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The Pre-Obamacare Trainwreck

20 Nov

Obamacare-symbolSome of my friends are conservatives. Shocking, I know. They occasionally post things to social media that are critical of people whom I support, and policies with which I agree. Occasionally, I will argue or even troll, but once in a blue moon, I will try to present a reasonable counterargument that is factual and not particularly argumentative. Rare, but it happens. 

On Tuesday, I saw a post linking to this article. My Facebook friend annotated his post by declaring that “progressives…really do all suck”.  I read the article, which detailed the travails of a single mom trying to buy insurance on the Washington State exchange, and having problems with bad advice and equally bad results. I feel horrible for her and anyone else similarly situated. The new insurance mandate, and the fact that the policies have to maintain a minimum standard of coverage means that some people are paying more, and the subsidy schemes are complicated. 

But it’s the “Affordable” Care Act. Not “inexpensive”, not “cheaper”, not “free” – affordable. But once you argue the semantics, you’ve lost. People’s perception is that everyone’s cost would go down, and whenever this proves not to be the case, it gets blown up into a scandal. 

So, let’s take a step back for a second. The Affordable Care Act – Obamacare – is not what I think is best or perfect for this country, but it’s 1,000x better than the utter trainwreck that preceded it. Here’s what I posted as a comment to my friend’s Facebook indictment of “progressives” in general and Obamacare in particular: 

At some point between 1990 – 2009, the Republican Party decided that universal health care coverage was no longer a societal goal, regardless of how it was to be implemented. When “HillaryCare” was proposed, conservatives pushed as an alternative the model now known as RomneyCare and ObamaCare – a regulated and partially subsidized marketplace of private insurance policies that you are (a) mandated to participate in if you have no employer-based coverage; and (b) meets some minimum standard of what qualifies as “insurance”. 

Now that we have Obamacare, which is a regulated individual marketplace of policies, different in each state, conservatives have not just refused to go along with it, but have actively and passively worked to sabotage it. 

Big laws that do big things aren’t going to be perfect in an imperfect world. Under normal circumstances, we would at least have consensus on “everyone should be insured” as a societal goal. We don’t even have that starting point, so everything else must fail. But even if, hypothetically, Republicans did agree that we should all have decent health coverage, under normal circumstances and in a responsive representative democracy, they would work to help fix problems that arise. This, too, we don’t have. That’s why things that have come up as problematic now have to be amended through regulation and executive rulemaking. 

If the right wanted to present an alternative to Obamacare – which is itself the alternative to HillaryCare – then they should have done so. They never, ever did. All they’ve done is try to block it, then sabotage it when they weren’t done repealing it. Oh, sure they bleat on about “tort reform” and the anti-federalist notion that policies should be one-size-fits-all across the country to enhance “competition”, just like the Telecom act of 1996 enhanced cable TV “competition” and the breakup of Ma Bell enhanced telephone “competition”. Just like the merger of Exxon and Mobil or United and Continental enhanced “competition”. 

In the end, government exists, in part, to fill in the holes that private industry can’t – or won’t – fill. Our private health insurance system in this country is unique in its user-dissatisfaction, physician time-sucking, inefficiency, and waste. It has proven to be almost completely unworkable in contemporary society, and its problems are underscored by the fact that no other country in the world sees fit to implement anything resembling it. 

By the same token, the German, Swiss, French, British, and Canadian models are also imperfect. They do, however, produce better results for far less money – and they do it in a way that satisfies the health care consumer. 

ObamaCare’s lack of situational perfection doesn’t take away from the fact that you no longer face lifetime policy maximums; you can no longer be denied coverage due to a pre-existing condition; insurers can no longer arbitrarily drop you when you get sick and use your coverage; preventive care and immunizations will be free of charge with no co-pay or deductibles; females are treated equally now; myriad consumer protections are put in place to help people appeal adverse insurance decisions. All of these changes are significant – so much so that it’s disgusting that these sorts of things were not implemented before. 

But, you know, glitchy website. 

Yes, I’m disappointed that ObamaCare isn’t perfect. But that disappointment is tempered by my disgust with the pre-ObamaCare status quo. I would much prefer a hybrid NHS single payer system that had public care with private sur-care policies. This will not happen in this country in my lifetime unless it’s proposed by a nominal conservative. In the meantime, have fun pointing out the problems that 1/300,000,000th of the population has with an individual policy under a state-run scheme and not only indict the federal program, but anyone who supports it, as horrible.