The Obama care debacle
continues to roll along, along with the decades of gaming applied to the medical
and drug industry already; it is unbelievable that it is still working. The way it is now structured, one third of
the population will subsidize one third and completely cover the other third
for a service that is able to jam the cost structure right across the board in
every manner.
The protocol of who
pays could be tolerated if the cost side of the equation had not been a runaway
to begin with. What makes it far worse
is that it is insurance monopoly pricing and they are also incentivized to jam
pricing. Then they even got to write the
law.
Everywhere else in the
world, the government simply established a State owned insurer and took over
the business while expanding the coverage to everyone. That made for a meaningful transition because
they did not right away invent new coverage.
From that base, profits derived from cherry picking disappeared and
pricing discipline could be imposed however unsatisfactory.
What we have in the
USA is a massive sell out of the American people to an insurance industry
monopoly by a Democratic party who was paid visibly and well. As the costs hit home and every American
realizes that they are been hit with an effective head tax to the insurance
industry with no representation they can trust, the political fallout must be
catastrophic.
The
Obamacare Disaster and the Poison of Party Loyalty
Four years ago,
countless Democratic leaders and allies pushed for passage of Barack Obama’s
complex healthcare act while arguing that his entire presidency was at stake.
The party hierarchy whipped the Congressional Progressive Caucus into line,
while MoveOn and other loyal groups stayed in step along with many liberal
pundits.
Lauding the
president’s healthcare plan for its structure of “regulation, mandates,
subsidies and competition,” New
York Times columnist Paul Krugman wrote in
July 2009 that the administration’s fate hung in the balance: “Knock away any
of the four main pillars of reform, and the whole thing will collapse—and
probably take the Obama presidency down with it.” Such warnings were habitual
until Obamacare became law eight months later.
Meanwhile, some
progressives were pointing out that — contrary to the right-wing fantasy of a
“government takeover of healthcare” — Obama’s Affordable Care Act actually
further enthroned for-profit insurance firms atop the system. As
I wrote at the time, “The continued dominance of
the insurance industry is the key subtext of the healthcare battle that has
been raging in Washington. But that dominance is routinely left out of the news
media's laser-beam concentration on whether a monumental healthcare law will
emerge to save Obama's presidency.”
"Obamacare is a mess
largely because it builds a revamped healthcare system around the retrenched
and extended power of insurance companies—setting back prospects for real
healthcare reform for a decade or more."
Today, in terms of
healthcare policy, the merits and downsides of Obamacare deserve progressive debate. But at this point
there’s no doubt it’s a disaster in political terms—igniting the Mad Hatter Tea
Party’s phony populism, heightening prospects for major right-wing electoral
gains next year and propagating the rancid notion that the government should
stay out of healthcare.
That ominous takeaway
notion was flagged days ago on the PBS NewsHour by commentator Mark Shields,
who worried aloud that “this is beyond the Obama
administration. If this goes down, if … the Affordable Care Act is deemed a
failure, this is the end—I really mean it—of liberal government, in the sense
of any sense that government as an instrument of social justice, an engine of
economic progress… Time and again, social programs have made the
difference in this country. The public confidence in that will be so depleted,
so diminished, that I really think the change—the equation of American politics
changes.”
At this pivotal, historic, teachable moment,
progressives should not leave the messaging battle about the ACA to right
wingers and Obama loyalists. While critiquing the law for its entanglement with
the profit-voracious insurance industry, we should fight for quality healthcare
for everyone—definitely including the people who live in states where
right-wing officials are blocking expansion of Medicaid coverage. (In a recent
Nation article, historian Rick Perlstein cited a grim example of a chronic
mentality: “the policy wizards in the Obama White House build a Rube Goldberg
healthcare law that relies on states to expand Medicaid and create healthcare
exchanges, and then are utterly blindsided when red-state legislatures and
governors decline.”) We should challenge all efforts to deny the human
right of healthcare.
What we should not be doing is what
MoveOn.org is now doing—proclaiming that the Obamacare law is just fine. In a
November 14 email blast, subject-lined “Obamacare in serious trouble,” MoveOn
acknowledged that the rollout “has been badly botched” but flatly declared:
“Obviously, the law itself is still really good.”
Huh?
The problems with
Obamacare involve far more than simply bad website coding. They’re bound up in
the enormous complexity of the law’s design, wrapped around a huge corporate
steeplechase for maximizing profits. As a Maine physician, Philip Caper, wrote this fall, the ACA “is far too
complicated and therefore too expensive to manage, full of holes, will be
applied unevenly and unfairly, be full of unintended consequences, and be
easily exploited by those looking to make a quick buck.” The ACA is so
complicated because it has been so relentlessly written for the benefit of — and
largely written by — insurance companies.
Along the way, the
“individual mandate” cornerstone of the ACA—required by government yet actually
enriching the private insurance industry—is a tremendous political boost to
demagogic GOP leaders. I’m not engaging in hindsight here. Like many others, I
saw this coming before the ACA became law, writing in
March 2010: “On a political level, the mandate provision is a massive gift to
the Republican Party, all set to keep on giving to the right wing for many
years. With a highly intrusive requirement that personal funds and
government subsidies be paid to private corporations, the law would further
empower right-wing populists who want to pose as foes of government ‘elites’
bent on enriching Wall Street.”
Obamacare is a mess largely because it builds
a revamped healthcare system around the retrenched and extended power of
insurance companies—setting back prospects for real healthcare reform for a
decade or more. Egged on by corporate media and corporate politicians, much
of the public will blame higher premiums on government intervention and not on
the greedy insurance companies which, along with Big Pharma, helped write
the law in the Obama White House and on Capitol Hill.
It should now be painfully obvious that
Obamacare’s little helpers, dutifully reciting White House talking points in
2009 and early 2010, were helping right-wing bogus populism to gather steam.
Claiming that the Obama presidency would sink without signing into law its
“landmark” healthcare bill, many a progressive worked to throw the president a
rope; while ostensibly attached to a political life preserver, the rope was
actually fastened to a huge deadweight anvil.
In the process, the political choreography
included a chorus of statements by Congressional Progressive Caucus members
before ultimate passage of the Affordable Care Act. Having previously removed
the words “single payer” and “Medicare for all” from their oratorical
vocabulary while retaining the laudatory language—and after later excising the
words “public option” in a similar way—those legislators still pretended that
passage of the ACA would be an unalloyed positive triumph. Like the president,
they resolutely oversold Obamacare and made believe it would bring about an
excellent healthcare system.
With such disingenuous sales pitches four
years ago, President Obama and his Democratic acolytes did a lot to create the
current political mess engulfing Obamacare—exaggerating its virtues while
pulling out the stops to normalize denial about its real drawbacks. That was a
bad approach in 2009. It remains a bad approach today.
This work is licensed under a Creative Commons Attribution-Share
Alike 3.0 License.
Norman Solomon
is co-founder of RootsAction.org and founding director of the Institute
for Public Accuracy.
His books include “War Made Easy: How Presidents
and Pundits Keep Spinning Us to Death” and "Made
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