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.