By Rose Ann DeMoro
Executive Director, National Nurses United, AFL-CIO

At a time when so many Americans continue to fall through the gaping holes in our healthcare system, it's hard to imagine a more dysfunctional debate in Washington than the charade this week over the Republican effort to repeal President Obama's healthcare law.

Consider that, to name just a few points:
 

• The number of officially uninsured tops 50 million,
• Half of all Americans are considered to have pre-existing conditions and thus subject to rampant insurance denials (and ways big insurers will surely find to game the system even if the law remains as is),
• Arizona is denying life-saving transplants to poor people on Medicaid,
• Blue Shield is ignoring protests and pushing through premium rate hikes in California of up to 59 percent for individuals
• A UNICEF report ranked the U.S. a pathetic 22nd in health well-being for our children.

Yet Congress is going through a Kabuki theater that will end without repeal or real, comprehensive solutions to the ongoing healthcare crisis.

Here's a Top 10 list for the inanity of the repeal debate:

1. The public is already rightfully confused. A Kaiser Family Foundation poll last month found that nearly as many people (20%) favor expanding the law as favor repealing it entirely (26%). And, perhaps, most significantly, 43% of the public said they were still "confused" about the law.

2. Despite the rhetoric from the right, the law was not a "government takeover," much less "socialized medicine." In fact, it serves to prop up and protect the broken private system from a more fundamental reform, single-payer/expanding Medicare to cover everyone, just as President Nixon pushed HMOs as an alternative to single-payer 40 years ago (as Talking Points Memo noted last week).

3. Many Republicans do not really care if people are covered, they care about business making money. The "alternatives" discussed by the repeal crowd would unleash more of the same "magic" of the market that created the current crisis in access, cost, and quality.

4. Democrats and liberals have, ironically, become the foremost champions of "individual mandate," a concept first proposed by Republicans and adopted in Massachusetts by a Republican Governor Mitt Romney (with a law which has been steadily unraveling in rising costs with the state reducing eligibility and covered services). Yet Democrats now promote the deception that forced purchase of private insurance constitutes "universal" healthcare, while Republicans wail that idea they once loved is unconstitutional.

5. Though the Republicans publicly say they oppose the law in part because it is unfriendly to business, nearly all the giants in the healthcare industry backed the law.

6. Despite a desperate need for fundamental change, proponents of the most far-reaching reform are dismissed as "naive" and "not serious". Only those who support an unsustainable status quo in corporate control of our health were granted a seat at the table by the Democrats, and anything more than the most token coverage in the media.

7. In an environment where "objectivity" is defined as letting both sides have their say - as long as you stay within the parameters of the story as defined by the media - the side that is willing to tell bigger lies wins the most ink. Thus the debate was distorted by deliberate deceptions about "death panels," seniors being cut off Medicare, and similar fantasies.

8. Challenging the efficacy of healthcare as a commodity is off the table no matter how many lives are compromised and discarded. Thus, we have a law that is not universal, does little to control costs in rising premiums and un-payable medical bills, improve quality or reduce disparities. And the repeal fans want it to do even less.

9. Few are discussing that the healthcare crisis will grow if the law is repealed or left as is. Insurers, drug companies, and providers will continue to price gouge, insurers will continue to cherry pick healthier customers and find pretexts to deny needed care, the medical technology both sides promote as a panacea will put more patients at risk by eroding professional caretaker judgment, long waits for care will remain, and the ongoing recession will produce a further shredding of the frail safety net, especially as more public hospitals and clinics are forced to close.

10. While everyone talks about a global economy, no substantive consideration was given by policy makers or the media to the way other industrialized countries assure health coverage with lower costs and better outcomes through national or single payer systems, all while failing to challenge those who falsely claim "we have the best healthcare system in the world" (we don't).

Instead of repealing the law, let's urge Congress to expand it by opening up the cost-efficient, universal, equitable Medicare program to everyone.