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Published: February 25, 2010

If we’re lucky, Thursday’s summit will turn out to have been the last act in the great health reform debate, the prologue to passage of an imperfect but nonetheless history-making bill. If so, the debate will have ended as it began: with Democrats offering moderate plans that draw heavily on past Republican ideas, and Republicans responding with slander and misdirection.

如果幸运，星期四的峰会将成为这个庞大医疗改革辩论{zh1}一次，成为通过这份尽管不xx却创造历史的法案的序幕。果真如此，这场争论结束时将跟开始时一样：民主党提出温和的计划，这些计划在很大程度上借用共和党过去的理念， 而共和党却回敬以诽谤和误导。

Nobody really expected anything different. But what was nonetheless revealing about the meeting was the fact that Republicans — who had weeks to prepare for this particular event, and have been campaigning against reform for a year — didn’t bother making a case that could withstand even minimal fact-checking.

没有人真正期待有什么不同。但是，围绕这次会议揭示出一个事实，这就是为了这次特别事件准备数周，一年来一直反对改革的共和党，并不屑于提出任何可以经受最小事实检验的理由。

It was obvious how things would go as soon as the first Republican speaker, Senator Lamar Alexander, delivered his remarks. He was presumably chosen because he’s folksy and likable and could make his party’s position sound reasonable. But right off the bat he delivered a whopper, asserting that under the Democratic plan, “for millions of Americans, premiums will go up.”

{dy}位共和党发言人拉马尔·亚历山大发表讲话后，局势将如何进展是显而易见的事情。据说，选择他是因为他本人和气、讨人喜欢，他能让共和党的立场听上去更合情合理。但是他立马就可以编造出弥天大谎，声称民主党的计划“对千百万美国人来说，就意味着保险费用上涨。”

Wow. I guess you could say that he wasn’t technically lying, since the Congressional Budget Office analysis of the Senate Democrats’ plan does say that average payments for insurance would go up. But it also makes it clear that this would happen only because people would buy more and better coverage. The “price of a given amount of insurance coverage” would fall, not rise — and the actual cost to many Americans would fall sharply thanks to federal aid.

哇。我猜你会说从技术角度讲，他并没有说谎，因为美国国会预算办公室对参议院民主党计划的分析报告的确也说了，保险的平均支付保险会上升。不过，该分析报告同时xx表明，这种情况发生的{wy}前提是人们会购买更多、更好保险。“已知数额保险的价格”将会下跌，而不是上升。由于两帮资助缘故，许多美国人的实际支出会下降。

His fib on premiums was quickly followed by a fib on process. Democrats, having already passed a health bill with 60 votes in the Senate, now plan to use a simple majority vote to modify some of the numbers, a process known as reconciliation. Mr. Alexander declared that reconciliation has “never been used for something like this.” Well, I don’t know what “like this” means, but reconciliation has, in fact, been used for previous health reforms — and was used to push through both of the Bush tax cuts at a budget cost of $1.8 trillion, twice the bill for health reform.

亚历山大在保险非上撒谎之后，很久就是在程序上说谎。已以60票在参议院健康通过保健法案的民主党现打算用一个简单多数票来修改一些数字，这一程序叫作和解。亚历山大先生宣布，和解从开没有在“这一类”事情上使用过。不过，我不知道我不知道他说的“这一类”是什么意思，但是事实上，和解在以前的医疗改革中已经使用过。还有在推动通过布什高达一万八千亿美元的减税法案中也使用过，这一数额为医疗改革涉及金额的两倍。

What really struck me about the meeting, however, was the inability of Republicans to explain how they propose dealing with the issue that, rightly, is at the emotional center of much health care debate: the plight of Americans who suffer from pre-existing medical conditions. In other advanced countries, everyone gets essential care whatever their medical history. But in America, a bout of cancer, an inherited genetic disorder, or even, in some states, having been a victim of domestic violence can make you uninsurable, and thus make adequate health care unaffordable.

不过，有关这次会议，真正使我留下深刻印象的是，共和党无法解释自己如何应对当前正处于许多有关医疗保健辩论情感焦点的问题，即那些因为先前病史而遭受歧视待遇的美国人的命运。在其他发达国家，不管病史如何，每个人都可以享受基本的医疗保健服务。但是在美国，一患有癌症，一旦发现遗传基因紊乱，在某些州甚至家庭暴力的受害者，都足以让你排除在保险之外，从而让你支付不起恰当的医疗服务。

One of the great virtues of the Democratic plan is that it would finally put an end to this unacceptable case of American exceptionalism. But what’s the Republican answer? Mr. Alexander was strangely inarticulate on the matter, saying only that “House Republicans have some ideas about how my friend in Tullahoma can continue to afford insurance for his wife who has had breast cancer.” He offered no clue about what those ideas might be.

民主党计划的{zd0}优点之一，是它对这种不可接受美国例外论画上了句号。但共和党的答案是什么？在这个问题上亚历山大先生令人奇怪的模糊不清，他仅仅说“有关我在Tullahoma朋友如何继续能为身患乳腺癌的妻子支付保险的事情，众议院共和党有一些主意。”可他没有提供这些主意的任何细节。

In reality, House Republicans don’t have anything to offer to Americans with troubled medical histories. On the contrary, their big idea — allowing unrestricted competition across state lines — would lead to a race to the bottom. The states with the weakest regulations — for example, those that allow insurance companies to deny coverage to victims of domestic violence — would set the standards for the nation as a whole. The result would be to afflict the afflicted, to make the lives of Americans with pre-existing conditions even harder.

在现实中，对于问题病史的美国人，众议院共和党人提不出什么东西来。相反，他们一个很大的想法——允许跨州进行不受制约的竞——将导致彻底的竞争。管制最弱的州，例如那些允许保险公司拒绝为家庭暴力受害者提供保险的州，将为整个国家设定标准。结果是折磨被折磨的人，使有先前病史的美国人的生活更加艰难。

Don’t take my word for it. Look at the Congressional Budget Office analysis of the House G.O.P. plan. That analysis is discreetly worded, with the budget office declaring somewhat obscurely that while the number of uninsured Americans wouldn’t change much, “the pool of people without health insurance would end up being less healthy, on average, than under current law.” But here’s the translation: While some people would gain insurance, the people losing insurance would be those who need it most. Under the Republican plan, the American health care system would become even more brutal than it is now.

不要光听我说的。看看美国国会预算办公室对众议院共和党计划的分析报告。分析报道措辞谨慎，与预算办公室闪烁其词地宣布，没有投保的美国人数量不会有大的改变，“无健康保险的人群与现行法律下比较，最终平均健康状况会差的多。”但是，可以有这样的诠释：虽然有些人会得到保险，但失去保险的人将是最需要保险的人。按照共和党的计划，美国的医疗保健制度会变得比现在更加残酷。

So what did we learn from the summit? What I took away was the arrogance that the success of things like the death-panel smear has obviously engendered in Republican politicians. At this point they obviously believe that they can blandly make utterly misleading assertions, saying things that can be easily refuted, and pay no price. And they may well be right.

这样，我们从这次峰会得到什么？我所得到的信息是那种狂妄与傲慢。像死亡小组这样的污蔑居然奏效，这种狂妄与傲慢明显根植于共和党政客之中。在这一点上，他们显然相信他们能够顺利地做出xx是误导的推断，声言许多事情可以轻而易举地驳倒，而且不用支付任何代价。他们这样说可能是没有错的。

But Democrats can have the last laugh. All they have to do — and they have the power to do it — is finish the job, and enact health reform.

但是，可以笑到{zh1}的是民主党。民主党人要做的只是（他们有权利这么做），完成这项工作，使医疗改革成为法律。