‘Re­peal and re­place’ pro­posal is a morally rep­re­hen­si­ble move

Houston Chronicle Sunday - - OUT­LOOK - SoRelle is a for­mer Hous­ton Chron­i­cle med­i­cal writer.

dent Lyn­don B. John­son signed the leg­is­la­tion that es­tab­lished Medi­care, in­surance for peo­ple who had reached the age of 65. As the abil­ity of physi­cians and health-care providers to treat the great killers of our day — heart dis­ease, can­cer, stroke and di­a­betes — has in­creased, so have the de­mands on this life-sav­ing pro­gram to cover the costs of treat­ment.

Medi­care and the state-fed­eral com­pan­ion Med­i­caid that pro­vides care for the poor and dis­abled were a boon to peo­ple most in need of health care. For these peo­ple, Medi­care and Med­i­caid pro­vided the se­cu­rity that if they got sick, one of these pro­grams would pro­vide help. When the state Chil­dren’s Health In­surance Pro­gram de­signed to help fam­i­lies of mod­est in­come pur­chase in­surance for their chil­dren went into ef­fect in 1997, the se­cu­rity was re­in­forced.

The es­tab­lish­ment of the Af­ford­able Care Act in 2010 ex­tended that se­cu­rity to those who owned their own busi­nesses or worked for em­ploy­ers who did not pro­vide health in­surance. In those states that were for­ward­look­ing, leg­is­la­tors ex­tended the reach of Med­i­caid beyond the poverty level. None of these pro­grams — some fed­eral and oth­ers a com­bi­na­tion of fed­eral and state — were per­fect, but they were enough to give peo­ple a back­stop when dis­as­ter struck.

To­day, the Re­pub­li­can-held Congress — House and Se­nate — is search­ing for ways to strip that se­cu­rity away from those who need it the most. That means sin­gle moth­ers with sick chil­dren, the un­em­ployed and un­der­em­ployed with jobs that pro­vide no health ben­e­fits, chil­dren and young peo­ple born with ail­ments that re­quire ex­pen­sive treat­ments and surg­eries and a host of oth­ers. House Speaker Paul Ryan opines that un­der the pro­posed House plan, peo­ple will lose their health in­surance be­cause they choose not to pur­chase it. That is sophistry. Be­fore the Af­ford­able Care Act, they could not af­ford health in­surance, and with­out the aid pro­vided un­der the ACA, they will be with­out it again.

For res­i­dents of Har­ris County, Har­risHealth will once again have to step into the breach. That tax-sup­ported health sys­tem is re­spon­si­ble for pro­vid­ing care for at least 1 in 3 county res­i­dents.

The lack of se­cu­rity in health care came to the fore al­most daily when I was the med­i­cal writer for the Hous­ton Chron­i­cle from 1978 to 1998. I met par­ents whose em­ployer-pro­vided health in­surance would not cover the cost of or­gan trans­plan­ta­tion their chil­dren des­per­ately needed. I saw moth­ers who could not go back to work be­cause the added in­come would make them in­el­i­gi­ble for the Med­i­caid that was a life­line for their young­sters. Cru­elly, many large em­ploy­ers in Hous­ton pro­vided health in­surance for work­ers but not their fam­i­lies.

I can­not un­der­stand the cal­lous­ness of lead­ers like Texas Sens. Ted Cruz and John Cornyn and Speaker Ryan, who have de­signed plans that will strip the needy of health care. Cruz’s plan to of­fer stripped-down poli­cies of­fers lit­tle or no pro­tec­tion and makes in­surance ul­ti­mately un­af­ford­able to those with pre­ex­ist­ing con­di­tions. He and his state Re­pub­li­can co­horts have al­ready made Texas the most unin­sured state in the na­tion. Moth­ers giv­ing birth in Texas die at rates that are the United States’ high­est. This is in­hu­man­ity in its worst form, and it can­not con­tinue. We must fight to main­tain the health in­surance that our peo­ple need.

Sen. Mitch McCon­nell, R-Ky., has given Congress un­til the end of July to re­peal and re­place ACA. Do­ing so would not only be a dis­as­ter, but would also be morally rep­re­hen­si­ble.

As Dr. Michael E. DeBakey, an iconic fig­ure in U.S. medicine and driv­ing force in the es­tab­lish­ment of Hous­ton’s Bay­lor Col­lege of Medicine, often said, “We can de­liver the best med­i­cal care in the world, and we have the worst method of dis­tribut­ing it.” The GOP pro­posal am­pli­fies his point.

Health care leg­is­la­tion should em­brace DeBakey’s wis­dom and seek to make health care more ac­ces­si­ble, more hu­mane and more ef­fec­tive to en­sure that no one in the United States ever again suf­fers from its lack. My grand­fa­ther’s story was a story of health care’s past. The GOP pro­posal will make sto­ries like it part of health care’s fu­ture.

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