Health Care's Lowest Foes

H.L. Mencken famously observed that no one ever went broke underestimating the intelligence of the American people. Were he alive today and watching our debate over health-care reform, he would nod his head knowingly and say, "See? I told you so." And he would no doubt have more than a few things to say about those whose seeds of deception have found such fruitful soil in the fears and prejudices of so many of our fellow citizens.

Reform's fate will be uncertain until the last possible moment, and if the legislation does succeed, it will be by the skin of its teeth. Perhaps the success of reform will be enough to wipe away the bitter taste the last few months have left in the mouth of anyone who cares about American democracy. But ask yourself this: In your lifetime, can you recall a debate in which lie was piled so high upon lie, in which one side operated so cynically, in which fear was so gleefully wielded, in which ignorance and misconception and plain old stupidity so thoroughly determined the course of events?

If nothing else, you have to give the Republicans credit for creativity. After canards of death panels and coverage of illegal aliens and mandatory sex changes, the latest tactic they have devised is to tell people that if reform passes, "GOP voters might be discriminated against for medical treatment in a Democrat-imposed health care rationing system." That is not a joke; it appeared in a mailer from the Republican Party. At this point, I fully expect them to move on from these kinds of horror stories to actual horror stories. Did you hear that on page 225, there's a provision that requires taxpayers to foot the bill to give tummy tucks to zombies? And did you know that health-care reform would allow vampires to drain you of your blood once you turn 65? And my cousin told me that if the public option passes, a government bureaucrat would decide which of us get health care and which of us get turned into werewolves!

It may be that this time -- as has happened so many times before -- victory will belong to those who lie most eagerly, who exploit the worst impulses of citizens' hearts, who believe that ignorance and fear are to be celebrated and encouraged. If they do manage to prevail, will they feel the faintest twinge of shame? Will they look back and wish they had been just a little more honest, a little more concerned with the suffering of others, a little more willing to hear the voice of morality speak? It's possible, but I doubt it. If they win, they will exult and believe that victory validated the means they employed; if they lose, they will decide that things would have been different had they only been a little more ruthless.

I surely can't be the only one who has watched this "debate" with frustration rising in my chest, tired from shouting "Are you kidding me!?!" so many times. The gun-toting and Nazi-sign-wielding maniacs are deeply disturbing, but it is not them whom I want to reach through my television screen and throttle. It's not even the retiree, Medicare card in hand, proclaiming his worries about government getting involved in health care. It's not those stirred to opposition by claims so outlandish a child ought to be able to see through them.

No, the ones at whom we should be angriest are not the misinformed and ignorant. It's the ones who know that Medicare is a government program, who know that there are no death panels, who understand that nearly all the criticisms reform opponents have made are just baloney. It's the people who are growing giddier by the day as they inject their poison into the debate and watch it turn diseased.

I have tried to find the good-faith opponents of reform, the ones who share the goal of getting insurance for everyone, who are outraged by the fact that people die for lack of health care in America, who know that thousands of people being forced to camp out overnight at a basketball stadium just for the chance to see a doctor is a moral abomination in a country as wealthy as ours. I have tried to find the people who have sane reasons for disagreeing with this particular reform and who will, if this effort fails, immediately try to do something about these problems.

But I can't find them. Instead, we see Tom Davis, a famously moderate former GOP member of Congress, tell a 62-year-old woman who can't get insurance because of her diabetes that she should just go get a job with a big employer (good luck with that, dear). We see Tom Coburn, a Republican senator and a doctor himself for heaven's sake, tell a sobbing woman who can't get coverage for her husband with a traumatic brain injury that government can't help her. Instead, he suggests, "The other thing that's missing in this debate is us as neighbors, helping people that need our help," as though the answer for her and the other millions of people without insurance is to start knocking on doors to see if the folks on her block can come up with a couple of hundred thousand dollars for her husband's care. Again and again, we see people who have been given the power to make laws labor mightily to convince citizens that their most ridiculous fears about health care are true and that they've never had it so good. I try to believe that these critics are moral people whose outlook on the world simply differs from mine and that they are not actually pathologically indifferent to the suffering of others. But the longer this debate goes on, the harder it is to detect any light of human feeling in those working feverishly to destroy the hope of reform for another generation.

We all tend to caricature our political opponents. And we assume that their problem is not just that their solutions are misguided but that their motives are dark and sinister. This assumption is usually a mistake. Like many people, I spent eight years railing against George W. Bush. But in the end, I concluded that for all his faults of character and epic screw-ups, he was trying to do what he thought was best for the country. Bush was wrong about virtually all of it, but he was not evil (his vice president may be another story).

But what is one to conclude about political figures whose ends seem as indefensible as their means? Who will appeal to the worst in their fellow citizens, who will lie without remorse ? and for what? So that the number of Americans without health insurance can swell past 50 million, while insurance companies rake in billions in profits?

One can have honest disagreements about the many measures we might take to reform our health-care system. But one cannot say that this system should be allowed to continue, and still claim to be a moral human being with a functioning conscience. Whether reform succeeds or fails in the end, we should not forget what this debate was like and should judge all who participated accordingly.

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