January 4, 2017

Ready for Another Health Care Debate?

Although I voted for President Obama in 2008, it did not take long for me to find myself feeling both disappointed with him and frustrated by his approach to many important issues. I believe he made a serious mistake right from the beginning by refusing to hold his predecessor accountable for war crimes, and I fault him for being so eager for bipartisanship that he botched countless negotiations with Republicans. Eight years later, there are many things about his presidency that I have come to admire and many that I still detest. I'm in no position to evaluate his overall legacy; that task will be left to historians in the future.

That having been said, I must admit that I find it more than a little sad to see what is happening with the Affordable Care Act (ACA) now that a majority of my fellow citizens have decided that they want Republicans to control all branches of government. President-elect Trump is going to find it awfully difficult not to repeal the ACA even though it is becoming apparent that his party has no clear idea how they might replace it. It was such a central part of his campaign and one of the few areas where he clearly has the overwhelming support of Republicans in Congress that it seems unlikely that he could backtrack now even if he wanted to do so.

What's so sad about it? The prospect of millions of Americans losing their health insurance is the main thing that comes to mind. People who could not afford health insurance prior to the ACA are at risk for losing their coverage entirely. The very idea of living in a country where health care is viewed not as a right but as a privilege (or even a luxury) is incredibly sad. People go broke because of health care costs, and that just doesn't seem right to me.

Another thing I find sad about this is that the failure of the ACA seems to be due, in large part, to yet another messaging failure on the part of the Democrats. They have had years to explain the ACA to the public and sell the legislation. They have not figured out how to do so successfully, and now it appears that they are scrambling around trying to figure out how to muster enough public support to deter Congressional Republicans from repealing it. It seems like far too little and much too late. And this is merely the latest example of the Democrats losing the messaging battle to Republicans. We have seen this again and again.

It has been disappointing to see health insurance premiums rising under the ACA. This has led many to wonder whether it ever should have been described as "affordable." At the same time, we are now being told by desperate Democrats that health care premiums would have risen even higher if it was not for the ACA. This is likely true, but it reminds us once again that the ACA was a piss-poor substitute for the single-payer system we needed and still need. If there is a solution to exorbitant health care costs that does not involve moving us to a single-payer system, I'm not sure what it would be. Most of the rest of the world seems to do well with single-payer, but we refuse to kick the insurance companies out of the picture to our collective detriment.

And yes, I am even sad for the working class Americans who voted for Trump and other Republicans without fully understanding what this was likely to mean for their access to affordable health care. I get to see it up close every day in Mississippi. The people who are most likely to be adversely impacted by Republican policies continue to vote for Republican candidates. And when things get worse for them under Republican leadership, which they inevitably do, they become even more firm in their support for Republicans and even angrier at the Democrats.