I am more and more convinced that we would be in better shape if John Kasich had been elected president. Like victims of addiction, it is sometimes best to hit the bottom before coming to grasp with reality so that sustainable changes can be made.
Our citizenry has been addicted to complacency, a high degree of ignorance of and non-involvement in our electoral system, a quickness to adopt the opinions of political hacks and a far too lenient attitude toward our elected representatives. Sound bites have replaced thorough investigation. Partisan rhetoric has replaced thoughtful discussion. Our country needs a serious change in governance and it has to come through the grassroots but the "grass" is not being cultivated.
The Affordable Care Act is certainly flawed but had it not been so poorly legislated and implemented we would not have realized the depth of the problems. We did not know how many otherwise healthy citizens would opt not to have health insurance, knowing that they would not be refused treatment at hospitals and, because newly insured persons cannot be refused coverage due to pre-existing conditions, those facing serious illness or injury can obtain coverage practically after the fact, thus passing the cost to those who responsibly purchased insurance as best they could.
Rather than try to fix the problems in the ACA, Republican partisan politics cited Democrats as irresponsibly promoting payment for health care costs far beyond realistically available resources. Then came a repeal and replacement attempt by the Republican opposition which immediately lost credibility and the opportunity to compromise when the Senate majority leader, in the first sentence of his announcement introducing the proposed legislation, attacked the opposing party rather than highlighting the merits of the legislation. Of course the opposing Democrats opted not to cooperate in a meaningful revision of the ACA leaving a small caucus of Republicans to write a partisan draft of legislation that, should it pass, will be targeted for yet another repeal and replacement when the Republicans lose the Senate.
Not to be outdone in the contest the Senate minority leader, immediately following publication of the Republican draft of replacement health care legislation, denigrated the opposing party and the proposed legislation with remarks apparently prepared prior to reading the draft of the proposed legislation. And so it goes.
The contestants in Congress continue to play their games while the American public suffer for want of a solid health care plan, and much of the nation's business remains unaddressed. The partisan politics serves only to continue the shell game of who pays the cost which in its present or replacement form. By anyone's count, is beyond our collective ability to pay without increasing the national debt and/or depleting individual savings, capital reserves and equity. Some would fund increased costs by raising the national debt for short term political gain. Some want more taxes on the fortunate few who can well afford them. The "tax cut for the wealthy" that is characterized as an evil thing could be writ large as "reduced tax gouging" as those with high earned income pay nearly 40% in taxes and inheritance taxes on small businesses and farms that can easily bankrupt the business out of existence. But even increased taxes, let alone reducing them, would not be enough to pay the bills.
So what can we do? Few who understand the potential for waste and inefficiency in large organizations not held accountable by market pressures would seek a single payer health care system but it looks like that may the answer. Policies would have to be implemented to reduce the number of citizens who game the system by not participating. All costs would have to be considered and more efficient means of delivery would have to be designed. Health care should not be refused to anyone, even those who abuse the system, but costs, not just insurance costs but costs of health care in general, need to be better managed. This will only be accomplished when Congress stops the partisan contest and sincerely addresses the issues and brings all the players – physicians, hospitals, pharmaceutical companies, patients, labor union — everyone together to approach the problem with an open mind and an attitude of fairness that excludes the "us vs. them" atmosphere that has plagued the Congress.
There is a general un-American attitude that has developed in our country. The strength of our nation built on unity of purpose has been eroded by egocentric tendencies exemplified by the behavior of members of Congress. Indeed, the president has also unfortunately extended the "me first" attitude to the exclusion of and deep concern by our international partners. Our democratic republic demands cooperation and compromise to foster our successful existence. A self-centered approach to problems will lead to our eventual demise.
Our nation has, in decades past, been fortunate to have had the advantage of an excess of wealth. That has changed. We are now largely a consumer nation reliant on the production and supply of an international economy. We do not create wealth and generate profits by combining labor and resources as we did in the post second world war economy. Much of our manufacturing fled to foreign shores. Economic competition from emerging nations grows stronger. Employers no longer have the luxury of providing health care insurance as an expected benefit. Yet the cost of health care continues to rise.
Surely it is time to move health care from the arena of competitive politics and into the sanctuary of cooperation. It is not just a humanitarian issue. We need our citizenry to be healthy in body, mind and spirit to adapt and compete in a world economy. Health care that includes treatment as well as prevention and education is too important to remain a political football in a never-ending game in which all lose.
Enright is an associate broker with Long & Foster Real Estate in James City County.