A letter I may or may not send to Rep. Paul Ryan (R-WI), who took part in the health care summit today and who was on CNN this evening discussing his party’s position on health care reform:
Dear Mr. Ryan,
In the past weeks and months, I have heard you and many members of your party talk a great deal about the fiscal problems with the current health care bill. A lot of this talk was on display today at the health care summit. You say the bill is too expensive, America can’t afford it, it won’t bend the cost curve enough, it will add to the deficit, it will not solve the problem of Medicare’s looming insolvency, and so on. These are all questionable claims – some of them have been roundly refuted – but for the moment I concede them.
I want to direct your attention to another point. Over the last several months, and years really, multiple studies done by well-respected institutions, both inside and outside of government, have shown the human toll inflicted by our current health care system. Some forty-five million people in our country do not have health insurance, over forty thousand per year die simply because they do not have it or can’t afford it. People, including children and the elderly, are routinely denied insurance because of pre-existing conditions and other factors. Just in the past month, many people have been priced out of the insurance market because of massive premium hikes that they cannot afford.
My question to you is this: do you really believe, given these substantiated facts about our current health care system, that objecting to this bill on fiscal grounds is a morally defensible position? Even if it is economically defensible, do you really believe that shrinking our deficit is as important as saving people’s lives?
The measures that you and your Republican colleagues have proposed to add to the bill speak directly to the financial challenges of providing health care to a large and diverse populous. Enabling people to purchase insurance across state lines, cutting waste and fraud, conducting tort reform, making Medicare solvent, and other ideas all address economic and fiscal concerns. Admittedly, many of these concerns are profound. But I cannot help wondering if you and your party have forgotten that health care is only secondarily a financial issue; it is, first and foremost, a human issue. Throughout this debate, the insurance companies have focused on the financial repercussions of health care reform. That is unfortunate but predictable, as they are companies and inevitably driven by the profit motive and increasing their bottom line. What worries me is that your party believes this issue is only about finances – about who profits and who loses, who gives and who receives, who is in debt and who is not.
President Obama deflected several questions today by saying that his party and yours have “philosophical differences.” That is a mysterious phrase, and the only real philosophical difference I see in this debate is whether one is willing to do the right thing, the moral thing, no matter what the cost. Where the Democratic party stands on that question is uncertain, but your party most certainly considers cost the paramount issue in this whole debate. As a reasonable and moral person, do you really think that is acceptable?
In the weeks ahead, I urge you and your colleagues to consider the principles upon which your party, our government, and this country are based. I urge you to consider that health care is a human right, not a product of the free market, not a gift to be selectively administered by the capricious hand of private corporations. I urge you to consider that providing health care to all Americans is a human challenge with financial obstacles, not a financial challenge with human considerations.
I am an American for whom health insurance has always been as sure a thing as food on the table. This is true of most of the people I know, and it is probably true of you and most of the people you know. I would ask you first to consider the role that this plays in your thinking about the problem. Second, and more importantly, I would ask you to imagine the difficulty you might have in telling a person whose child, spouse or parent was sick and without insurance that national fiscal difficulties prevented you from concurring with a plan to provide them with health insurance. If you think that might be a difficult conversation for you to have, then I would urge you, at the very least, to temporarily bracket your financial misgivings about this bill.
There are many ways of measuring cost. People who are healthy and affluent measure it differently than those who are sick and poor. Different people in different situations gauge affordability in different ways. Consider these differences. There are real people in my state and yours, and in all others in this country, who are sick and dying and cannot get the health care they deserve. These people do not correspond to lines on a balance sheet. This issue is not about money, it is about human decency.
Thank you,
Jasper Engel