The Tough Choices of Life and Death

Written by Byron Williams

Friday, 19 June 2009

By the end of 2009 I predict President Obama will sign something that will be touted has healthcare reform. Whether or not that something will be classified as universal healthcare, is yet to be determined.

With a bipartisan coalition of three former Senate Majority Leaders making their way to Capitol Hill pitching Congress to pass healthcare legislation, there is unprecedented momentum in the air.

Bob Dole, who led the opposition against former president Clinton’s failed healthcare plan, is now advocating to get something passes this year. Howard Baker compared the current healthcare debate to the seminal moment when Congress passed civil rights legislation in the 1960’s. And Tom Daschle urged for the bill to have bipartisan support.

But questions linger.

Can there be a public plan that competes directly with the existing private companies? If so, does that create a climate of unfair competition? Where Congress comes down on these questions depends on their political philosophy be it liberal, moderate, or conservative.

The other issue is cost. It’s hard to believe Congress can pass an effective piece of legislation given the size and scope of what’s initially estimated. The preliminary discussions for a healthcare bill that does more than tinker around the edges is in the range of $1 trillion to $1.5 trillion over 10 years.

The identified $300 billion in cuts to Medicare merely scratches the surface. This reality raises an additional question: Will the politics of the issue allow for the fruition universal healthcare?

Most experts agree universal healthcare cannot be achieved unless employer benefits are taxed. But to merely tax the rich doesn’t reach the requisite dollars for a comprehensive plan. Therefore, the president would also need to tax middle class workers.

But this goes against one of the president’s campaign pledges. It is common knowledge, especially among his opponents, that candidate Obama promised not to raise taxes on the middle class.

Proponents of universal healthcare should welcome the contrarian questions; it is the only way to avoid being under the illusion their position is immune from its own set of downsides that require difficult choices.
But there is also a bitter irony to the healthcare debate. Why is it on matters of life we are justifiably cautious, but on matters of death we are much more cavalier?

Imagine if the run up to the Iraq invasion and occupation was carried out in a similar manner to the ongoing healthcare debate. What if there was a legitimate attempt to have a bipartisan consensus—as the former Senate Majority Leaders advocated for healthcare reform—that did not shy away from asking the tough questions on Iraq?

According to the National Priorities Project, by the end of FY 2009, the cost for Iraq and Afghanistan will exceed $907 billion—an amount that in less than 10 years rivals the anticipated cost for universal healthcare. Iraq as a stand-alone is expected to exceed $700 billion this year.

We’re bleeding money that leads to carnage and it is hardly mentioned. But many of those who gave bombastic speeches on the Senate floor that jettisoned our young men and women into harm’s way are now concerned about the cost to ensure all Americans have access to healthcare.

Tough choices notwithstanding, the questions raised about healthcare come down to political will. Do Congress and the president have the will to make this potentially groundbreaking legislation law?
If so, tough choices can’t be avoided. Universal healthcare will probably not result in an equitable system. And raising taxes only on the rich won’t get it done.

The president will need go to the American people and courageously explain why he must renege on his campaign pledge—that the view from the campaign trail as the Democratic Party’s presidential nominee is very different from the one in the Oval Office that must transcend political affiliation.

If the president fails to do this we may have reform, but it will not be universal healthcare.

To fully appreciate the different emphasis we place on matters of life and death, in the time required to read this column we dedicated roughly $800,000 to our war efforts.