Can We Afford To Talk About Health Reform Without Talking About Afghanistan?

The two central issues in our national discourse are more intertwined than we want to believe.

Few would challenge the assertion that health reform and the war in Afghanistan dominate the political agenda du jour/month/year. Both issues affect Americans profoundly and in mass quantities: forty seven million U.S. citizens are uninsured, and that number is likely to rise to 52 million by 2010. One in three families will experience a loss of health care at one point or another.

One hundred and twenty thousand people are on the ground in Afghanistan (counting defense contractors), and 814 have died there. We now have more troops committed than the Soviet Union did at the apex of its involvement in the country.

All these people have names. And homes. And families. That’s the simple part.

The hard part is this: because both debates impact Americans in profound, often immediate ways, complexity and contradiction tend to cling to the issues with suffocating audacity – the way stink follows a pig or doom follows Dick Cheney. All of a sudden, pseudo-legitimate political figures turn out in droves to call “death panel!” or employ graceless, race-baiting techniques. All of a sudden, you begin to see stories on the front page of the New York Times about how Obama is seeking the support of GOP hawks to keep pushing this war.

Most of all though, you see a categorical separation between health care and Afghanistan – a sort of collective mental tidying process: column one, column two.

On the rare occasion that the two issues do intertwine, the language is predominantly dollars and cents: “This many billion is ‘invested’ in Afghanistan, so health reform is complicated by ‘commitments’ there.” Or, “Why are we fighting a war for other people when we can’t afford to keep our own population healthy?”

We talk this way because the alternative is an agonizing conversation about how we prioritize life in times of war. It’s a conversation about how we tune out “troop escalations” and “carte blanches” if it means we’re closing in on universal health care. After all, while we’ve been chasing a public option stateside for four months, American casualties in Afghanistan have shot up at an unprecedented rate.

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