Two votes.

Two entirely different votes in the coming week are weighing on my mind (and starting to fill my Twitter feed). The vote on the referendum in Sudan for the Southern independence, January 9th, is one; the second is the vote being brought to the floor of the U.S. House of Representatives to repeal the Affordable Care Act, passed by the 111th Congress just a few months ago.

The first vote worries me, due to potential violence in the region, though the current President has spoken in support of a seamless transition to an independent South. There have been a number of people attracting awareness to the challenges surrounding the referendum, and polling stations are being supplied with the appropriate materials. I defer to others with far more expertise on the situation in Sudan to comment on that issue.

The second, on the other hand, embarrasses me as an American. Political game/gimmick/statement that you might call it, it pains me that when the U.S. finally took a step towards more equitable provision of health care, the immediate reaction by those who don’t agree with the move politically is to kill the Act entirely. Or at least take a symbolic vote making that statement, seemingly more related to election politics and placating tea party members, without having a proposed alternative to offer.

Few would argue what passed is ideal. Former New Hampshire Congresswomen Marjorie Smith wrote in the Politico Arena (1.4.11):

“The health care law is far from perfect. Some of its most significant weaknesses came from an effort to answer concerns of some Republicans who, after pushing for the changes, still said no to the bill. Just as Medicare and Social Security were fought, so too will the health care law be fought. And, just as with Medicare and Social Security, there are opportunities for improvement. The law is complicated, and its advocates have done a less than adequate job of explaining its strengths.”

The burden falls on Democrats to defend the core tenants of the plan, and to encourage meaningful discourse on what changes may need to be made. In 2011, select components of the health care legislation fell into place which the majority of Americans support. Recent college graduates who would otherwise have to pay for expensive COBRA packages can instead stay on their parents’ insurance while they look for work in this tough economy. Senior citizens no longer have to worry about the donut hole in their prescription plan. Pre-existing conditions are no longer justification for refusing coverage.

To anyone telling horror stories about how this bill is going to be an economic disaster, look at the money spent in higher premiums and through tax dollars to cover the uninsured when they have nowhere to go but the emergency room for what could have been prevented, or could be treated earlier through routine care. To those conjuring nightmares of long waiting lines and the dreaded R word (*rationing*), recognize this: we already ration care, but instead of rationing based on need, we ration based on finances and ability to pay. And while I won’t argue that those with the means should be able to pay a price for quicker/better services in our capitalist economy, I support the movement towards more equitable provision of health insurance.

We cannot afford to avoid making changes to how we finance and provide health care to American  citizens. As an editorial by HHS Secretary Kathleen Sebelius stated in today’s Chicago Tribune:

‎”Unless we want to take coverage away from cancer patients, reduce oversight for insurance companies, raise prescription drug costs for seniors, weaken Medicare, add $1 trillion to the deficit and undo dozens of other reforms that are improving health around the country, we can’t afford repeal.”

The rhetoric the Republicans are offering regarding the content of their supposed alternative plan to-be-announced/created are the same words most Americans support: lowering premiums, increasing the number of Americans with insurance coverage, and strengthening the doctor-patient relationship. They also, of course, want to prohibit taxpayer funding of abortions and “provide conscience protections of health care providers” (the latter sounds like quite a departure from the secular grounds on which laws should be based, but I’ll leave that for another day).

But what is their policy plan to make these statements reality? Why don’t they have answers beyond “tort reform”?  The health care challenge is not a new one, and, at this point, rhetoric has about as much value to me as the devalued Zimbabwean currency rumored to be used as wallpaper halfway around the world a while back. And, to me, the vote being taken in the House on January 12th is just one more form of that rhetoric.

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