gracchusdixit

Two days ago, in hundreds of towns and cities across the land, thousands of Americans gathered to protest the “election” of Donald J. Trump and, even more pointedly, to decry the looming repeal of the Affordable Care Act—an event that would deny health insurance to 30 million people and send insurance premiums rocketing skyward.

In the long and hard-fought run-up to the passage of the Affordable Care Act—arguably Barack Obama’s greatest achievement as president—tea party lunatics like Michelle Bachman charged that the ACA would lead to the rationing of healthcare and, far worse, the creation of bureaucratic “death panels,” which might decide to pull the plug on dear old granny just to save a few pennies.

Needless to say, this prophecy of a satanic, socialist future never materialized, since the worldview of people like Bachman is rooted, not in reality, but in the nightmarish fantasies of the Book of Revelations.  Not only did the ACA not create “socialized medicine,” let alone “death panels,” it immediately began to make things better for millions of Americans, expanding coverage, improving health outcomes, slowing cost increases, and  strengthening the long-term financial prospects of Medicare.

None of this caused Republicans to change their rhetorical tune or budge from their bitter opposition.  From the very day the ACA was passed, they declared it to be a catastrophic failure, a canard endlessly repeated on the campaign trail by Donald Trump and echoed by Republican leaders.  Trump is now promising that he will soon reveal an alternative that will “take care of everyone” and do so with lower deductibles at a lower cost.  Since he has thus far failed to deliver on any of his promises, this latest boast is in all likelihood pure fiction, another rhetorical bait-and-switch designed to sucker his hapless, naïve, and gullible supporters.

What is not fictional is that, within hours of the new Congress being sworn in, Republicans took the first steps to abolish the ACA, without having the slightest idea of how to replace it.  The only alternative they have thus far presented is the hopelessly vague notion that “market-based solutions” will somehow fix the fundamental problems of our healthcare system.  This notion would be laughable if its consequences weren’t so serious.

The truth is, Republicans are so blinkered by their ideology that they have lost all ability to see reality even when it stares them in the face.  Their mystical faith in the efficacy of “market-based solutions” is a dramatic case in point.  It is a faith that is not only impractical but immoral.

The impracticality is abundantly clear to anyone with open eyes and an open mind.  The healthcare system of the United States is already “market-based,” and it is a woeful failure.  Our system is twice as expensive as any other in the advanced world and by virtually every measure produces inferior results.

The reason for this outcome is also abundantly clear.  The reason is that our system is not primarily designed to provide decent and affordable healthcare to all our citizens, but, rather, to generate wealth and profits for insurance companies, drug-makers, and healthcare providers.  Every other advanced country in the world confronted this reality a long time ago,  came to the conclusion that a “market-based” system is utterly incapable of providing adequate healthcare at a reasonable cost, and pursued a different solution.

The choices other countries made range across a wide spectrum.  The United Kingdom and Canada chose to nationalize their healthcare systems outright, decisions that, no matter what you hear from critics in the United States, are overwhelmingly popular in both countries.  France, which by virtually every metric provides to its citizens the best healthcare in the world, chose a hybrid approach, in which the government provides essential healthcare to all citizens, leaving individuals free to pay for supplementary private care.  Germany chose to make employers responsible for providing healthcare, under strict and mandatory guidelines.  Other countries, like Switzerland and Japan, chose to leave the job of funding healthcare to private insurance companies, while the government negotiates prices and regulates costs.

The moral choice made by the rest of the advanced world is no less clear.  The United Kingdom and Canada, France and Germany, the Dutch and the Scandinavians, the Swiss and the Japanese, have decided that decent healthcare is a fundamental human need, even a “right,” which a responsible society must provide to all its citizens.  The only question is how to provide it most effectively and affordably.  Every advanced country in the world, other than our own, has concluded that “market-based solutions” are neither effective nor affordable.

Republicans in Congress have chosen to ignore these facts, to ignore the evidence, to insist on solutions that are ideological, impractical, and immoral.  The tragic irony is that, in the name of “appealing and replacing” the Affordable Care Act, Republicans are about to impose upon the American people the very nightmare they once pretended to deplore.  Millions will lose their health insurance, and many will sicken or die as a result.  The Republican majority in Congress has become a “death panel,” and its members will soon have blood on their hands.