The Republican impasse over Medicaid reflects what passes for a crisis of conscience at the heart of their current politics.
One side of the Republican caucus insists that elevating individual opportunity doesn't require pushing down everybody else. The other side wants a legislative win, whatever the cost.
What neither side acknowledges, nor even seems aware of, is another moral divide that exists in the shadow of the Medicaid battle. It is created by politicians who cannot resist offering extraordinary, extremely expensive and rickety lifelines to individuals whose suffering makes the TV news. At the same time, they are entertaining dramatic and life-wrecking cuts
to the basic humanitarian care we provides to millions of poor Americans -- children, disabled and elderly.
They'll spare no expense when there's a name and a face behind a need, but if they don't know for sure which of their fellow citizens might benefit, pennies get pinched, and dollars slashed.
Think about our reactions to recent health-care crises: A baby named Charlie Gard, on the other side of the Atlantic, is dying from an awful mitochondrial disease
that has sapped his ability to control his body. President Donald Trump welcomes
his family to our shores for a try at an experimental therapy his native country will not deliver.
Otto Warmbier, a young American captured in North Korea, lay in a vegetative state for over a year following cardiopulmonary arrest, his body kept alive by an evil regime hoping to use him as a pawn. The State Department paid for a medical flight
from the Korean peninsula to Cincinnati, where doctors confirmed they had nothing further to offer.
Warmbier died not long after being returned to the United States. The same fate is expected for the infant Charlie.
Ours is a health system of unbelievable heights, offering innovations and levels of care other first world nations do not. But we are also a nation of catastrophic lows: vast underserved areas, inaccessible medical records, tens of millions of uninsured and opioid addicts dying in the street.
But why do so many of us see ourselves in Charlie Gard's pleading parents and Otto Warmbier's grieving family, but not in the life of Rita Sherman
, a Massachusetts woman who saved up, paid into long-term care insurance, yet still needed Medicaid?
The Obamacare replacement proposal singles out the opioid crisis as a problem deserving a special fund of $45 billion, and while it's plainly a gesture to try to woo some of the moderate Republicans, using this fund to trade-away the Medicaid entitlement is symptomatic of our health care tokenism at large.
When children are wandering off to find the neighbors because their strung-out parents are lying unconscious on the floor, opioids deserve the headlines. But we can only solve the opioid crisis with a comprehensive medical system that gets people the care they need, when they need it.
The BCRA encourages health care irresponsibility, informing Americans that we aren't required to purchase health insurance even if we can afford it, and if we can, encourages us to purchase the cheapest plan possible, plans that place arbitrary caps on coverage or leave out major categories of care.
America can tout
more billionaires than any country on the planet, a super elite that holds almost four times the wealth of billionaires in the next closest country, and together our elites could buy many other countries. Yet most of the population
has no significant personal savings
Over 28 million of us still lack basic medical insurance even under Obamacare, a problem the BCRA will only make worse.
We can do better. We can have our surplus of billionaires, provide a dignified social safety net and still staff the Mayo Clinic. Republicans should not pretend health care is a zero sum game that risks our collective prosperity. Rather, productivity surrounding the care we provide to one another represents
almost 18% of our economy.
Americans will always welcome in suffering children who catch our hearts, and we can do so without neglecting our own.