Time to throw out the Obamacare baby with the bathwater? No, it’s not.
I’ve defended Obamacare for six years. However, I also acknowledged, every time I defended it, that it’s not perfect, that it must be seriously tweaked as it evolves. I also wrote and said repeatedly if Obamacare (Affordable Care Act) becomes unaffordable, it will have turned into a misnomer, an unaffordable “Affordable” Care Act, and that it will be time for a major overhaul or a new system to replace it.
That time has come – for an overhaul, at least.
One reason I’ve always defended Obamacare with such vehemence is that its knee-jerk enemies, like Rep. Ted Cruz, who triggered a government shutdown because of it, constantly spoke of the ACA in apocalyptic terms – train wreck, unmitigated disaster, a death spiral. One Obama-hating politician, Dr. Ben Carson, called it “worse than slavery.” Ah, yes, the sky is falling, the end is nigh, and it’s all Obama’s fault.
If the ACA is totally scrapped, as those who hate it so wish, some fine day some of those opponents or their loved ones just might desperately need it. Alas, too late; it will be gone. Be careful what you wish for.
Obamacare, I’ve often maintained and still do, is better than nothing for these reasons:
- About 20 million people are insured who never had insurance before.
- It forbids insurance companies denying coverage to those who have pre-existing medical conditions.
- It allows people up to the age of 26 to stay on their parents’ insurance policies.
- It requires standards of care and preventive services, such as early detection of serious threats like cancer.
- It prohibits hiking premiums for women just because they are women.
- It has lowered the costs of health care in many sectors, other than the recent spate of premium increases.
Who can deny those outcomes are not good things?
The bad outcomes, which I’d always worried and written about, are these:
- Giant insurance companies and drug companies are often the tails wagging the dog.
- Even though federal subsidies cover most of these big premium spikes, the taxpayers get soaked for those increases, and the insurance companies and drug companies know that all too well – smugly so.
- The deductibles in some of the insurance plans keep increasing, sometimes by thousands of dollars, making a policy all but useless for some policy holders. Those kinds of deductible outrages, let’s remember, happened often, long before the ACA.
The problems with Obamacare do not constitute a “train wreck.” After all, before the system was even conceived (in a Republican think-tank, no less), insurance premiums had been skyrocketing in double digits for many years, so these recent increases, which average 25 percent – some less, some far more – should not necessarily be such shockers. However, I fully admit if not a train wreck, the Obamacare train is slowing down to a problematic chug-a-chug.
Let’s fix it, as Hillary Clinton proposes, and let’s not throw out baby as her opponent Donald Trump would like to do. The best way to fix it now is to let it include a “public option,” allowing some people to buy into the current Medicare program.
And if the ACA has to be scrapped completely, let’s first figure out how to replace it. Those who have so rabidly hated it from the get-go come up empty-handed, empty-headed when asked what they would put in its place. In some cases, they feebly propose tax credits or tax-free health-savings accounts, as if hard-working but financially-strapped people who have trouble putting food on the table can afford to sock away bundles of money for health care.
Another replacement proposal is the good-old free-market solution with the presumption that rigorous competition will lower prices. Free-market forces have never worked well in the labyrinthine health industry. In fact, they are more the problem than the solution. Big Pharm, to use just one example, is an outrage. When the Medicare Part D Drug Act was passed under President George W. Bush, part of the agreement is the government is forbidden to negotiate for lower drug prices with drug companies.
As a result, some vital life-sustaining drugs now cost insanely-inflated amounts. A hepatitis-C drug made by the drug company Gilead Sciences used to cost $1 a pill; it’s now $1,000 a pill. It’s a life-saving pill that many war veterans require to stay alive. And that is only one example of health-care forces far beyond the control of people facing life-and-death situations.
For many decades, I’ve researched health systems throughout the world. Bernie Sanders is right – a one-payer, universal system is the only way to go. I believe it’s inevitable and the flawed ACA was – and is – a step in its direction.
It’s disappointing how many Americans are not aware of the excellence and cost-efficiency of one-payer systems in other nations where every citizen is covered. Trouble is, we have been conditioned for decades by the powers-that-be to think of any health-care systems other than our own as bad – where sick people die while waiting in line for incompetent treatment that never comes. It’s the same kind of nonsense some people believe about Scandinavian countries – where people are so beaten down by socialism they commit suicide. Nonsense.
Medicare and the Veterans Administration health system are both in a way “one-payer” systems. I would bet that within 10 years, the United States, at long last, will absolutely have no choice but to adopt a one-payer system – funded with our taxes instead of skyrocketing premiums.
