Politics and Healthcare

It’s nearly the 236th anniversary commemorating the adoption of the Declaration of Independence, which makes it a fine time for me to talk about a few things regarding politics and healthcare.
Last Thursday (June 28th), the Supreme Court ruled that the major provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA) were constitutional. As I understand it, the PPACA has not gained in popularity since its enactment. Some complaints include:
Length
It’s too long. 2,000 pages is the number I’ve heard most quoted. I’ve got a PDF copy up on my other monitor, which says it’s 974 pages, but I suppose it depends on what font is used. Anything could be 2,000 pages if you use 24 pt. font.
I’m not entirely sure how 974 pages could be construed to be 2,000. Perhaps because the Health Care and Education Reconciliation Act of 2010 sometimes gets lumped in with the PPACA, but it is 55 pages. Both bills taken together comprise 1,029 pages.
Regardless, no matter how you slice it, the PPACA is a long bill. However, nobody said that healthcare was going to be solved with a three page bill.
Actually, that’s not true. Herman Cain once said:
Engage the people. Don’t try to pass a 2,700 page bill — and even they didn’t read it! You and I didn’t have time to read it. We’re too busy trying to live — send our kids to school. That’s why I am only going to allow small bills — three pages. You’ll have time to read that one over the dinner table. (Thinkprogress.org, retrieved July 1, 2012. http://thinkprogress.org/politics/2011/06/07/238779/herman-cain-long-bills/?mobile=nc)
Complaining that the bill is “too long” is a petty excuse, and it’s naïve to think that anything as complex as healthcare could be solved in three pages.
More Expensive to Me
I suppose the major complaint is that the PPACA is or will make life more expensive for “me,” as in the average tax-paying American. I haven’t seen the numbers, and I probably should go out and search the internets to find the data. My initial impression is that it will shift the cost of healthcare slightly, but essentially the same group of Americans will end up paying for health care. The burden has always been on the taxpayer’s and business’ shoulders, and the burden will remain on their shoulders.
I suppose time will tell how it plays out when it comes time to pay our taxes. I’m fine paying into the system to ensure that everyone gets some sort of health care. Other civilized countries do it around the world, and their healthcare expenses are significantly less than the U.S.’s, while their people are healthier and happier. Maybe we’ll get some of the good side effects rather than just a higher bill.
As it is, anyone who walks into a hospital—whether covered by healthcare insurance or not—must be seen and cared for. The Emergency Medical Treatment and Active Labor Act has been law since 1986. And while people who are in the country illegally will not be covered by insurance any more now than they were before the PPACA, at least the Americans who walk into the ER will actually have insurance now.
Paying for Stuff I Think Is Immoral
Catholic hospitals and universities and other religious organizations have made a stink about the PPACA because they think that the PPACA will mandate paying for abortions and birth control. It’s a good thing that we’re a secular nation and not run by theocrats. If it’s a battle of morality, the Catholics will always lose. Catholics are partially to blame for millions of deaths alone when it comes to stating that condoms do not prevent the spread of HIV, and even claiming that European condom manufacturers are deliberately infecting condoms with HIV to spread AIDS in Africa. (BBC News. http://news.bbc.co.uk/2/hi/7014335.stm.) Who has the moral high ground, even if the law did fund or abortions and mandate paying for birth control? The law would. Roll over and take it, Catholics. And if you don’t like it, move to some forsaken country where your official policies hold millions of people down in poverty and sickness.
It’s Socialism to Be Forced to Buy Anything
Americans have had a long history of not liking taxes (re: Boston Tea Party, the Revolutionary War, etc.). So having to buy healthcare insurance or pay a penalty to the IRS could be seen at odds with the American ideal of living in a happy commune of libertarians who personally pay-as-they-go when it comes to defense, industry, and the common good. Being forced to buy something seems socialist.
I’ve seen the rhetoric against “socialism” escalate to the point where, among a certain group of people, being called a socialist was akin to being called a racist. Gasps ensue all around and the accused says, “You take that back!”
In general, socialist countries seem to have much better happiness, education, and health outcomes than the dear old U.S. (See “The World’s Happiest Countries,” Forbes.com. http://www.forbes.com/2011/01/19/norway-denmark-finland-business-washington-world-happiest-countries.html.)
Socialism doesn’t seem that bad. I’ve been to Canada plenty of times and it’s downright pleasant. The way Fox News throw around the word “socialist,” they make it sound equivalent to Russian-style Cold War communism, where people stood outside for hours enduring the winter’s fury to get a loaf of bread. The socialism in places like Denmark or Sweden is a far cry from starvation and human depravity.
I heard someone say that if you drive a car, you’re expected to purchase auto insurance. If you start living as an adult in a civilized country, perhaps it’s reasonable to purchase health insurance. In both cases, if something goes wrong, you can’t always just expect the “other guy” to pay for it.
Burden on the States
I’ve read articles about states having to scramble to implement the provisions of the PPACA in time to meet 2014 deadlines. Is it just me, or did they sit on their asses the last two years hoping that the lawsuits against the PPACA would culminate in the Supreme Court declaring the PPACA null and void?
Other Criticisms
While I’ve brought up some of the major objections I’ve heard the last few years, my biggest personal problem with the PPACA is that it didn’t go far enough. I would have much rather have a single-payer healthcare system, like most other countries’, rather than the pieced together system that now ties healthcare somewhat to employers, somewhat to states, somewhat to Medicare/Medicaid, and entirely gives too much authority to insurance companies as a whole.
Perhaps that’s just my personal experiences battling with insurance companies over the years. Being an insulin-dependent diabetic means that I’m expensive to insurance companies. I’ve got a chronic, incurable disease that requires the constant consumption of supplies. I’ve had numerous encounters with the “Oh, well, that’s not covered by your plan,” when it should be, or “Oh, we’re going to arbitrarily raise your rates by 20% for that request, because it’s considered ‘special’ prescription durable medical equipment.”
I’d much prefer that there would be checks and balances in place when it comes to my healthcare and they not have it all in the hands of some claims representative at the company. Then again, I have a good amount of skepticism that the government would do any better of a job.
The Good Stuff
There is a lot of good stuff immediately visible about the PPACA, like protecting the consumers’ rights to not have their insurance canceled because of preexisting conditions, encouraging low or no-cost preventative care, keeping your kids on your health insurance plan until age 26, and of course, establishing affordable insurance exchanges that allow people to buy affordable insurance.
I think if you were to talk to anyone who thinks the PPACA should be repealed, they’d say, “But I like some of the law, just not all of it.” Probably if anything, they’re against the tax penalty if they don’t buy insurance, because, well, it’s a tax, and Americans hate taxes.
Racism?
Meg seems to think that the anger against the PPACA (or, as they call it, “Obamacare”) stems from an old-fashioned notion of racism against blacks. President Obama (or as they call him, “Barry Hussein Osama”) is black, and we’re going to rail against everything that he does because, well, he’s a black man and somehow inferior.
I thought about it for a bit and told Meg that I hadn’t even thought about that. Being a child of the 1980s, it’s hard for me to comprehend that anyone would be racist in this day and age. I don’t think of Obama as a black man. I think of him as a president. I wouldn’t think about him any more or any less whether he was white, Asian, Middle Eastern, Australian, or whatever from any other decent. The genetic variation among any so-called “race” is only skin-deep anyway; we all share common ancestors. And by the way, we’re all Africans.
But my personal color-blindness regarding Obama aside, maybe Meg’s right. Maybe part of the buried anti-Obama rhetoric stems from just pure racism. It’s ironic that the Republican Party was the party of Abraham Lincoln.
Who Wrote This Thing?
Obama didn’t sit down and single-handedly write the PPACA. Sure, he signed the bill into law on March 23, 2010. But he didn’t write it—the 111th U.S. Congress did. In the Senate, it garnered a vote of 60-39; in the House of Representatives, it passed with a vote of 219-212. Sometimes I think presidents get entirely too much credit for legislation. It wasn’t Obama who wrote and initially passed the thing—it was U.S. Congress in 2009 and 2010.
Whenever I talk of other laws, I don’t immediately start talking about presidents. I don’t say “Ronald Reagan’s Expedited Funds Availability Act of 1987…” Instead, I just say that the U.S. Congress passed the EFAA in 1987. I suspect that after a few years, we’ll do the same for the PPACA and the whole topic will become less controversial and divisive.
In Conclusion
This is starting to sound like a college paper. Not really my intent, but I’ve been meaning to write about the PPACA for quite some time. It’s been interesting to witness the invectives being used, to hear the topic passionately debated, to see the ridiculous pictures and captions posted on Facebook. I’m happy that the PPACA withstood the first major court ruling, partially because of the schadenfreude at seeing so many disappointed Republicans, and partially because I think it’s a step in the right direction with healthcare reform.
I was too young in 1994 to pay attention to Clinton’s push for healthcare reform, or that its subsequent failure. This time, I’m making some notes about it. I voted for Obama four years ago because he wanted to change things. And “things” at the time meant eight years of a president I didn’t like, two wars, condoned torture, faith-based funding, abstinence-only sex ed., anti-science rhetoric, and a collapsing economy. The Democrats did change some things. Maybe not everything I want, like closing Guantanamo Prison, or ending the “War on Terror,” but at least Obama and the Democrats got this much: maybe, possibly, healthcare in America will now be a little better.

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July 1, 2012

I think that over time this will be thought of as the opening door to a better system. As for the screaming right, well, they had a fit over social security and medicare too, back when they were introduced. Rush Limbaugh threatened to move to Costa Rica if the court upheld Obamacare; be interesting to see if he carries out the “threat.” Heh.

July 1, 2012

this is the worst bill ever. This bill is costing us 1.1 trillion dollars. Then obama says that it will reduce the budget by a trillion dollars by the year 2030. Hello, it will take to the year 2030 for the bill to pay for itself. There is no regulation what so ever in the bill. No that they can force us to buy health insurance, what is next? This bill is an invasion of personal freedom.

July 2, 2012

Yeah, so is auto insurance.

July 2, 2012

I agree 100% with all of these responses to the critics (though, like you, I can’t quite accept the racism one– I mean Herman Cain and Clarence Thomas are fine with them). I fear, however, that there are many people in this country with noses firmly ensconced up Rush Limbaugh’s arse (sorry if you’re eating lunch) who, understandably, can’t hear you. Actually, “Obamacare” was dreamed upby conservative economists like Mark Pauly in the 1980’s as an alternative to the dreaded single-payer threat. Heritage foundation loved it, as did Romney. I think, to give credit where credit is due, that it should be called “Romneycare.” Davo

July 2, 2012

I’ve always like the auto insurance comparison. Except. I can choose not to get auto insurance by not buying a car. I can’t choose not to be an adult. That being said. I’m happier than not about the PPACA. I work 60 hours a week at jobs that pay more than minimum wage. Neither job offers health benefits and I can’t afford it on my own. I don’t drive a new car or live in a big house. Infact, I’m not sure my car would even fit in my apartment. I don’t live outside my means. But I still can’t afford health insurance. So… yah. I’m happy about this, and I really like how you laid all this out. Even if it was a little “college paper-esque.” 😀 ~rory

July 2, 2012

TL;DR lol I work for an insurance giant and let me tell you that with a twist of some words people in America will believe that we have the best shit in the world. For instance: Fox news “OH NO! CANADA HAS RATIONED HEALTHCARE!!! BEWARE!! um…hey Fox news, have you looked at insurance plan documents. I mean call your insurance carrier or employer and asked them for a copy ofyour plan documents. VERY few Americans have UNLIMITED insurance plans. If it’s not unlimited…guess what? It’s rationed!!!! But instead of saying rationed because that would piss American’s off, the insurance carrier says yearly maximums or visit limits Do you know if you need to be admitted to the hospital, the hospital has to get permission from the insurance carrier first or they will deny the claim? Instead of calling it permission, the giants call it pre-authorization. That makes it sound fancy. People need to wake up and read their insurance plan documents. I can promise you most people don’t. If they did….they wouldn’t be complaining at all about Obamacare.

YAH
July 2, 2012

Where is this happy commune of libertarians who personally pay-as-they-go when it comes to defense, industry, and the common good? Are they the rich who employ tax lawyers to minimize their taxes?

July 2, 2012

Very well-written. Probably the best written piece on this particular topic that I’ve seen. I, like you, am of the middle class. My private health insurance cost has more than doubled in the last two years. So, why am I not screaming in the streets how unfair this bill is? Because I happen to believe that it’s a basic human right to have access to affordable healthcare, not a special privilegethat only people above a certain income level should have. People who refuse to carry health insurance are part of the problem. Sure, they’re mostly young adults without chronic medical problems but just who do people think pays when one of these uninsured people has a catastrophic accident or illness? Poor people have access to medicaid. Working people who either don’t have the option to buy health insurance or can’t afford it are the ones who end up in those situations. People are required to insure their cars, their homes (if they have a mortgage, which is usually government backed) their businesses, their employees for disability and workers comp. I don’t see requiring people to carry health insurance as any different. I pay taxes because they are required but I also

July 2, 2012

realize that they are necessary in order to provide things like police and fire/rescue/etc, as well as libraries and parks and museums and public schools. Maybe these far-right wing people should think about what it would be like if you had to pay to have the fire company protect your house and if you opted out of that payment then your house could just burn to the ground before you’d get anyhelp. Or if you had to pay for police protection and if someone was holding a gun to your head that police officer would just cruise right by unless you had paid into it. That heart attack you’re having? Well, sorry, you haven’t been paying your abulance fees, so even though YOU have private insurance I guess you’re SOL because nobody’s gonna let their tax money cover your ride to the hospital. So, anyway, yes. You are awesome for bringing this point out as clearly as you have. Thank you.