Newtown, CT – April 3, 2015
And the angel of death passed over the marked doors, but settled on the others – This sacrifice of the many for the many was followed two millennia later by the sacrifice of the One for the many. And, now, two more millennia later, we contemplate an environment in which, in some States, the sacrifice of the many for the few is looming, while across all States, the sacrifice of the few for the many is in jeopardy. In the States that have steadfastly refused to expand Medicaid, and have thus consciously decided to sacrifice many in need of health care coverage for the few whose taxes might have gone up to foot the bill, the angel of death is now settling on top of hospitals, mostly rural ones, who have tried to compensate for the failures of the States' leaders. The continued burden of uncompensated care, which is truly now uncompensated, can no longer be borne, and so those to whom health care coverage has been denied, now face the very serious possibility of seeing health care denied. At some point, whether in this life or the next, the leaders of those States will be held responsible for the harm they are inflicting on the least of their citizens, and we hope it will be in this life. Across States, throughout the land, two separate plagues threaten the many who had been promised respite. The Supreme Court of the U.S. will determine whether federal subsidies for federal exchanges are to be upheld. If they are struck down, millions may lose coverage, and we already know that some State leaders will simply ignore the plight of those citizens. Separately, the coverage that is available is forcing many to choose between two evils: expensive decent coverage, and less expensive very slim coverage.
What this means to you – It's hard to believe that after so many trials and travails millions of Americans may find themselves worse off than the worst off in all other advanced economies of the rest of the world. Most of us thought those days were behind us, that the "Affordable Care Act" was just that, and for a short time, it has been. But the cracks are starting to show at a time when the effects of the delivery system's reform through new payment models is finally showing its desired results. Health care cost trends are inflecting, but not fast enough, and premiums are rising while benefits are thinned out to maintain the illusion of affordability. And it is an illusion when an individual with moderate to low income has to dish out thousands upon thousands in out-of-pocket costs. At this point, we're past benign neglect. What's happening instead is wanton abandon for the sake of pleasing the very few. When did not caring for one another become the principal political motive driving decisions? Or rather, when did only caring for the few and forsaking the many become the law of the land? It's happened like many past social shifts, slowly but surely. Nothing, however, is inevitable, and the somber nights of 4,000 and 2,000 years ago that we commemorate tonight and tomorrow remind us of the essential values that we must hold dear. So gird your loins, take up your staff and get ready, for the journey isn't over, and neither is the fight.