Saturday, November 30, 2013

The Conservative Life and Death of Obamacare

I never did write a second series of post on health. However, I think it's about time I said something about the Affordable Care Act, aka Obamacare, aka the Socialist Scourge of the Earth.

Let's start with the obvious: Obamacare is not socialist. Yes, it involves government regulations and mandates, but last time I checked, that is not the definition of socialism. From what contact I have with them, I often see the undereducated folks from Real America and brainwashed Tea Party ideologues complain about the imposition of a "national healthcare plan" to accomplish the goal of making sure every American has access to health care. Apparently, they think that Obamacare is a public health insurance plan. They may have forgotten, or never realized, that Obama was forced to drop his public option from the ACA. So no, sadly, Obamacare is not a public option, does not contain a public option... and as has now become clear, never will have anything to do with a public option.

Now, one could argue that increasing government regulations and mandates equates to socialism. Then, of course, they are going to have to try to explain how to clearly distinguish socialism from capitalism when the difference is only a matter of degree, with no clear dividing line. The truth of the matter is, many of the provisions of Obamacare were dreamed up by conservatives. A republican governer (Romney, former republican presidential candidate) employed a version of the law in Massachusetts, and was heavily supported by conversatives activists and think tanks, like the Heritage Foundation. Obamacare is a conservative idea.

Furthermore, the ACA depends on and works through private insurance companies. Insurance companies have helped write the law and develop the national health exchange. Insurance companies also stand to benefit from the increased coverage, especially that of healthy young adults (who are now penalized for not having insurance).

Simply put, the ACA is an idea conceived in conservative circles and given flesh by private corporations. It is about the furthest thing from socialism I can possibly think of.

For these reasons, also, Obamacare is largely crap.

Yes, it makes somes attempts to cut costs (mostly in order to pay for itself, not to make health care more affordable, as the name of the law implies). Yes, it provides subsidies to some people who will better be able to afford insurance. Yes, it allows young adults the option to stay on their parents' insurance a little longer. Yes, it has gotten rid of pre-existing conditions restrictions. Etc.

This will undoubtedly be very helpful to a few people.

But it does nothing to address the exorbintantly high cost of health care (which is the main problem with the U.S. health care system), caused mainly by: 1) price gauging by hospitals, medical device manufacturers, and pharmaceuticals (the provision to allow Medicare to negotiate drug prices was stripped from ACA, as was the public option, both of which could have addressed price gauging by competetive downward pressure); 2) High overhead/beaurocratic costs (increasing the complexity of the insurance marketplace will only make this worse); and 3) Over-use of treatments and medications.

The last point, in particular, is a sensitive one .Americans, saturated as they are in the "rugged individualist" mentality, completely blind to the effects individual actions have on the rest of society, insist on their right to opt for whatever absurd, costly, and unnecessary treatments they want. "No one is going to tell me what treatment I need!" And then, of course, we like to sue medical care providers when they are not able to work miracles. All of this results in an over-reliance on expensive diagnostic imaging, over-prescription of antibiotics, and the like. In addition to conbributing to the rise of antibiotic resistant superbugs, this dramatically increases the cost of medical care for everyone. The poorest of society are harmed the most, of course. And since ill health follows lines of political/economic/social marginalization, the poorest are often most in need of this expensive care that they can't afford.

So, as nice as it might sound to have the "freedom" to keep your 97-year-old father on life support for another 2 weeks, because you are emotionally incapable of dealing with the inevitability of death, that "freedom" comes at the direct expense of poor people who have their whole lives ahead of them.