We’re not well. Even before such shifts materialize, the U.S. confronts numerous worrying trends at home. Life expectancy fell last year. Rates of maternal mortality are much higher in the U.S. than elsewhere in the developed world, and getting significantly worse over time. Tens of millions of Americans are overweight. Suicide rates are up. As are rates of death from alcohol abuse and, of course, opioid addiction.

The party in power in Washington hopes to pass a law to reform the nation’s health-care system in such a way that something on the order of 24 million fewer people have access to affordable care. It’s hard to see how the consequence such reform would be anything other than a worsening of every single trend.