Monday, May 27, 2013

"Obamacare" Shock - They System May Work Despite GOP Efforts to Destroy It


I have noted frequently the juxtaposition - dare we say hypocrisy? - of the Republican Party and its Christofascist party base when it comes to claiming to honor Christian values while in the very next breath displaying an utter contempt for the Gospel directive to feed the hungry, clothe the naked and care for the sick.  There doesn't seem to be a single social welfare program that the GOP and its base doesn't want to slash or eliminate.   Particularly those that work to feed the hungry, clothe the naked and care for the sick.  As Paul Krugman notes in a New York Times column, few programs have drawn the wrath of the GOP and far right more than the Affordable Health Care Act, a/k/a "Obamacare."  And now, there are signs that Obamacare may actually deliver much needed healthcare coverage to those most in need.  It's a stunning contrast to the GOP/Christofascist approach of throwing American citizens on the trash heap like garbage.    Here are highlights from Krugman's column:

The Affordable Care Act, a k a Obamacare, goes fully into effect at the beginning of next year, and predictions of disaster are being heard far and wide. There will be an administrative “train wreck,” we’re told; consumers will face a terrible shock. Republicans, one hears, are already counting on the law’s troubles to give them a big electoral advantage. 

Yet important new evidence — especially from California, the law’s most important test case — suggests that the real Obamacare shock will be one of unexpected success. Before I can explain what the news means, I need to make a crucial point: Obamacare is a deeply conservative reform, not in a political sense (although it was originally a Republican proposal) but in terms of leaving most people’s health care unaffected.  

[T]he California bids are in — that is, insurers have submitted the prices at which they are willing to offer coverage on the state’s newly created Obamacare exchange. And the prices, it turns out, are surprisingly low. A handful of healthy people may find themselves paying more for coverage, but it looks as if Obamacare’s first year in California is going to be an overwhelmingly positive experience.

What can still go wrong? Well, Obamacare is a complicated program, basically because simpler options, like Medicare for all, weren’t considered politically feasible. So there will probably be a lot of administrative confusion as the law goes into effect, again especially in states where Republicans have been doing their best to sabotage the process. 

Also, some people are too poor to afford coverage even with the subsidies. These Americans were supposed to be covered by a federally financed expansion of Medicaid, but in states where Republicans have blocked Medicaid expansion, such unfortunates will be left out in the cold. 

Still, here’s what it seems is about to happen: millions of Americans will suddenly gain health coverage, and millions more will feel much more secure knowing that such coverage is available if they lose their jobs or suffer other misfortunes. Only a relative handful of people will be hurt at all. And as contrasts emerge between the experience of states like California that are making the most of the new policy and that of states like Texas whose politicians are doing their best to undermine it, the sheer meanspiritedness of the Obamacare opponents will become ever more obvious. 

So yes, it does look as if there’s an Obamacare shock coming: the shock of learning that a public program designed to help a lot of people can, strange to say, end up helping a lot of people — especially when government officials actually try to make it work.
My principle complaint with Obamacare is that it did not go far enough.  We need a national health care system like France.  Back when I was with a law firm that represented a hospital system, our client cared nothing about the delivery of quality, cost effective medical care.  It was instead all about monopoly wars with other systems and making as much money as possible.  And this was a "non-profit" hospital system.  At the wedding this weekend one of the guests was a friend I have known from high school who just retired from a major healthcare system.  From our conversation, my experience and observations were the norm, not the exception. Cost effective health care for all is the last thing that America's big health care systems want to provide.  And who are these people in bed with?  The GOP and the "godly Christian" folk.

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