Okay, everyone, take a very deep breath. No, deeper than that. Things have been pretty dicey these last few
weeks, actually much longer than a few weeks.
I'd characterize it as an amplified mess. As to the mess, the launch of the Affordable
Care Act (ACA) has been a colossal embarrassment with its
not-ready-for-primetime website and communicative missteps. The Administration screwed up and badly! As to the amplified, a not so surprising rocky
start to a very complicated undertaking has been blown way out of proportion. This would have the ACA doomed and President
Obama on his way to oblivion. Right. That may well be today's storyline put out by
the program and his opponents, one opportunistically fueled by the media, but
we're only about a month in for a program designed to last for many years to
come. Moreover, this is hardly the first
time the President has been written off.
Remember that widely predicted (though never substantiated by polls) cliffhanger
of a presidential election?
That deep breath, please! Let's start with the basics. There is nothing wrong or malfunctioning with
the ACA program as enacted into law. If
it has faults, they lie in its doing too little, covering too few, not in doing
too much or being too intrusive. This
legislation is the product of big time compromises. Republicans like to paint
it as socialized medicine. In truth, the private insurance industry,
which lobbied hard against anything close to universal Medicare, was and is a
big winner. There has been a big
brouhaha about people being thrown out of their (mostly sub-par) insurance
plans. In fact, not only are the vast
majority of covered Americans keeping their plans, they no longer have to worry
about pre-existing condition turndowns when or if they move to new ones. Women can no longer be penalized with higher
premiums. And, perhaps most important, the
kind of lifetime caps that brought families to the poorhouse are no longer
legal. Basic Medicare stands unchanged except
for a significant enhancement: closing the so-called doughnut hole in prescription
drug coverage. Finally, unless living in
a state like North Carolina or Texas controlled by (seemingly mean-spirited and
cruel) right-wingers, millions of the heretofore-uninsured poor will have
access to expanded Medicaid.
There is an abundance of misinformation about the
ACA, facilitated in part by the fact that insurance — all insurance — is
complicated. This is a murky fine print
terrain. What is not in question is that
even before its start, Republicans, especially but not exclusively in the House,
have been relentlessly fighting it. As
of this writing they have voted to repeal or defund the program 47 times. They made it a principal issue in 2010 and
again in the 2012 presidential election.
They tried to use defunding as a bargaining chip during the manufactured
crisis that ended up closing the government and threatening the country's full
faith and credit. They made gains in the
House in 2010 but President Obama was reelected and with a higher margin than
any recent chief executive. So, despite
all their efforts, the act is moving forward and by the still months away deadline
millions of the uninsured will likely have signed up.
What the Republican opponents have been up to of
late, including purposeful misinformation and fear mongering, is nothing
new. Back in 1961 Ronald Reagan, then a
spokesman for the business right, cut
a record for the American Medical Association opposing the establishment of
Medicare. Reagan considered the proposed
approach to healthcare contrary to the American free enterprise way. The future president argued that it was
simply a foot-in-the-door toward socialism.
Reagan concluded his argument and call to action
with this dire warning about the bill's passage:
I promise you...just as surely as the sun will come up tomorrow and behind
it will come other federal programs that will invade every area of freedom as
we have known it in this country until one day...we will wake to find that we
have socialism, and...one of these days we are going to spend our sunset years
telling our children and our children’s children, what it once was like in
America when men were free.
Needless to say, his prediction was totally off the
mark. Not only is Medicare an excellent
and essential program, no American could even imagine being without it. And in case you haven't noticed, our free
enterprise system is alive and well with businesses raking in the billions, far
more than back in 1961. Reagan was wrong, but worse was his fear
mongering.
He remains the hero of today's Republicans — Reagan's
party not Lincoln's. Some say, the
current crop are much more conservative, but look at this anti-Medicare message
and you'll likely come to a different conclusion. There is clearly a sense of déjà vu consistency
in what Reagan's ideological descendants are doing and why they are so worked
up about the AFA. It isn't just about
health insurance but about a perceived threat to their way of life. One has to wonder what that "way of
life" might be relative to other Americans, most especially those who have
been deprived of something as basic as healthcare.
We should keep this in mind in watching the drama of
a so-called ACA failure unfold. We
should remember that those who are yelling loudest about the launch problems
are exactly those who oppose its implementation in the first place. Their voiced concerns about difficulties in
sign up are, to be generous, disingenuous.
They don't want to expand coverage, which they surely see (or pretend to
see) as what Reagan characterized the end of our freedom. Some Democrats in Congress, concerned about
their own reelection in swing districts are being sucked into this hysteria — shame
on them. The Affordable Care Act is a
modest step forward in bringing all Americans under the umbrella of healthcare
coverage. A bump in the early road to
its implementation is troubling, but we can't let it stand in the way of
progress. We can't allow ourselves to be
swayed by the calculated hysteria. Far
from being the end of the America that should be, it is a major step forward. Let's all take that deep
breath, see what's going on for what it really is, and continue our support.
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