The specialty of anesthesiology is one in which seconds matter. Treating an arrhythmia may require quick, decisive action to restore the heartbeat and blood pressure. Placing a breathing tube happens in a space of time measured in seconds and fraught with challenges: physical strength combines with deliberate movement and fine motor adjustments. Other activities, like weaning a patient from the cardiopulmonary bypass machine, require coordination, real-time information processing, quick judgment, and focused communication.

A lapse in preparation, an error in judgment, a misstep in skill, a delayed call for help…all can lead to devastating consequences.

And these attributes of a professional can frame the assessment of the professionalism of elected members of Congress. These representatives must balance the needs of their immediate constituents with allegiances to their party and the good of the country as a whole. They are professionals who must be informed by a philosophy of a common good, and yet willing to compromise, to be pragmatic, and to find solutions for complex problems that maximize the good for all.

In January Speaker Paul Ryan issued a press release in which he affirmed his aim of fixing problems related to the Affordable Care Act. His stated purpose is to control costs for families, improve the quality of healthcare they receive, and give them better options.

In the Speaker’s words, let’s get rid of the scare tactics and slogans, because “this is about people’s lives.” If the American Health Care Act truly aims to offer better and more affordable healthcare to more people, then we can applaud this. But if there’s merit to the criticism that the bill was created in bad faith, aiming to give tax breaks to the wealthy at the expense of the poor and the sick, and prioritizing the profits of healthcare insurers over the wellbeing of the very people to whom our government is responsible, then let us strip away the political jargon and assess the AHCA for what it is.

Equally important is the process. In Congress’s work, as in a physician’s work, actual lives and wellbeing are at stake. Complex factors require analyzing competing goods, weighing the effect of one action over another, and resolving tensions. Commitment, clarity, and effective communication are key. The integrity of a professional means that his or her stated aim is the actual aim.

But what is different is the timeframe for action. Crafting legislation takes time. Governing is hard work, requiring research, deliberation, and seeking opinions. It means assessing how well a bill accomplishes its aim, and what the unintended consequences may be; these are features of the analysis of the Congressional Budget Office. Of course there’s also a cost of inaction, even if that cost is subtle or indirect. But when the stakes are high, actions must be informed by cautious exercise of judgment, a willingness to compromise and thereby balance competing goods, and a commitment to communicating directly and honestly.

The American people deserve a government that serves them. In this real-world arena of action and inaction, health matters more than political philosophy. Security and peace of mind outweigh ideology. Our professional representatives would do well to remember this.


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