American Health Care — Where Do We Go From Here?

-Michael Bihovsky

I wrote and recorded a lot of content in an effort to help stop the devastating repeal of Obamacare (not to mention, the time spent planning a major activism campaign that, fortunately and unfortunately, I didn’t get to use). So I want to say a few things now that the Republican Senate failed in its effort to uninsure anywhere from 22 to 32 million Americans, depending on which specific legislation the Senate was voting on at any given moment.

The most important thing I want to say is that this isn’t over. I really wish it were. But while the defeat of the Republican bill was absolutely a victory for health care rights and for basic human decency, it is not a lasting solution. Left on its own, the Affordable Care Act (ACA) — Obamacare — will, in fact, implode. This is not the result of the legislation itself, but as detailed in an article by Steven Brill in The Washington Post, it is the result of early Republican sabotage against provisions of the bill that were intended to keep insurance costs down.

Trump himself said he is looking forward to seeing Obamacare implode so that he can blame it on the Democrats — even though it won’t be their fault. In fact, if President Trump and Congress acted to enforce Section 1342 of the ACA, requiring insurance companies to be compensated for losses suffered because of early unpredictability in the exchanges, and Section 1402, requiring insurance companies to be refunded for waiving costs for low-income plan holders, the insurance companies would be guaranteed to receive the subsidies they were promised under the new law, and consumer premiums would immediately plummet.

But this is a president, and for the most part a party, that would happily watch millions of people die (That’s not an exaggeration — health care is as life-and-death as it gets.), and see one-sixth of our entire economy collapse if it meant that they could use it to their own political advantage.

So what do we do now?

Courtesy of Mike Stanfill.

The three Republican senators who voted against the bill to repeal the ACA. Courtesy of Mike Stanfill.

First, let’s take a moment to celebrate. We’ve earned it. And let’s give credit where credit is due. I acknowledge Sens. Susan Collins, Lisa Murkowski and John McCain for their honor and bravery in voting against this travesty, and all the Democrats who stood united against it as well.

But even more so, I want to thank all the amazing disability activists out there for their diligence and sacrifice, in particular the incredible souls of ADAPT, who were dragged out of wheelchairs and thrown in prison for staging a die-in at Sen. Mitch McConnell’s office. When you are disabled, it is difficult enough just to get out of bed in the morning — but these people literally threw themselves to the ground to stop this legislation from passing. Many of them went to jail. They endured physical agony to save their own lives and the lives of millions of others. They are the true heroes.

But 49 senators did not care. Remember that. This was too close, people. The bills and amendments that were proposed would have gotten unanimous opposition in every other first-world country on the planet. In our country, the final bill was one vote away from passing.

The Republicans have vowed that they have not given up on health care — and what I want you to do is write to them and tell them that they shouldn’t.

Yes, you read that right. Tell them not to give up. But tell them to switch tactics. Tell them to work alongside Democrats to craft legislation that would actually help the American people. Because not all of the Republicans’ ideas about health care are bad, and not all of the Democrats’ ideas are good. Obamacare asked the question, “How do we pay for exorbitant medical costs?” It never addressed the more fundamental question of why these costs are so high in the first place.

There are so many ways to bring down medical costs that actually include a great deal of common ground between Democrats and Republicans that even Sens. Bernie Sanders and Ted Cruz have expressed areas of solidarity on this issue. We can make direct-to-consumer advertising illegal, as it is everywhere else in the world and as it was here for most of our history. We can implement meaningful tort reform for frivolous medical malpractice lawsuits. We can allow people to purchase medications and medical equipment across country lines, where they are cheaper. We can allow Medicare to negotiate drug and medical device prices just like any other insurance company can, which alone could save $650 billion over the next decade. These are just a handful of examples that could dramatically reduce health care costs, and they share support on both sides of the aisle.

So please write to your representatives and tell them to fight together on these areas of agreement, and encourage Republicans to drop their so-far successful attempts to undermine Sections 1342 and 1402 of the ACA. If they do this, they can genuinely solve the American health care crisis.

We have to work together. We can no longer afford victories that consist only of defeating our opponents. Our system used to work. We compromised when appropriate, but more importantly, we tried to combine the best ideas of both sides. That on its own is an ideal worth fighting for. Will the solutions be perfect? Of course not. But increasingly, the only choices I’m seeing are for whether we move backward, or whether we stand still. I want to move forward — and incremental change is better than nothing.

In addition, we liberals and progressives need to do a better job at verbalizing what we are for, and not just what we are against. If we want a public option, we must make the case for it. Every time the Republicans start talking about the corruption, waste and negligence of big government, we should talk about those same qualities in big corporations. If we want to end factory farming, decrease income inequality and end discrimination in all its insidious forms, we must fight for those things and so much more. It is a subtle but important difference to stand for equality, rather than to merely stand against inequality, and I believe that within this positive framework, more transformative arguments can be made.

This is how we move ahead. Who’s on board for the ride?

Michael Bihovsky is an actor, composer, playwright and health care activist.


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