To hear Democrats talk, Dean Heller must have recently grown a mustache, just to twirl in delight over the anticipated untimely deaths of thousands of Nevada’s children.  

The liberal activist group EMILY’s List denounced Dean Heller for even being part of the debate (isn’t that his job?) over a “cruel” bill, insisting he’s putting “Americans’ lives at risk for his own political future.” You expect this from activist groups cynically trying to whip up their donors so they’ll open their checkbooks, but what about sitting lawmakers? Surely, those serious statesmen of the loyal opposition are more measured in their critiques, and don’t assume nefarious and wanton motives of their colleagues?

Rep. Ruben Kihuen complains that the Senate’s “Better Care Reconciliation Act” (BCRA) will be “devastating,” and that Republicans are rushing it to a vote “just so they can skip out of town in time for the Fourth of July weekend.”  (The vote was delayed until after the 4th.)  Senate hopeful and sitting Congresswoman Jacky Rosen described the plan as “ruthless,” and claimed GOP senators willing to support their current bill, “stripping away their [health care] protections just so they can give a massive tax cut to the wealthy.”  Sen. Catherine Cortez-Masto called it an “atrocious and callous” effort to “strip health care from millions of Americans.”

You have to be either stupid to think this is actually what’s going through Republican heads, or a liar for knowing how silly it is and saying it anyway.  I honestly don’t know which is worse.

After slagging their GOP counterparts by accusing them of actually wanting to kill people (or at least see them die) for fun and profit, these three wizards of governance then whine about a lack of bipartisan cooperation. And of course, not a one of them accept any sort of responsibility for the failed system that a) requires a fix and b) led to Democrats losing power to Republicans in the first place.

A high school debate team that conducted itself this way would be laughed out of any competition they attended. Clearly, our congressional delegation is somewhere below that level.

~~~

I carry no water for the Republican version of top-down federal control of the health care spending decisions of hundreds of millions of individual Americans. But let’s review the status quo, shall we?  

Since the Democratic version of top-down federal control of health care spending decisions (the ACA) was passed, millions of consumers have lost their choice of doctor, seen their premiums rise dramatically, and have fewer choices when it comes to the types of policies.  Democrats gallingly tried to blame the latest round of insurers leaving the ACA exchanges on Republicans (debating policy changes causes “instability,” so we should never change policy ever again!), but the fact of the matter is that the insurer exodus has been happening steadily nation-wide ever since the ACA was originally passed. And at least one of the companies leaving rural Nevada under our current system has endorsed the GOP plan as a better alternative.  

(Nevada’s exchange board chairwoman, Florence Jameson, was reduced to begging the insurance companies to stay and “operate at a loss” to be “heroes”.  When your public policy model relies on service providers to perpetually lose money until they inevitably go out of business, you probably ought to significantly re-think your philosophy of government regulation.)

Politicians love to argue in anecdotes, and every Democrat has a few ACA successes to tout. But at what cost? Since the ACA was signed into law in 2010, total federal spending went from $14.669 trillion per year to $16.546 trillion. The federal debt went from “only” $12.671 trillion on the day the ACA passed to $19.846 trillion today (more than $10,000 in new debt for every man, woman, and child in the US).  Obviously those aren’t all health care costs, but that rate of increase in federal spending and debt-going-into is unprecedented, and Obamacare is no small part of it. The debt numbers are truly alarming, because that’s money that eventually has to be paid back (with interest) – which means it’s money future generations won’t have to pay for their health care.

In other words, even many of the ACA’s real benefits are ephemeral at best. The status quo these political luminaries are defending is unsustainable, wasteful, and does more harm than good. Talk about “cruel,” “atrocious,” and “callous.”  

The GOP Senate bill will probably fare little better in the long run, even if it passes. But the reason for that promise of failure is that still carries the ACA’s fatal flaw – the belief that a top-down federal bureaucratic solution, along with more federal spending (it’s a lie to say that the Senate Republican bill “cuts” Medicaid spending – rather, it increases that spending by millions of dollars).  

Let’s be honest – if the ACA had been passed by Republicans, Rosen and company would be righteously ripping it as the money wasting folly that it is. And if the BCRA were sponsored by Democrats, Republicans would be out there crying about its “cruelty,” and about the madness of federal top-down, one-size-fits-all attempts to meddle in markets.

~~~

The reality is that health care policy is hard, and will never be perfect. Resources are not unlimited, which means that hard choices will always have to be made in balancing long term affordability (both for individuals and for the government) with available services, and in funding safety nets without driving costs up for non-indigent consumers. No matter what we do, either an absolute free market or a single-payer socialist dream where the government mandates which babies live or die regardless of parental assets or wishes, someone will be unhappy.

Neither Dean Heller (who wants to make everyone happy, and in doing so, is succeeding in accomplishing the opposite) nor our congressional Democrats are willing to debate on these honest terms, or even to define victory correctly. (Access to care is not the same thing as “covered by insurance.”) Rep. Mark Amodei is the only one who speaks on this topic as a serious adult, and he alone isn’t enough.  

Breathlessly explaining how your political adversaries want to kill children may be great for fundraising or even getting people to the polls. But it does nothing to provide the humility or honesty necessary to either correctly identify current problems or actually improve access to health services to Nevadans.

Orrin Johnson has been writing and commenting on Nevada and national politics since 2007. He started with an independent blog, First Principles, and was a regular columnist for the Reno Gazette-Journal from 2015-2016. By day, he is a deputy district attorney for Carson City. His opinions here are his own. Follow him on Twitter @orrinjohnson, or contact him at [email protected].

Photo: By Norbert Kaiser (Self-photographed) [CC BY-SA 2.5 (http://creativecommons.org/licenses/by-sa/2.5)], via Wikimedia Commons