Obamacare: What do we do now?
In an ideal world, politics is the means by which we resolve competing interests without losing sight of the principle that every politician’s first responsibility should always be serving the well-being of the body politic.
In the world in which we actually live, issues and interests are readily configured as weapons that serve the goals of competing parties. And has there ever been a better weapon than ObamaCare?
Obamacare’s supporters and opponents can both claim as their objective the condition most essential to happiness: good health. The weightiest issues can be brought to bear, including fear of mortality (“death panels”!), appeals to self-reliance and, of course, money.
Obamacare is an easy battle-ax to swing at the Democrats. President Trump has repeatedly called it a “disaster,” “collapsing,” “imploding,” “exploding” and in a “death spiral.” But the real collapse occurred Friday when Republicans failed to hammer together a replacement for ObamaCare.
Since ObamaCare will remain in force, what do we do now?
First, Trump is prone to overstatement. Is ObamaCare really the collapsing disaster that he imagines?
Obamacare may have its faults, but in one important respect it was enormously successful: it put the subject of health care on the table as never before and made many Americans realize that without health insurance their physical and financial well-being are potentially in significant jeopardy.
Further, ObamaCare reminded us that health care driven strictly by the marketplace is likely to create a lot of casualties. Why would any health care insurer cover someone who has a pre-existing condition unless it’s forced to?
In practical terms, as well, ObamaCare has been more successful than its opponents will admit. Previously we were content to accept the precarious uninsured situation of many millions of Americans. Now many more are covered, and we’re unlikely to settle for the pre-ObamaCare status quo without objection.
In addition, ObamaCare is beginning to work well for many Americans. According to the Census Bureau, in 2015 the uninsured rate dropped to 9.1 percent, which is, I suspect, the lowest it’s ever been. According to a 2016 Kaiser study, as reported in The New York Times, 77 percent of Californians who gained health insurance said that their health needs were being met very well or somewhat well. The comparative figure from three years earlier was 49 percent.
Other numbers undercut the doomsday characterization of ObamaCare, as well. A study from the National Center for Health Statistics found that the percentage of persons under 65 who were having problems paying medical bills decreased from 21.3 percent in 2011 to 16.2 percent in the first six months of 2016.
These are small numbers, but there are many others like them. Together they represent progress, and they partly explain why Republicans last week couldn’t come up with a plan to replace ObamaCare.
But these are only numbers, and health is about people. Before the dust had begun to settle last Friday over the Republican health care fiasco, I ran into a Tea-Partier friend of mine, who asserted that ObamaCare is still a disaster, even though Republicans couldn’t come close to replacing it with something better.
He referred to a low-income acquaintance, who pays $6,000 per year for a policy that carries a $6,000 deductible. I haven’t verified the numbers, I don’t know the details of the coverage nor do I know whether others are covered, as well.
Nevertheless, this is a significant problem with ObamaCare: in some cases, premiums and deductibles are much too high.
But here are two things we can be pretty sure of: First, before ObamaCare, this woman had no insurance whatsoever, and health problems do not have to be catastrophic to quickly exceed a cost of $12,000.
Second, this is a solvable problem; nearly all Western societies except for ours have figured it out. But it won’t be easy. Republicans must put the nation’s health ahead of their contempt for ObamaCare. Democrats must resist the temptation to gloat. Indeed, lives are at stake. The time to solve this problem has come.
John M. Crisp, an op-ed columnist for Tribune News Service, teaches in the English Department at Del Mar College in Corpus Christi, Texas.