Tom Kawczynski - Off the Record

I’ve avoided writing about health care as long as humanly possible because there is no topic which I have found more difficult throughout my political involvement.  Literally an issue of life and death for some people and some families, the equation has always come down to an inhumane choice between cost on one hand, and quality of life on the other.  How can we have an unfunded mandate against how can we watch someone suffer because they lack the resources or coverage?  I struggled with this in my abortive state legislature run, and almost never talk about it because I could not articulate my thoughts clearly enough.  I will do so today, so this may end up being a very long discussion, and I will talk about the pending legislation in light of my personal views.

I believe access to quality health care should be treated as a right.  I fully agree with those who state that it is not included in Article I, Section VIII of the Constitution, and that it was never the intention of the framers to see this.  To them, it would never have occurred to be a problem because the relationship between the doctor and the patient was direct, and health care was as simple as a bottle of whiskey, a couple of aspirins, and a house call.  Times have changed, and I find this is a question we should be asking ourselves as a society.  Given the resources we have and how we would choose to spend them, should we invest in our own future through making sure that everyone who wants access to health care has some ability to see both they and their families are covered.

Like many people who follow the issue, I have known that health care reform has been desperately needed for some time.  The present mishmash of public programs, emergency room visits, and underfunded clinics only costs more money because it is so disorganized.  It is misleading to some extent to point out only the structural costs of any pending legislation because we are paying all these other costs now.  Comprehensive reform, executed properly, would save many billions of dollars, and could help us compete as a nation with other countries where their businesses do not have the shoulder the burden of health care costs.

Having spent years as a Republican, I learned how to make a very effective economic argument for health care reform.  The truth, however, is that the real calculation has always been a human one for me.  When I walked the trail and talked to people, I learned of the real mishaps and misfortunes that people faced.  I learned about people losing their jobs because they got ill, and losing the insurance that sustained them.  How can you ever go to someone, whatever their background, and say in good conscience that your life or well-being just isn’t worth the cost?  Imagine the society that such thinking would create.  We like to believe we haven’t been that way, but I wonder.

I agree with the requirements that people with pre-existing conditions neither be excluded from health care coverage nor be dropped upon their discovery of an ailment.  Having insurance that only covers people in their health is ridiculous, and the sign of an industry that has the justifiable distaste of many people.  I do not trust health insurance companies as they stand between you and your doctors.

This debate has made it clear that the reason many people oppose this reform is out of fear for losing what health insurance they have.  I agree with and am very sympathetic to those fears.  I also see the fears of those who have no insurance at all, and must hope for the best.  I see those who are on public health care now, and who don’t have access to good care.  I see a need for change, and a challenge for our nation in facing the issue, and showing what we believe.

Life, liberty, and property:  I’ve argued time and time again for these three rights.  Health care is life.  In an age where we live in a land of great prosperity, seeing that all Americans have access to health insurance is morally right.  This is my belief, and I will defend it in private and in public.

Having shared that belief with you, I strongly oppose the bill before Congress this evening. 

The most important reason why I am opposed to this bill is because it requires an individual mandate whereby you are forced to purchase health insurance or you will be subject to civil penalties, scrutiny by the Internal Revenue Service, and the potential for criminal action as a result.  This is the exact thinking that I became involved in politics to oppose, and that I believe is the complete opposite of the American tradition and intent.  Government should not be able to force Americans to do anything, but this bill would do that.  Functionally, this bill says get covered or get charged.

I have explained how I believe that every American should have access to quality health care as a fundamental right, but I also believe that the choice of getting that care must be reserved to the individuals themselves.  In America, you should have the right to say “no”.  Whether it is advisable or not, whether it serves the public interest, we are still a nation of individuals living under liberty, and we should be able to say “no thanks”.  Not for others, not for people who are suffering, and not to turn a blind eye to a problem that is bigger than people’s ability to handle.  But for ourselves, yes.  We have that right, and no government should and no power can ever remove that.

I have other issues with this bill.  I dislike how it has been drafted, with many meetings in secret, and numerous perks designed to attract specific votes.  I believe legislation that is well written should stand on its own merits and not need such lather.  I honestly do not think we can afford it, and having read more about how this will work, worry how the funding being reassigned from both Medicaid and the Social Security Trust Fund will help, especially as those programs are already on a trajectory for insolvency.  I could go on for a while talking about things I don’t like, but you can read that elsewhere.

There are those who might say that while these objections are fair, that we should pass the bill because providing support now to the people who need help matters most.  They do need help and we should act quickly, but we cannot afford to act rashly either.

The fundamental relationship that drives the health care equation must return to the doctor and the patient.  Health insurance plans are not going to achieve this.  New government programs are not going to achieve this.  This bill does not achieve this.  If anything, it empowers insurance companies, many of whom support this legislation because they know the requirement that people must buy insurance will increase the number of people they serve.

When I came to understand this bill, it reminded me precisely of why I mistrust Washington and why I’ve rededicated my own career path to local politics.  I am sick of arguments so rancorous and partisan where every argument is an attack designed to score points for the next election cycle.  This is a real problem we are facing here.  But, this bill is a combination of elements that don’t fit:  designing a public policy solution from an administration that wants a public answer, mixing private and public parts in a way that just doesn’t add up to me.  If you limit what people can be charged, but limit what companies make, and force employers to pay more, what will happen is that you will reduce choices, harm business, and hurt employment as larger businesses will cut their marginal employees.  A fully public option, or fully private option would work better and make more sense, but this is neither.  It’s a collection of ideas, some of which are good, some of which are bad, but that come together to make a new bureaucracy which will not be efficient and will have damaging effects we can only guess today.

We should ask these questions and have been remiss in not doing so, which is why we face the situation that we do today.  This Administration and this Congress, for better or worse, have been willing to do so where everyone should have done so long before.  Too many Americans have been sick and dying, and we simply accepted this.  The anger, the fear, and the needs of our fellow citizens have led us to this moment, and the government is responding to them.  No one else did.  That was our loss.

I support health care reform.  I support access to health care for all Americans who choose coverage with any conditions they may have.  I do believe it is a moral question, and one we should have all been asking with that degree of clarity.  But, even though it may already be too late, I wish there would have been a better way.  Not for the Republicans or the Democrats, but for a nation that needs to find a way to heal wounds that are more than just physical at this point.

I’m tired.  I’ve listened, fought, and tried to understand over this issue.  I know that I’ve managed to alienate my friends on the left and on the right, and it makes me quiet and feel sick.  I’ve seen hatred and a country dividing itself.  What makes me sad is a conviction deep inside wondering if it was all necessary, and the unshakable feeling that it wasn’t.  I blame everyone and blame no one, but I hope one thing:  I hope that whatever else this bill does, if it passes, and survives the numerous parliamentary, constitutional, and state obstacles, that people get the help they need.

More than ever, our failing as our nation isn’t our government.  It’s that we can’t solve our own problems anymore, and this was a big one that we just punted.  That’s the saddest thing of all to me.  This never should have become the problem that it is.