Obamacare / ACA

I'm torn between the idea of surrendering more liberties to the central government, and the idea that freeloaders in the healthcare marketplace are responsible for the price distortions that help make healthcare unaffordable to 20% of our population. In many other countries, they see healthcare as a right. (I'm not saying whether it should be a right.) The idea that all citizens deserve high quality healthcare as a matter of right indicates that those countries value social cohesion more than individual freedom compared with the USA. In Canada, it is one area of government which treats both rich and poor the same way - a tool for putting the rich in the same boat as the less privileged.  America may have something to learn from its Northern neighbor - if it is lucky enough to learn some humility.

With that being said, one of the signs of a good law is that people on both sides of the aisle are unhappy with the law. In the case of ACA/Obamacare, the left said we didn't go far enough towards a single payer system. Where the right said we went way too far in telling individuals that they must participate in a specific market place. Using this criteria, ACA/Obamacare has the potential of being considered a great move forward if it survives the test of time. So, what do we make of Thursday's decision? If we ignore the rhetoric from both sides, we can see the ideas behind the law from a historical perspective. Most of the ideas behind ACA/Obamacare were developed by the GOP from the days of Richard Nixon. Romney implemented the model for ACA/Obamacare in Massachusetts when he was governor. Most people in that state are very glad the law exists. The odds are, that as people become familiar with the benefits of ACA/Obamacare, they will grow to like it. But if they don't, they will be free to throw it out - especially with a GOP in ascendency across the nation. 

Before the ruling, I was telling people NOT to make any assumptions in regard to how SCOTUS would rule. This ruling neither legitimizes nor delegitimizes the authority of the court. It simply is an exercise of the power of that court as a co-equal branch of government. I had a feeling that a conservative court would be very hard pressed to overturn a president's major legislative effort when both sides of the argument said that government had the power to pass ACA/Obamacare into law based on the government's taxation powers. That ended up being the salient point that Justice Roberts focused on, and his way of saying that he will evaluate cases first based on his interpretation of the merits of a case (with the bias of a conservative justice), and not the politics behind it.

I'm still wondering if the GOP wins, whether they will fulfill their promises to repeal Obamacare / ACA.  If they do, they'd better have something better with which to replace this law, or we'll be in trouble.  This would be the first time that the political system not just cuts off its nose to spite its face, but it will show the political system as not caring one bit about the American pledge to help people in need....  We're starting to see America's social cohesion decay.  And once we lost it, we'll be no better than most other countries on this globe....

Lies, Damn Lies, and Statistics

It's a damned shame that reason doesn't play a bigger part of political life.

As much as I call myself a centrist, I've gotten disgusted at the GOP. America has long needed a means to provide adequate healthcare access for the 20% of our citizens who do not get subsidized access from either the corporate world or the government. And when the Federal government has used a model enacted by a Republican governor, that same (now) ex-governor is repudiating support of what should be his greatest achievement. When asked about how the (not by choice) uninsured would get health insurance, he issued a polemic about being responsible.....

A big problem with America's health care "system" is that the uninsured are guaranteed treatment regardless of ability to pay once they reach most hospitals. This does not jive well with a supposedly market based system advocated by the GOP, because of the cost shifting that inevitably takes place. One either has to turn away people who can't pay for care, or recognize that health care is too important an issue to be left to market based solutions. Some might say - there's enough charity care to go around. That's not the case. Hospitals also negotiate deals with insurance companies which call for the lowest possible rates being charged to their covered beneficiaries. If 80-90% of the public is covered by HMOs or other insurance structures, that leaves the remaining 10% or people to cover the uninsured via excessive rates for services provided by a hospital. This is not right....

When people are polled - do they support "Obamacare"? most say NO. But, when you ask the same people about the individual provisions of the same law (without mentioning it is "Obamacare"), the same people support most of the individual provisions. So what does this mean? To me, these people are siding with their "tribe", accepting the lies being told by cynical leaders. Yet, there is some truth to the criticisms of the law - the most important being that this is only the second law in American history which compels a person to participate in the purchase of a good. (The first was enacted in early American Constitutional times, requiring all citizens to purchase a firearm and ammunition for purposed of establishing a well regulated militia. This is a law I could support even now, with some minor exceptions.) Do we want to require people to buy a good they don't want?

Sadly, what existed before 2010 was worse than nothing. When one has hundreds of people waiting on line for free health care (provided pro bono) at health care clinics because they can't afford it otherwise, we have serious problems. This is not a third world country. But we're treating a growing segment of our population as if we were in the third world. Obama's law does not socialize medicine, as many in the GOP claim. In fact, one of my friends keeps spouting the GOP party line that we'll lose our right to choose our own doctors if this law is allowed to continue. Has anyone experienced this? I haven't so far..... But I'm afraid that if the law is repealed by the courts, that some future administration will force in single payer insurance and truly socialize healthcare in this country - a very possible situation which may be forced by a desperate public.

In short, there is an underlying tension between individual rights, society's rights to insure that there are no freeloaders for social benefits, and our basic human nature to help people in need. How should we best answer this challenge? Should we let politics continue to get in the way of finding an optimal solution which reflects the medical and social needs of America?