Columns » Ernest Dumas

A vote against reform is a vote against Arkansas



If anything beneficial came of Jared Loughner's attempt to assassinate an Arizona congresswoman and as many of her followers as he could take out, we will find out this week when the House of Representatives takes up repeal of the health-insurance reform law.

The silver lining to the tragedy would be a calm and rational debate — even if a ruthlessly partisan one — on what the health law and its repeal will mean. The outcome is certain (the Republican House will pass the repeal) and meaningless (it will die in the Senate or on the president's desk), but if there is a thorough and frank argument on what the law has done and will do and the country is not distracted, it will be a marvelous thing. It hasn't happened yet.

But why connect Tucson and the health-care debate?

Yes, even the president of the United States has said no one could know what demonic ideas ran through Loughner's brain when he went to the Safeway to gun down Gabrielle Giffords, but it is equally certain that it was a political event, an assassination as Loughner himself described it. It was not an attack on a liquor-store clerk. Loughner harbored all sorts of quack conspiracy theories about the government and women in authority, even if he had not been influenced by posters in Tucson by her opponent, Jesse Kelly, that urged people to help remove her from office by shooting a full automatic M16 rifle with Kelly, or seen Sarah Palin's celebrated crosshairs on Giffords's district. After she voted for the health bill, Giffords' office door was shattered and she received threats.

So Speaker John Boehner and others promise a civil and respectful discussion this week. The Republicans are going to say that the Affordable Care Act will run up huge budget deficits, put people out of work and drive up the cost of medical care even higher. Congress' independent experts, formerly praised by the Republicans for shooting down Bill Clinton's health reform bill in 1994 and disputing Democratic claims on this law, say none of that is true and that, in fact, the Affordable Care Act would do just the opposite.

That debate should winnow the issues down to the one central question: whether people ought to expect their government to contrive a way for every citizen to be insured against sickness and injury regardless of his or her wealth and to make medical care and insurance more affordable to all, or whether the government should leave all that to the mercies of the market? That also is a debate worth having.

How nice it would be if the arguments could be telescoped to Arkansas. What do Arkansas's four congressmen intend by voting to repeal the act? A good debate would have each of them explain why the law's various provisions are bad for the people of Arkansas. Specifically:

• Why should the 1.4 million Arkansans now covered by private insurance risk having their insurance canceled or have lifetime spending caps put on their insurance after they are in an accident or suffer a grievous illness? The new law will prevent it.

• Why should the state be stopped from setting up a one-stop exchange for individuals and business to shop for insurance, with government assistance if they cannot afford it?

• Why should 250,000 or so Arkansans whose family incomes are below 133 percent of the federal poverty line be denied hospitalization and medical coverage, and why should the federal government be prohibited from pumping $10 billion or more into the state over the first six years to improve their health care?

• Why should the 25,000 poorest Arkansans on Medicare lose rebates to help them with their catastrophic prescription drug costs? Repeal will return them instantly and from now on to the infamous "doughnut hole" that makes them choose between medicine and other necessities of life.

• Why should the state's 506,000 seniors on Medicare once again have to make a copay to receive preventive services like mammograms, flu shots, colonoscopies and cancer screenings?

• Why should people who buy new insurance plans be denied the choice of primary-care doctors in the network or the right to see an ob-gyn without a referral? The new law gives them that protection.

• Why should people who can afford insurance, with or without the government's help, not be required to purchase coverage or else pay a small tax rather than rely on the beneficence of hospitals, the government and the insured when they have expensive illnesses or injuries? They must buy retirement insurance, old-age medical insurance and car insurance, so why not health insurance.

• Why should 13,600 Arkansas young adults lose their insurance coverage through their parents' plans, which is guaranteed by the new law?

• Why should insurance companies once again be allowed to spend whatever they wish from your premiums on executive compensation and bonuses, advertising, lobbying and profits? The new law will require them to spend at least 80 to 85 percent (depending on the size of the employers) of your premium dollar on actual health care starting in 2014.

Those questions would be a debate worth having. Alas, no one of the state's Lilliputian delegation will want to discuss them.

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