your understanding of their needs and wants.
So, now you step back as a policy maker and review your options. You will soon conclude that private assistance, one-on-one, is the best delivery system for medical care. You want to be both effective in treatment and efficient with time and money. You would approach medical providers and ask them if they would give some of their time to assist the poor and even build a professional relationship with them. But if, for whatever sad reason, those medical providers do not step up, you have to move beyond them – or, rather, you have to pay them to provide services they would otherwise donate.
Here comes your first big realization: If the private sector will not or cannot cover the care, you are left with two choices – either public assistance or no assistance at all.
As you peel back the layers on this task, you’ll soon discover that caring for the poor becomes a multi-oriented approach – some private, some public, some not at all. The only approach that will remain constant is that to effectively and efficiently care for the poor you will have to know them and love them. And that is necessarily personal and local in application.
In other words, if D.C. politicians really want to help the poor with health care, they would place all authority and resources in the hands of state and local providers, both public and private. End of Senate health care debate. Period.