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Friday, March 26, 2010

I Read the Bill... And The Bill... And The Fix

March 26, 2010

by F. Grey Parker

Several weeks ago, I began my own personal endgame with Health Care Reform. For months it seemed, the growing mantra of the opposition had become the argument that nobody understood the legislation, just as it had been with 2009's stimulus package against which Rep. John Boehner (R-OH) had so famously boomed. We just didn't get it. It didn't matter whether we were discussing the House Bill, the Senate Bill or the Fix. The leadership of the opposition kept telling us that we were against it and if we weren't, well, then we just didn't understand it. These arguments didn't sit right with me from the beginning. There was something about that declaration, so insistently parochial, that was patently offensive to me.

To be fair, one of reform's more ardent proponents, Rep. John Conyers (D-Mich), didn't exactly help to clarify the situation last summer. But we have been no less than bombarded with scary talk. We have been warned of "death panels," "an unconstitutional personal mandate" and "taxpayer money for abortions." Division has been our political food for breakfast, lunch and dinner for 14 months. The Wall Street Journal has called reform reckless. The Tea Partiers have called it "socialism." Reason Magazine went so far as to say the very issue of Health Care is incomprehensible. Aren't we all fragile, little dears?

So the message got through. Nobody understands the bill or has read it or could possibly ever hope to even fathom the issues at hand. Nobody. Well, nobody is a stark word. It is a word unequivocal in meaning and words matter. They matter a lot. So I kept running it over in my head and trying to determine what the ramifications of this were, that nobody has truly understood this bill, that it was somehow so mysterious or arcane.

It finally occurred to me why this was so bothersome. Every time gentlemen such as Boehner or Cantor or McConnell spoke against health reform, I would hear the voice of my late grandmother. You see, she was a brilliant woman. She was an intellectual, multiply degreed and polylingual. She had traveled the world. Once in a while, as a child, I would hear her assessing the political landscape and, in her best moments, she was utterly succinct. So, I took a deep breath as well as one last look at the donnybrook our great national debate had become. Her response to all this would be, I believe, something like this...

"Bullshit," she would say. Grandmother Josephine had a knack for knowing when to shoot from the hip.

It was a breath of fresh air for me. I hunkered down and finished reading the house bill I had started to read last fall. Then I read the senate version. Lastly, I read the so-called reconciliation fix, which, I might add, was blessedly short. It took a lot of work. There were numerous queries to be made. Not being an attorney, I had to ask a lot of questions. It was a start-stop process and, yes, it was mind numbing. But, it is done. Now, if I could do it without a staff of support researchers, without multiple aides sourcing obscure constitutional precedent and more importantly, without a budget, then what was the big deal?

The first and most important observation to share before the next round of controversies is in regard to the so-called "personal mandates." Opponents are still hopelessly trying to portray this provision of the law as unconstitutional. You will find the final language you have been told to fear in section 1002 of H.R. 4872. This is the "fix" to the sections titled "Individual Responsibility" in both H.R. 3200 and H.R. 3590. (Links to all three in PDF are provided above for ease of searchability.)

 To declare this so-called "mandate" a threat to our republic, or "Armageddon," in the words of Rep. Boehner, is to also declare the establishment of mandatory income withholding in 1943 a clear and present danger to the United States. This is tax law. Is it fairly radical? Perhaps. But, so is the federal government arranging for you not to take home a paycheck until after they get their cut. Does anyone really think that this section of the law was written in such a way that the next version of the EZ form won't accommodate it? However potentially regressive a tax one might find this, it is not illegal. Now, here is the rub. If you aren't sure what to believe, then look it up for yourself. Got it?

Those "death panels" we heard so much about will really get your blood boiling if you read the section of H.R. 3200 ominously titled Section 1233: Advance Care Planning Consultation starting on page 424. With a title like that, you just know they plan to kill grandma. Right? The language of this section does involve discussion of patient end-of-life decision making. Do you know how? By providing support under Medicare,  rather than potentially having to pay out of pocket, to draft a living will with your doctor. As such, it is far more likely that you will actually have one. This is to guarantee that no one, and I mean no one, but you makes these decisions about you. The only risk to any of us of coming before a "death panel" is in not having our wishes clearly and legally made in advance. Are we to say now that only those who can pay out of pocket be guaranteed the resources to make these arrangements?

The language of the bill itself:
"Such consultation shall include the following:
‘‘(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.
‘‘(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
‘‘(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
‘‘(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning,"

That this would even be construed as untoward, much less as some sort of plot against the elderly, is absurd. The real argument by opponents has been, literally, that there is some unwritten agenda that might be implemented through this. For a spooky read, check this out.

Civics 101, kids. If it's not in the law, then it's not the law.

Lastly, we were subjected to the desperation move of opponents alleging that our citizen's purse was about to be used for some sort of mass abortion experiment. This, I won't dignify with any response beyond the obvious: that the Hyde Amendment is still the law of the land, President Obama has already issued his executive order affirming that and that it's time to give Rep. Bart Stupak (D-Mich) a day off.

So. Over the past few months I moved much further from observer of debate to staunch advocate. I had reached such a point of revulsion with the tactics of reform opponents, that I was actively politicking for passage daily. A lot of calls were made by me to our representatives. Many friends and colleagues participated and made sure to share their experiences. For all of their hard work or just simple inclusion, I am deeply grateful. It would be naive to think that all of those to whom I posted so many links or sent so many pleas to get involved were exactly excited by the process. And yet, very few complained. Without exaggeration, precisely one person with whom I communicated felt so politically hopeless as to say it was a "waste of time."

Is there still plenty to dislike about the bill? To be certain. Am I elated at it's passage? Unequivocally, yes.

And, if you are still not sure what to make of things, don't let me tell you. Read the law for yourselves. That's what I think the whole point of the opposition's tactics has been all along. To keep you from doing so.

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