Wednesday, September 14, 2016

6 years since Obamacare was signed into law.



It's almost been 6 years since Obamacare was signed into law, and we're now seeing the problems in the law.  Democrats rightfully say that more people are covered by health insurance, while Republicans rightfully say that there are fewer choices in medical care. What is the objective truth?

To look at this law objectively, one has to look through the lens of American politics, and what happens when the political system periodically breaks down in this country. The other day Rachel Maddow talked about an interesting phenomena on her show. It had to do about "Nativism" and when it pops up in our society.  Nativism, as I like to describe it, relates to a frustration held by native born citizens related to their place in society (and in the economy), a tendency to blame their problems on the foreign born, and a remedy to stop (or reverse) immigration by unwanted foreigners. 

When Nativism first became important, it was in the guise of the "no nothing" movement. Our political system was breaking down over the festering issue of slavery, there was political paralysis caused by the Northern and Southern states refusing to work together to govern effectively. In the end, the Whig party died, the GOP was born, and we had a brutal civil war before we had a government that could govern again.

We are again seeing the signs of our political system breaking down.  Donald Trump is only a symptom of a much larger problem. 


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America is again at a crossroads.  Every so often, its politicians tend to become so opposed to each other, that the normal business of government doesn't get done.  We have a Supreme Court nomination that the GOP controlled Senate refuses to act upon, simply because it wants to deny the current Democratic president any ability to make constitutionally mandated decisions that may affect the balance of power for years to come. They falsely claim that a lame duck president has no right nominate a person for a Supreme Court opening, stating that the next president should be the one making the nomination. Tribal loyalty is trumping (no pun intended here) duty to the nation. And we all suffer for it.

As a nation we have serious problems that are not being addressed.  We have refused to act on rationalizing America's immigration policy for years, effectively encouraging a "catch and release" policy for illegal immigrants.  Many people believe that the big problem is Mexican immigration to the USA, when the reality is that Mexicans are going home because of opportunities opening up there.  We have people who want "forever wars", and a Military-Industrial complex which is all too eager to oblige them.  We warehouse many of our poor in prisons, locked away for trumped up charges, all in the name of keeping our nation safe from crime.  (We'd be better off legalizing hard drugs, and taking away the reasons people commit crimes to buy these substances, and imitate Portugal in this area.)  We still have not been able to cover 100% of Americans in a medical insurance program, in part because of political bickering, in part because of big pharma having prevented some of the meaningful reforms that would allow medical insurance to be profitable for both the customer and the corporate entity providing it, and in part because because we do not have a "Public Option" ("Medicare for All", as Bernie Sanders would call it) where private industry can't afford to provide care.  Our political class is paralyzed, and the people are revolting at the polls.


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This situation has happened in other countries, and we've seen the disasters. To me, the most notable disaster was the fall of Weimar Germany and the ascent of Hitler and the "Thousand Year Reich".  We all know what happened there. Europe's economies were destroyed for at least a generation, and many of the continent's scars are visible to this day. Yet, Nativism still flourishes there, with far right parties trying to throw the immigrants out. And I can't blame the Nativists, because many of these immigrants have not assimilated into European society, many still live in cultural ghettos, and many cause problems by trying to bring the failed social values of their old homelands to the new.

The Nativists are just as much of the problem as are the unassimilated immigrants. Neither has adapted to change.  In many ways, both cling to a past which has not served them well, and has left them unprepared for the future.  It's sad, as neither group realizes that the past is the problem and not the solution.  In both the US and in Europe, Nativists resent immigrants who they feel are stealing their jobs. In reality, they are doing the kinds of work that the native born consider beneath themselves to do.  To make things worse, the jobs that many of the Nativists once did are no longer available.  Both Britain and the US have reduced their needs for coal, but no one has provided for the displaced workers. They have good reason to feel angry.  Immigrants are also part of the problem, as they bring ways of life which are incompatible with life in the new countries.  Muslim immigrants are often shocked that Western countries do not, and will not accept Sharia law in their midst.  The native born Christians in these lands rightfully see this as a problem, as it could lead to an all out war between them, and a growing Muslim population.


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The future is not as bleak as one might think. Mexican immigrants have assimilated more easily into American society the further away they are from Mexico.  In the lands which once were part of Mexico, they have tended to maintain a stronger cultural identity, and pose an interesting problem for America.  How do we insure their primary loyalty is to America? Most Muslim immigrants do not want any part of Sharia law, nor do they want the customs of their homelands.  They see the problems in places such as Egypt, where the government has no value to the common person.  They also see that government in the USA has a rightful place in public life, and is much of an asset here, as much as it was a liability in the lands from which they came. And in virtually all cases, it is education that has made the difference.

It's hard to learn to think critically without a good education.  And many of Obamacare's greatest opponents come from the masses who have not been educated well.  They do not see the law as an important first step towards an effective health care system for Americans, as they have not been taught civics in our schools.  They do not know how the government functions, nor do they know how to achieve their goals using the powers reserved for the people.  Instead, they look for a strong leader to deliver them from the mess that they, themselves have made. The masses have caused their own problems, because they, themselves have delegated their thinking to others.

Luckily, we still have a critical mass of Americans who have been well educated, and they still outnumber the "unwashed masses".  Hopefully, these people will stop the "unwashed masses" from electing a bombastic demagogue as a strongman leader, and instead, force the two parties to work together again and govern.  I still have hope for America, as the structure of the government handed to us by the Founding Fathers is still resilient enough to deal with today's problems.  They saw the objective truth, and it wasn't pretty then.  And our objective truth is just as ugly today as it was then.  So I have faith that what was given to us by Hamilton, Franklin, Jefferson, Adams and others is strong enough to weather the likes of Trump or Clinton....











https://www.morningstar.com/news/Market-watch/TDJNMW_20160831501/update-how-gilead-broke-obamacare.html


http://www.politico.com/story/2016/07/obamacare-prescription-drugs-pharma-225444

http://www.forbes.com/sites/scottgottlieb/2015/01/08/what-a-drug-price-debate-reveals-about-obamacare/#6eed2d1578c2

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