When the CBO chickens come home to roost

Maybe the best thing that could happen to American healthcare is the worst thing that could happen to American healthcare—that McConnell’s draconian, cynical, ill-conceived, anything-for-a-win, health care bill passes the Senate, passes again in the House and gets signed into law, with all the “Upton Effect”, smoke and mirrors so-called “improvements”. It’s fine to get all “hair on fire” about the CBO reports, about the prospect of masses of people losing their insurance, about the states that most rely on Medicaid turning away thousands of their citizens, but until it actually becomes manifest, hardened reality, it may be just too amorphous and easy for Trump loyalists and /GOP Koolaid drinkers to dismiss. So go ahead. Pass the f-cking thing. Just get it over with. Some lessons have to be painfully acquired.

Then, after we endure the beer garden celebrating and the white-guys-in-suits back-slapping spectacle and the McConnell-Ryan-Trump wet kiss, happy dance, the bill will lie dormant for a while, like a herpes virus. Almost like it never really happened. We’ll all have moved on to tax reform and god knows what else.

But then, as we approach 2020-2021, it will slowly begin to spread into the population as the GOP health care bill becomes the law of the land, and we begin to experience the GOP’s vision of health care in America in all its glorious, toxic, pathogenic inhumanity.

And then all the sturm and drang and pundit outrage and think tank forecasts and media “told ya so’s” will become manifest in a million innocent looking letters that arrive in a million mailboxes saying that either a) you’ve been dropped by your provider, or b) we won’t cover your diabetes treatment or your pregnancy exam or your child’s asthma medication or c) your rates will increase by 300% as of your next renewal period.

And suddenly the stories will spread about friends of friends who lost their coverage because of a pre-existing condition, or you may get a call from a parent a few years away from qualifying for Medicare and who just had their rates jacked up so high it triples their monthly expenses and prolongs their retirement.

In other words, shit will start to get real. Not just real for New York Times readers and NPR Left Coasters. Not just real for Bernie Bros and Elizabeth Warren libdems, but real for red states, like McConnell’s beloved Kentucky, and real for rural America and its small towns, and real in places where there’s not a snowflake for miles. All of those long forgotten town hall protests back in ’17 will come back to haunt.

But maybe that’s what it‘ll take. Even with our obsession for so-called reality TV and reality TV stars who supposedly “tell it like it is” we Americans can be stubbornly unmoved until reality gets personal. And maybe that’ll mean 24 million CBO chickens, a few at a time, will need to come home to roost.

I leave you with the words of the old Henny Youngman joke, “I said to my doctor ‘it hurts when I do this’, and my doctor said, ‘then don’t do that’.

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