Obamacare: A big (#*%@#) deal

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With his surprising vote to uphold the core of the Patient Protection and Affordable Care Act, Chief Justice John Roberts may have salvaged the legitimacy of his court. A lopsided majority of Americans has come to see the court as just another partisan institution, according to a recent poll, and the chief justice probably doesn’t want that as his legacy.

Whatever his reasons, Roberts did his country a great service by paving the way to universal health care. Until Congress passed “Obamacare” in 2010, the United States had remained alone among industrialized Western nations in its failure to institute a health care system that was really, well, a system.  

Every other major Western democracy has a system in which all citizens have access to health care, whether provided by the state (Great Britain) or through a combination of public and private insurers (Germany). And all of those countries have better health outcomes — measured in statistics such as lifespan and infant mortality — than the United States. No matter how many times that a conservative argues that this country offers the best health care system in the world, it’s just not true.

Yes, you’ve heard news accounts of wealthy Arab potentates and deathly ill dictators coming to this country for this or that procedure because they believe the medical care in the United States is top-notch. And, at some hospitals, it certainly is. There’s no doubt that the U.S. offers cutting-edge research, advanced pharmaceuticals and world-class medical innovations. Unfortunately, many Americans cannot afford them.

A medical care system should be judged by the quality it offers to the majority of citizens; on that score, the U.S. is hardly the best. In this country, life expectancy is 78.2 years. In Germany, it’s 79.4; in Great Britain, it’s 80.5; and in Switzerland, it’s 82, according to statistics compiled by the United Nations. And that’s despite the fact that Americans spend so much more on health care. It’s money that is not well-spent.

The Affordable Care Act won’t fully renovate the country’s warped system of health care. It will still be expensive, wasteful and less focused on prevention than it should be. But now, 32 million more Americans will be able to visit a doctor, get a vaccination, get a mammogram or get medication for hypertension. Insurance companies can’t jack up customers’ rates willy-nilly because they get sick or refuse to sell them a policy because ten years ago they had cancer. That is, as Vice-President Joe Biden once memorably put it, “a big (expletive-deleted) deal.”

For decades, conservatives have argued that health care is best left to a free market, which, in their view, provides the best solutions. But health care is not like any other market. You may decide not to buy a flat-screen TV or a hybrid automobile, but you literally put your life at risk if you decide not to purchase health care.

Nor do health care consumers realistically have the option of shopping around for a better price. It’s absurd to think that the average 55-year-old woman, upon hearing the news that her breast biopsy has showed cancer, would start to dicker over the price of chemotherapy: Well, let me see if it’s cheaper across town.

At some point, each and every one of us will purchase health care. Many young and healthy Americans, however, choose to take their chances and avoid the expense of medical insurance. Still, lots of them end up with injuries or illnesses which take them to the emergency room. And that drives up prices for everybody else.

That’s why the widely-reviled “individual mandate” was necessary — to make sure that those “free riders,” as Mitt Romney once called them, buy health insurance. When Romney championed the Massachusetts version of the Affordable Care Act, he insisted that the individual mandate was good policy. Indeed, he defended it as recently as last January, during a GOP debate: “Because the idea of people getting something for free when they could afford to care for themselves is something that we decided in our state was not a good idea.”

Now,virtually all Americans will have health insurance, and the nation will be stronger and healthier for it. That’s a very big deal.

 

 

Comments

  1. Carol T says:

    All strawman arguments, that fail to address the real issue. The Republicans obligingly failed to raise these essential questions about the individual mandate: “Is it necessary?” and “Is it proper?” In fact, it is neither. Government programs already paid for three-fourths of the uncompensated costs of uninsured people. It would only have been necessary to expand those programs to cover the rest. And it would have been cheaper. Actual health costs of the uninsured average less than $1800 a year, while the subsidies to buy health insurance policies are expected to cost around $5800 each. So, the individual mandate was not necessary to cover the uninsured; and it increases costs to the public, not reduces them. It’s time for a real attack on the Constitutionality of the individual mandate!

    BUT – requiring the insurance companies to pay for goodies for some was a cynical gambit by the Obama administration to inflict financial hardships on the industry, while currying favor with the short-sighted. Then, they used those hardships that they imposed, unnecessarily, as the pretext for forcing people to buy policies to bail them out. And once enrolled, , all people would be in the clutches of the health fascists, who want to control the details of our personal lives, and whose pseudo-science is based on quackery, fraud and charlatanism! No escape would be possible, because those intrusions are a required part of every ACA-approved health insurance plan! The National Prevention, Health Promotion and Public Health Council will be chaired by the politician-appointed Surgeon General, whose every report on smoking has been suitable for a trial exhibit of scientific fraud. The Council members are the politician-appointed heads of other government departments, which will be enlisted into a monolithic health fascist policy juggernaut, with a politician-appointed Advisory Council which “shall develop policy and program recommendations and advise the Council on lifestyle-based chronic disease prevention and management, integrative health care practices, and health promotion.”

    And never forgive and never forget the propaganda campaign of hate and lies they unleashed against the uninsured, portraying them as “parasites.” As for who gets the biggest subsidy, exclusion of the cost of employer-paid health insurance cost the government $246 billion in lost revenue in 2007. $246B / 156 million people with private insurance = $1576 subsidy, while the $57 billion in uncompensated costs / 50 million uninsured people = $1140 each. And, “Although the tax exclusion provides a big boost to employer-sponsored health coverage, it is poorly targeted. It gives the greatest benefit to those with the highest incomes, although they are the group that least needs help paying for health insurance. The 24 per­cent of tax units with incomes over $75,000 in 2004 received almost half of the benefits of the exclusion, while the 27 per­cent of tax units with incomes under $20,000 received just 6 percent of the benefits.” (Limiting the Tax Exclusion for Employer-Sponsored Insurance Can Help Pay for Health Reform. By Paul N. Van de Water. Center on Budget and Policy Priorities, Jun. 4, 2009.) In 2011, among adults aged 18 and older, 70.4% of those earning over $90,000 per year had employer-based health insurance, while only 23.6% of those earning less than $36,000 did. (Fewer Americans Have Employer-Based Health Insurance. By Elizabeth Mendes. Gallup Wellbeing, Feb. 14, 2012.) Abolishing the tax exclusion would have provided plenty of money to pay for health care for the uninsured. The fact that these points were never brought out demonstrates the absolute control that the forces of evil had over the entire so-called “discussion.”

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