America at the Crossroads: The Budget Debate and Health Care

The health care debate and, now, the discussion of the president’s budget and his tax plan

Just who are we and who do we want to be? How much government at the federal level do we expect?

The president has proposed a budget that is heavy on military spending and light on social programs and the arts, such as PBS. It has been criticized by Democrats and lauded by Republicans – except the very conservative Republicans who think there’s still too much spending. So what is the role of federal government? What programs should it support and what should be left to the states? What items should Trump’s budget contain?

You might be wondering how the whole repeal and replace Obamacare fiasco we just witnessed is connected to the federal budget. And well you should. The elites in Washington have turned the passage of legislation into an inside game that no one – at least, not regular ordinary folks – can understand.

So here’s what I’ve got:

Paul Ryan and the Republicans decided that the replacement of Obamacare was not achievable and would not survive a Senate vote, which, on important issues like a new health care system, requires 60 votes. They reckoned that they could sneak by with a 51-50 vote, the tie – breaker being Vice-President Pence, if necessary.

To do this, they decided to make it part of the budget reconciliation process, which kind of made sense, since there were so many moving money parts – like Medicaid expansion under Obamacare and its use in their own bill.

They could have played it straight and done it conventionally, but, now, all we see are mysterious parliamentary tricks to get things done in Congress. And by conventionally, I mean that the Republicans could have gotten together to see what they could all live with and get an easy win in the House, accept amendments in Senate, and then haggle back and forth between the House and Senate until a bill with a chance of succeeding had been forged.

In Washington, the leg bone always connects to the ankle bone, er… budget process.

Obamacare is a hybrid of a public/private partnership between the Federal Government and business (health insurance companies). However, it demands that certain things must be covered like pre-existing conditions and dental and vision care.

The problem is that, in free enterprise, we, the shareholders, prefer profits. In fact, we like them a lot. So things like pre-existing conditions and making insurer’s cover them are akin to asking them to insure a burning house. So, naturally, they raise the premiums required by all of us or, if they think they can’t make a profit, they leave certain states and counties.

Somehow, the shareholders, who are also many of us through our various investments and retirement accounts, don’t get it when we are the pre-existing condition person, also.

So how do we reconcile this kind of problem?

In an earlier column, I stated that we, as a society, must take care of situations like this and also of people who can’t afford health care. I boldly said, and do now, that we should cut to the chase and go with a government health system augmented by private coverage provided by private insurers.

That’s my solution, but the issues, on which we are sharply divided, tell us about who we are.

In this case, the Republican “Freedom Caucus” in the House made a very clear stand for private enterprise backed by Medicaid. Others who like Obamacare’s universality disagreed. Ryan’s bill was doomed to failure.

All of this budget discussion – and, soon, tax reform – forces us to examine just what kind of America we want for health care: private or public; state or federal jurisdiction.

Moreover, what is the right balance between spending for social programs and the defense of our nation? Why do we publicly fund the arts? These are all valid, but arguable propositions.

In the case of the federal budget process, we need to think clearly about what we really want. Is America a federalist republic, as the Freedom Caucus maintains, meaning the Federal Government is secondary to state and local sovereignty? Or is it the other way around? What is America about?

And it’s not just Republicans and Conservatives who are confused about what they want. When it comes to things like sanctuary cities, for instance, liberals think that it’s okay to tell the Feds to go to hell, but they’d rather have the Feds govern and control most of our lives.. For example, when Conservatives talk about eliminating the federal Department of Education, Democrats scream with fury. How dare Republicans suggest that the states and local governments can handle education?

We’re all messed up no matter where we are on the political spectrum.

The polarization of the country and the sniping back and forth between the political parties makes it clear that we are thinking of the real fundamentals of how we wish to be governed; however, we are not always consistent in our views. This is an important point to consider when we discuss things with the so-called “enemy” on the other side. Let’s be a little more gentle with one another in this honest debate.

Jon Saltzman is the Publisher and Senior Editor of Political Storm.

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