A lot of heat has been generated this week in South Carolina about the Patient Protection and Affordable Care Act, but little light.
Our two U.S. senators, Lindsey Graham and Jim DeMint, are pushing bills that would repeal the law altogether or allow states to opt out without any requirements, taking us back to the place we were before - a time during which most states and the federal government failed to act effectively to rein in the nation's No. 1 fiscal threat, rising health care costs.
And on Wednesday, new S.C. Attorney General Alan Wilson called the law "currently void and unenforceable" in response to a ruling by a federal judge who said it was unconstitutional. Wilson didn't send out similar press releases when two other federal judges said the entire law was constitutional or when a gaggle of other judges dismissed outright lawsuits challenging the law.
Most of it was about political theater, given that everyone knows the law will continue to be implemented - and South Carolina will happily continue to receive funding designated by the law even as our leaders condemn it in press releases and sound bites - until either the Supreme Court overturns it or an anti-reform occupant takes up residence in the White House.
Premium content for only $0.99
For the most comprehensive local coverage, subscribe today.
Until either of those things occurs, talk of repeal is just that, talk.
What's most fascinating about this past week's development is the utter silence on the replace part of the repeal-and-replace mantra.
Every critic of the Affordable Care Act supposedly recognizes the importance of getting a handle on our growing health care problems and claims it is a priority. Yet, the Graham and DeMint bills don't detail an alternative; neither did the repeal bill that passed the House of Representatives recently.
And though there was talk before the governor's inauguration about South Carolina developing its own comprehensive health care plan to take advantage of a provision in the Affordable Care Act that would exempt the state from certain requirements, such as the much-despised individual mandate, there hasn't been much since.
Even as unexpected medical emergencies became the primary source of personal bankruptcies, businesses began dumping health insurance plans because they cost too much and a fifth of South Carolina's residents went without health insurance because they couldn't afford it, the state did not come up with an effective plan to solve those growing problems.
Even though the state still has space to create its own plan - even with the Affordable Care Act - energy is instead wasted on empty rhetoric.
And even though Graham did not make reform a priority while he was in Washington as part of the party that had complete control of Congress and the White House, today he makes an empty repeal gesture instead of using his position to either improve the Affordable Care Act or push for something better.
If the medical malpractice reform imbedded in the law isn't effective, why not push to strengthen it?
If the individual mandate, which would require most Americans to buy health insurance, creates legitimate constitutional questions, why not replace it with something that would be as effective at making insurance more affordable, widespread and staunch the rise in costs as the mandate is projected to?
If the Congressional Budget Office's projection that the bill will reduce our deficit by maybe $1.2 trillion over the next two decades doesn't pass the smell test, then why not focus on changing the law to make sure that happens, or create an alternative that guarantees it will?
If the doctor-patient relationship might be harmed by the law, why not lead efforts to make sure it doesn't, or present a reasonable alternative?
Far-reaching and comprehensive laws are always flawed at the outset, meaning change is always necessary as it is implemented. The Affordable Care Act is no different.
It's easier to complain about what others have done than to lead.
But on this issue, we need leadership, not posturing.