The End of the Beginning

Amid a year of overwrought rhetoric about death panels and government takeovers, the wheels of Congress ground slowly, but surely, to pass into law the Patient Protection and Affordable Care Act, aka the Health Care Reform bill. The law is a quintessential compromise, pleasing neither liberals nor conservatives, but it heralds the acceptance by the United States of the core philosophy of developed nations, that access to health care should be the right of all its citizens. To paraphrase Winston Churchill, this is not the end, or even the beginning of the end. It is, perhaps, the end of the beginning.

The demented attacks against the bill and its supporters have not gone away since its passage; rather, the rhetoric has ramped up, fueled by a potent confluence of naked political ambition and covert racism.

But the lunatic fringe has always existed; its views have traction today because of the misguided sympathies of the saner voices on the right, who should be denouncing the hate-mongers but who choose to remain silent.

That silence arises from a shared sense of grievance, though in the opinion of more reasonable conservatives, reform is unacceptable because it is a form of government “redistribution” that is, like the progressive income tax, essentially unjust. “Why,” asks the sensible ant, “should my hard-earned money go to shiftless, feckless, grasshoppers who have not bothered to save for the winter?”

To which I could reply, “Should we dismantle the (government-run) fire prevention infrastructure because your money is being used to put out your neighbor’s fire?” The assumption that each of us, through personal effort, can make ourselves immune to misfortune is pure American hubris.

Even setting aside the social and moral case for universal health care, there is a simple argument for wanting our (perhaps unemployed) neighbor to be covered by our tax dollars. Would you be comfortable knowing that the guy with the hacking cough next to you in the mall is depending on time, rather than medicine, to treat his illness? Do I want to pay 50 dollars for an aspirin in the ER because 99 others before me could not shell out the 50 cents it actually costs? Do we really believe that, in the event of a pandemic, our personal principles will act as prophylactics?

If opposition to reform has been guided by self-interest, there are enough selfish reasons to support it as well. In the meantime, let’s respect the democratic process and prevent it from being hijacked by the din of hatred and extremism. And that can be done only when we make our own voices heard.

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