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Friday 4 April 2014

US Politics: Obamacare

 
As of March 31st, 2014 over 7 million Americans have signed up for Obamacare (The Affordable Healthcare Act). All told,  at least 13 million uninsured Americans have gained coverage due to Obamacare when you add on those that are now getting Medicaid and those that are now covered under their parent's healthcare plan.



For those on the political right in the US this is a terrible thing. Republicans in Congress have voted 50 times to kill the law. Republicans have used every lie they could come up with to condemn the ACA. Death panels, death spirals, a government takeover of healthcare, are just a few of their tactics to try and scare the American people. It is hard to say which of their tactics is the most laughable to anyone with a brain. When people are mandated to buy their health care insurance, as they are with the ACA, through health care insurance companies you can hardly call that a government take over.

Why all the anger from the right in the US about Obamacare? You would think it would be a positive thing that millions more Americans were paying their freight for health care instead of turning up in the emergency room and leaving the bills to American taxpayers?
As with everything else political from the right there are concurrent things going on when it comes to Obamacare. The right in general is of the opinion that working people are takers and the wealthy are their benefactors. The fact that working people struggle to get health care coverage is beyond the compassion of most Republicans There is a faction on the right, predominantly from the US southern states, that really hates seeing a black man in the White House creating laws of any kind.


There is more to the Republican opposition to Obamacare. In some ways Republicans and Progressive Liberals are on the same page. Both sides feel that Obamacare is a stepping stone to universal healthcare. Not only would Republicans like to kill Obamacare, they would also like to kill Medicare by turning it in to a voucher system.

One really has to wonder about where Republicans are coming from. Obamacare and its mandate that healthcare insurance be bought exclusively from the private sector insurance companies is a concept thought up in a right wing think tank almost 50 years ago. Obamacare is essentially the same plan that US president Nixon was trying to propose before he was forced to resign his presidency. If that isn’t awkward enough for Republicans there is also the fact that Mitt Romney, the Republican nominee for president in the last election, implemented the same thing as Obamacare in Massachusetts where 97% of their citizens now have medical coverage.
 
A Brief Look Back At Health Care In The US
After World War 2 a number of countries recognized that they had to come up with a better way to provide health care for their citizens. Most of them chose to go the universal health care route where health care would be provided through the government. Paying for it would come through general tax revenue and a reasonable monthly fee. All of the countries that chose universal health care believed that socialism can be mixed effectively with capitalism. Some in the US refuse to recognize that the mix of these 2 “isms” is also part of the American fabric.
The list of countries that chose universal healthcare is not exactly one of crazy communists. The United Kingdom implemented universal health care in 1948 followed by Sweden (1955), Iceland (1956), Norway (1956),  Denmark (1961), Japan (1961), Finland (1964), Canada (1968), Australia (1974). Other notable countries with universal healthcare include Spain, Italy, Portugal, Israel, South Korea, Germany, France, Belgium, Austria, and Switzerland.
One country held out, The US. Why you might ask? As per usual, powerful people in powerful places starting with the American Medical Association. Many doctors felt that universal health care would restrict their earning power. You also have to remember the mindset of many Americans after World War 2. The cold war that would last for close to 50 years between the USSR and the US was happening. Communism and Socialism were blurred lines for many Americans. Universal health care was socialism.
The US was and is the richest country in the world. With all of their wealth they could attract the best doctors in the world and build the finest hospitals. The fact that most Americans didn’t have easy access to these superior hospitals was always ignored by those that touted America’s advancements in medical sciences.
To some it was Un-American to think that the government should meddle in the free enterprise of health care insurance companies. Very few questioned that for some reason healthcare insurance companies had anti-trust exemption. Very few politicians questioned why there needed to be a middle man in providing health care services to the American public when at times it could mean a matter of life or death.
Another thing that happened was that the companies people worked for more often than not provided their employees with their health care coverage. Where is the liberty in that? If you quit your job or were laid off you could find yourself with no health care coverage. Does freedom mean that your employer decides what type of health care coverage you have?
By far most people don’t pay a lot of attention to how corporate America goes about things. Even if you stumbled on the financial pages you probably wouldn’t pay much attention to one corporate acquisition or another. Over the past 40 years, one after another large insurance company has been bought out by a competitor.

Today the two biggest health care insurers in the US, Humana and United HealthCare, have 70 million customers each. The 3rd largest insurer, Aetna, has 18 million clients. That’s 158 million people using 3 insurance providers. That’s about half of the population of the US. The next several large healthcare insurers divide up whatever is left over from the pie not counting the 40 million uninsured and the 100 million or so on Medicaid or Medicare.



If one is honest, the fact is that most Americans could give a shit about healthcare insurance as long as they are covered. In the past 10 years health care insurance rates have increased by 138% and it is hard to get a handle on what the costs are for co-pays and deductibles. Many people with insurance put off seeing a doctor out of fear of what their deductible or co-pay will cost them. Even with these fears many rationalize that the company they work for is picking up the tab.
One thing is certain and that is that health care costs have become more and more expensive for middle class America. Wages haven’t increased to offset these costs. It is quite common for households to pay ¼ of their take home pay for medical coverage.
The end result has been that Americans pay far more for health care coverage than any other country on the planet.

What Changes With Obamacare?
#1 Children up to the age of 26 can be covered under their parents insurance plan. To date about 3 million people under the age of 26 have taken advantage of this part of Obamacare. Young people quite commonly think that they are invincible when it comes to needing health care.
#2 Women can’t be charged more than men for their health care premiums.

 
#3 Insurance companies can’t deny coverage to those with pre-existing conditions.

 
#4 Insurance companies can’t drop clients who become sick.
#5  Preventive services are offered with no out of pocket expense.
#6 No annual of lifetime limits. Medical bankruptcy is the #1 cause for bankruptcy in the US.
#7 Cost assistance is provided to individuals, families, and small businesses through the marketplace.
#8 Clients can choose a plan that is affordable to you through an insurance exchange. These plans include new benefits, rights, and protections.
#9 Clients have the right to a quickly appeal any health insurance decision.
#10 Insurance companies can no longer sell junk insurance plans with low fees and almost no benefits.
#11 Obamacare health care plans have easy to understand summaries so the client knows exactly what they are getting.
#12 Better care and protections for seniors.
The Republican Alternative To Obamacare
The Republican response to Obamacare first and foremost is to abolish it completely and go back to the way things were before. Not one Republican has suggested ways of improving Obamacare.
On the same day that Obamacare enrollment reached 7.1 million people Paul Ryan, the Republican budget guy introduced his new budget that of course included killing Obamacare totally. His budget also included turning the very popular Medicare into a voucher system. His plan also included eliminating trillions in future expenses that aid the poor and middle class while increasing defense spending and cutting taxes further for the rich. His plan alienates women, minorities, the poor and the middle class, and seniors.
Over at the Supreme Court a Christian owned company called Hobby Lobby is arguing that the government shouldn't be allowed to dictate to people of faith how they run their companies. Hobby Lobby believes that the company owners should not be forced to cover some forms of contraception with their healthcare insurance. It turns out that Hobby Lobby has an investment portfolio that includes pharmaceutical companies that manufacture abortion pills. Never mind that most of the products that Hobby Lobby markets come from China which is for all intents and purposes a godless country.

 
Republicans argue that Obamacare is going to cause insurance rates to go up in the coming years. In the past few years since Obamacare was introduced premiums have hardly increased at all. Where were the Republicans when insurance rates went up 138% over the past 10 years?

Republicans also like to talk about companies dropping insurance coverage altogether for their employees. If they do it will just mean more people using the Obama exchanges or getting on Medicaid.

And then there are the 6 million claimed that have lost their insurance due to Obamacare. The real number is closer to .5 million most of which had very crappy plans that didn’t adhere to the new standards that insurance companies have to provide.
Anyone with a brain finds it totally laughable the victims of Obamacare that the Republicans have trotted out from time to time. Every one of their stories have been debunked. You really have to be an idiot when you are saving thousands a year with Obamacare compared to your old plan but still hate Obamacare.
Why Didn’t Obama Try to Introduce Universal Health Care To The US?
Is it possible to be wise and naïve at the same time? Obama is a lot like Bill Clinton. He isn’t a “progressive” in the true sense of the word. He spent a lot of his first term trying to appease right wingers not accepting the fact that they wouldn’t agree with him on anything. Obama bought into the idea that universal health care was by far too big of a stretch to get passed into law in the US. Too many conservatives, too many insurance lobbyists, too many stupid citizens who wouldn’t understand the benefits and lower costs, too much money in the stock market invested in insurance companies, and too many people who will listen to right wing propaganda.
When Obamacare was being set up Obama met with the insurers and the pharmaceutical companies and gave a number of guarantees to both. Nurses and other hospital support staff were pretty well left on the outside. It is hard to say whether Obama  planned to start with Obamacare using it as stepping stone to universal healthcare for those that want it and private sector insurance for those that can afford it. When you think about it, Medicaid expansion is a lot like universal healthcare.

What Has Obamacare Achieved?

 
For starters it is called The Affordable Health Care Act. You would think (not really) that all those god fearing right wing Republicans would be really happy that millions of their fellow citizens no longer have to live in total fear of having some kind of health problem.
You might also think that these righteous right wingers would be over the moon that millions more Americans are paying for their health care and not ending up in emergency rooms at the taxpayer’s expense?
There are a lot of dumb people in the US. Close to 40% of them never bother to vote. Being kicked around by corporate America is something a lot of them just don’t understand. A number who do vote, vote against their own and their family’s well-being.
TV political ads and talk show hosts like Rush Limbaugh can convince a lot of people of a lot of things. Still, word and mouth is the way ideas also get around. You might be at a family bar-b-q, having a beer after work with some co-workers, you might be sitting around a pool on vacation and strike up a conversation with a complete stranger and….the subject of healthcare insurance comes up. Maybe you just want to share your good news that you are paying quite a bit less now that you have an insurance plan through Obamacare? Maybe you just care about your neighbours and your country and want to see it become a better place.
If 7 million or 9 million have signed up for the next year it is likely that each one of them is going to tell someone else of their good fortune. 5 years from now there will probably be 50 million Americans using Obamacare. The ones who still won’t be using Obamacare can still say thanks. They too now have more rights on their insurance plans.
PS
Monopolies and free enterprise are not the same thing!  Free enterprise is about competition. Monopolies are about having as little competition as possible.
US population…..314 million people.
Big 3 healthcare insurance customers….138 million people.
Americans on Medicare or Medicaid….110 million people.
Uninsured Americans….40 million people.
Sub Total….288 million people.
Americans covered by other insurance companies other than the big 3….26 million people.
Total….314 million people.
PS #2
Remember that it was Ronald Reagan who warned of the evil that would happen to America if Medicare ever became law. See what your parents have to say about giving up their Medicare!

Disclaimer

I am a Canadian.

 

 

 

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