It had been a while since I stayed up to watch a voice vote in the United States Senate, but last week’s events in Washington D.C. were high drama for political junkies. Repealing the Affordable Care Act (better known as Obamacare) had been a central plank of the Republican Party’s 2016 election campaign and the focus of its legislative efforts for years.
But as is often the case in politics, it is much easier to be against something than to offer up your own ideas for how things might be done better. Since taking control of the White House and Congress, the GOP had struggled to find a consensus on what to replace Obamacare with as the stark consequences of simply returning the pre-Obamacare era became clear to the public. Each plan offered up by the Republicans was projected to lead to more Americans returning to the ranks of the uninsured.
Last Thursday’s vote on the so-called “skinny” repeal of Obamacare was widely seen as a last ditch effort (for now at least). The drama arose because pundits had tallied up the known votes for and against and realized that the fate of Obamacare hinged on the vote of a single senator — Arizona Republican John McCain. The unpredictable McCain had not committed to one side of the other, had given mixed signals about his intentions and held his cards close to his chest until the very last moment.
Opposition to Obamacare had been an effective political foil for Republicans because it offered Republicans an opportunity to reach beyond their base and secure support from bread and butter voters who had been “losers” under the previous President’s signature legislation.
And Obamacare was certainly not perfect.
While it succeeded in securing health insurance for millions of Americans, premiums have risen substantially in recent years and some of the tweaks to insurance markets haven’t exactly gone according to plan. The so-called “individual mandate,” which requires those without insurance to buy it or face fines, was irksome for Americans who don’t like being told what to do, as well as young healthy people with other priorities. Conservative Republicans also hated an increase in government-funded Medicaid for poorer Americans, and various tax measures aimed to pay for it all.
But ultimately those who stood to lose if Obamacare was repealed had made their voices heard as well in recent months. In the absence of something better to replace Obamacare with the end result is the status quo will remain for the time being.
After the vote, Republican Senate Majority Leader Mitch McConnell — stung by defeat on such a high-profile issue — made no secret his frustration with those Democrats and moderate Republicans who had scuttled his efforts. He accused his opponents of offering no solutions of their own and lashed out at those who preferred “socialized” and “European-style” health care. That line of argument probably fell flat with the handful of Europeans and Canadians watching late-night legislative coverage.
America’s inability to establish a health care system that provides coverage for all is a bewildering sight for many of us north of the border.
But it is important not to be smug, because we are far from perfect.
Those who have ever faced the frustration of long waiting times for vital surgery, or spent days or weeks sitting in overstretched hospitals know that not everything is sunshine and rainbows on our side of the border. For those in need of timely care, our underfunded health care system can feel like a smothering nightmare you can’t wake up from.
Socialized medicine by definition means surrendering to society our individual power to decide how much money we want to spend on health care. The amount of money that is spent on health care in our country is almost exclusively a collective decision.
That would be just fine and dandy if we all gave health care the prominence it deserves but Canadians have too often been distracted by other shiny objects. For years we have underfunded this crucial pillar of our society. Decisions about health care spending get subjected to the same crass politicking, and retail politics of public decision making, not to mention the buck-passing of federal-provincial relations.
Those who would prefer to devote more money to our ailing health care system so everyone can get better care have enjoyed middling success and have no choice but to accept the collective decision making of Ottawa or their province or territory.
That is a bitter pill to swallow for some. For those suffering with serious ailments alike treatment tends to be priority number one. No sum of money is too small to get the care and service one needs. It is the frustration with this apathy towards health care spending that drives calls for two tier health care, and court challenges to the prohibition of pay-for-access when waiting lists are so dreadfully long.
On a whole, I’ll take the equality of service we enjoy here in Canada over the dysfunction of the American system any day. Obamacare attempted, however imperfectly, to remedy gross moral failing of a wealthy society that allowed the so many to fall into a dreaded choice between foregoing care or going broke trying to pay for it.
But I can also understand the reluctance of some Americans to give up control over such a deeply personal and fundamental important matter like health care to the whims of collective decision making. There’s little guarantee that one’s fellow citizens will take our lives and those of our loved ones as seriously as we do.
Kyle Carruthers is a born-and-raised Yukoner who lives and practises law in Whitehorse.