Commentary: Missing the boat, and the water, on health care

By John Krull 

INDIANAPOLIS – So, it turns out that solving America’s health coverage problem isn’t easy, after all.

John Krull, publisher,

For nearly a decade, Republicans across the country have descried former President Barack Obama’s Affordable Care Act and vowed they would “repeal and replace” it as soon as possible. Again and again, they asserted that coming up with a better model – one that reduced premiums, extended coverage and made everyone happy – would be as easy as falling out of a boat and hitting the water.

It turns out, though, that the deep thinkers in the GOP can fall out of a boat – and miss the water.

A few days ago, Republicans unveiled their supposed replacement for Obamacare. Conceived by U.S. House Speaker Paul Ryan, R-Wisconsin, and promptly endorsed by President Donald Trump, the new plan was dubbed “Obamacare-Lite” by conservative critics upon arrival.

Not a good sign.

But then things got even worse.

The non-partisan Congressional Budget Office released its study of the new GOP plan. The CBO’s analysts – who, again, don’t have a dog in the perpetual Democrat-vs.-Republican canine clash – found that the new plan would strip coverage from 24 million Americans over the next decade and increase premiums for millions more, primarily older, poor and rural Americans.

Moderate Republicans in the U.S. House of Representatives and basically all Republicans in the U.S. Senate rose in revolt. They inquired if they couldn’t be asked to support something more politically palatable to their base – such as, maybe, mandatory bubonic plague injections or nuclear radiation testing at child-care centers.

Sen. Lindsey Graham, R-South Carolina – who increasingly is emerging as a, if not the, truth-teller in conservative circles – said “Trumpcare” was mortally wounded and should be withdrawn. He also said Republicans were trying to do too much too fast and were likely to make things worse, much worse, by doing so.

President Trump and Speaker Ryan could have chosen to heed the counsel from Graham and other concerned Republicans and take a pause.

Instead, they chose to go another way – one that seems to be the default position for the president and his amen chorus.

Confronted with disquieting facts that contradict their assertions or prejudices, they attack the source and try to discredit the information. Rather than look again at their plan and its numbers, Trump and his allies went after the CBO, saying – as usual, without supporting evidence – that the CBO’s numbers were wrong, wrong, wrong.

Except for the one sliver of positive information in the CBO report.

That was that the GOP plan would result in more than $330 billion in tax savings over a decade.

Those tax savings, of course, likely would be achieved by imposing higher premiums on the elderly, the poor and the folks on the farm – and would be greater still if Ryan hadn’t built a huge tax cut for the rich into the plan.

But, when grasping for straws, a politician must take whatever hold is available.

The Trump folks said the tax savings were right, but that everything else in the report wasn’t.

Democrats, understandably, have pounced on this debacle like wolves going after a baby rabbit. Battered by years of Republican attacks on Obamacare, Democrats now see a chance to get in some licks of their own.

This is what’s wrong.

Health care in this country isn’t just a political opportunity.

It’s a problem – a problem we must solve.

But the way we’ve conducted the discussion about health care over the past two decades will make that difficult. If we Americans continue to make every mention of the challenges of caring for the sick and the elderly an opportunity to score political points, it will be hard to meet the challenge of helping ailing Americans in any efficient and morally defensible fashion.

And it will be impossible if we can’t reintroduce a word and concept into the discussion that both Republicans and Democrats seem to have forgotten.

That word is sacrifice.

We aren’t going to provide adequate health care for Americans without requiring concessions from some and perhaps many citizens. In a just and rational society, people understand that the greater good sometimes requires sacrifices.

For more than 20 years, we’ve pretended providing health coverage to Americans was easy.

It isn’t.

Maybe we’ll accomplish more if we acknowledge that.

John Krull is director of Franklin College’s Pulliam School of Journalism, host of “No Limits” WFYI 90.1 Indianapolis and publisher of, a news website powered by Franklin College journalism students.

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