In the eternal struggle between
reason and emotion, reason doesn’t have a chance.
Not wishing to give up, however,
let me try again to inject facts and reason into discussions of health reform.
Here are some observations I hope you will consider objectively.
One: The health reform laws (collectively the ACA or “Obamacare”) do
not so much change the healthcare system as they reform the insurance industry.
Those who claim the ACA is a “takeover” or “power grab” by the federal
government are either woefully uninformed or being disingenuous. Helping people choose insurance from
private insurance companies is not a takeover.
Two: These insurance reforms—
- Guarantee you can get coverage even if you have pre-existing conditions
- Prevent your being charged higher a premium based on health status
- Cover prevention services including vaccines and screenings
- Eliminate lifetime and annual limits
- Allow young adults to continue on their parents’ plans to age 26
- Make it easier to shop for private insurance through the health insurance marketplaces (“exchanges”) with refundable tax credits if needed
- Provide standardized information and greater transparency about prices for purposes of comparison shopping
- Shrink and eventually close the Medicare “donut hole” for prescription drugs
- Expand Medicaid for states that voluntarily decide to extend coverage
When asked about these changes one
by one, without being told that they are part of the ACA, people overwhelmingly
approve of them. Only when the epithet “Obamacare” is used does support for
them go down.
Three: Yes, there is an “individual mandate” – a requirement that
everyone have insurance beginning next year or pay a penalty. With more than 40
million uninsured people in this country, the policy issue is: is it better that a few be
inconvenienced than millions of others have no coverage? This is, fundamentally, a moral issue as well as an economic one. But laying aside issues of morality, the purpose of
insurance is to spread risk. The only way to do that is to have everyone in
the insurance pool. And, by the way, an individual mandate is part of “Romenycare,” the
Massachusetts health insurance plan on which much of “Obamacare” was patterned.
Four: Yes, the insurance marketplaces have had
a rocky start, especially the federal Website healthcare.gov. But what
new computer system doesn’t have bugs in the early going? Just think of upgrades
to the Windows operating system or your iPhone. Those are never perfect on day
one and always require “fixes.” (And, by the way, the federal site worked fine
for me. That may be because I’m in California, one of the states that embraced reform.)
Five: It is unfortunate that the President
said “if you like your health plan you can keep it.” That was not totally accurate
and he’s had to backtrack, thus giving his opponents political ammunition. But
more fundamentally, it means that some substandard policies will continue in
force, to the detriment of those individuals’ coverage and causing a delay in
getting to the goal of spreading risk.
Finally: Obama is the eighth president to champion
health reform: TR, FDR, HST, JFK, LBJ, RMN, WJC, and now Obama. If Watergate hadn’t
intervened we probably would have adopted universal health insurance 40 years
ago because that was Nixon's plan. I wonder what Tea Partiers and Republicans would
have said about that.
Churchill once said: "Americans always do the right thing ... after
they've tried everything else first." I say: a century of trying other
things is enough.
I don’t care whether you agree
with me or not, but please base your opinion on facts and reason, not emotion
and the “spin” you get from Fox News, politicians, etc. The highest form of
ignorance is when you reject something you don’t know anything about.
