But symbolism matters. It sends a message about values. And so it's worth considering what values this generation of Republicans has decided to embrace.
Over the last year, the Republicans have spent a lot of time arguing that the Affordable Care Act will cost too much, that it will micromanage care, that it will burden business with taxes and bureaucracy. The most outrageous claims, like the notion of government-run "death panels," have zero basis in fact. And even the less explosive arguments frequently rely on flimsy evidence. But the most remarkable thing about the Republican campaign against health care reform is what the advocates of repeal haven't said.
They never bothered to engage with the fundamental moral logic behind the Affordable Care Act--that a modern society guarantees everybody access to doctors, hospitals, and the treatments they provide; that it's wrong to sit by and watch people give up their savings, or their lives, just because they happened to get sick. The more serious Republicans have some ideas, yes, but nothing that would come remotely close to insuring 30 million people or bolstering coverage for the people who have it.
As recently as the last major debate over health care reform, in the 1990s, there were prominent Republicans with sincere interest in helping the un- and underinsured. Even today, you can find conservatives who feel the same way or who, at the very least, are honestly convinced that fiscal constraints put those goals out of reach. But the Republicans in the House? The ones who'd gladly run up red ink to finance more tax cuts for the rich? If they care even a little bit about the human casualties of our health care system, they haven't bothered to show it.
In 1965, the House passed H.R. 1, a set of amendments to the Social Security Act that, when signed into law, created Medicare. The designation of the bill as the legislature's first order of business was no accident. President Lyndon Johnson and his allies understood that Medicare was a moral imperative--that extending insurance to the nation's seniors, thus sparing them the familiar indignities and financial deprivations of illness, was among the most important things they would ever do as lawmakers.
Today's vote to repeal the Affordable Care Act was H.R. 2. It, too, was a deliberate signal that the leadership considered this a top priority. All 244 House Republicans voted for it. But this was a bill to take insurance away from millions and to weaken it for millions more.
History remembers what happened in 1965. I hope it remembers what happened in 2011, as well.
Geoffrey T. Manley, chief of neurosurgery at San Francisco General Hospital, isn't one of them.
"This was not a miracle," Manley said Thursday, referring to reports that Giffords, who suffered a through-and-through gunshot wound to the head nearly two weeks ago, can stand, follow some directions, recognize people and make affectionate gestures.
Instead, Manley said, the Arizona Democrat's apparent good function "demonstrates what aggressive, modern trauma care can do for what we once believed were non-survivable injuries."
If all you knew about the Affordable Care Act was what you gleaned from watching the Republicans make their case against it, you probably would not know that the legislation means health-care coverage for more than 30 million Americans. Or, if you did know that, you'd be forgiven for not realizing it's relevant: It almost never gets mentioned (see this congressman's rundown of the bill's contents, for instance), and the repeal legislation the Republicans are pushing does nothing to replace the coverage the Affordable Care Act would give to those people.
The lack of concern for how more than 30 million Americans will get their health-care coverage makes for an ugly contrast with the intense concern that Rep. Andy Harris -- a proponent of repeal -- found when he heard that his congressional health-care coverage wouldn't begin until a month after he took the oath of office. "He stood up and asked the two ladies who were answering questions why it had to take so long, what he would do without 28 days of health care," recalled one of the session's attendees. He knows his taxpayer-subsidized insurance is important. But what about Driver's?
We have a tendency to let the conversation over health-care reform become a bloodless, abstract discussion over cost curves and CBO models. We do that for two reasons: First, cost is important. Second, it's important to the people who have political power, which is, by and large, not the same group who doesn't have health-care insurance. Someone involved in the 2008 campaign once told me he'd seen numbers showing that 95 percent of Obama's voters were insured. The numbers for McCain were, presumably, similarly high, or even higher. These are the people the political system is responsive too.
But that doesn't make the plight of the uninsured any less wrenching. The Urban Institute estimated that 22,000 people died in 2006 because they didn't have health-care insurance. John Ayanian, a professor of medicine and health-care policy at Harvard Medical School, testifiedbefore Congress on this issue. “Uninsured adults are 25 percent more likely to die prematurely than insured adults overall," he said, "and with serious conditions such as heart disease, diabetes or cancer, their risk of premature death can be 40 to 50 percent higher.” And none of that takes into account the unnecessary suffering and physical damage that flourishes in the absence of effective medical care. Nor does it speak to the economic devastation that illness unleashes on uninsured families.Malaria Parasite's Brutal Blood Cell Invasion Finally Caught on Video
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The F.D.A. usually follows advice from its advisory committees, and Alzheimer’s experts anticipated that the scans would be approved. The additional requirement would not be a big hurdle, said Dr. Daniel M. Skovronsky, chief executive of the company, Avid Radiopharmaceuticals, that applied to market the scans.Federal Research Center Will Help Develop Medicines
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