So I don’t blog for a couple of months, then, when I finally decide to break radio silence, it’s about Obamacare? Sure, why not. Go ahead and alienate at least half the population no matter what I say.
Anyway, here’s the thing. The premium numbers are in – first year numbers anyway. All along, a big part of the Republican narrative has been that premiums under Obamacare would be far too expensive. But the national average comes in at $328 a month. I’ve got pretty good health insurance through my employer, and I pay $314.28 a month – and that’s after what my employer chips in. Not to mention that, under Obamacare, health insurers are required to cover a wide range of preventative care items that insurers are not required to cover currently and they also can’t disqualify people because of pre-existing conditions. All in, it looks like a fair deal.
Here’s another thing. With Obamacare in place, I don’t have to base my employment decisions on health insurance anymore. And I’ve had to do that for the last twenty-some years. I’ve got kids, two of whom have disabilities. You add up drugs, therapy, doctor’s visits, those disabilities get real damn expensive. Drop out of an employer plan, and those disabilities turn into pre-existing conditions. That happens, not only would I end up paying at least twice what I pay now in premiums just to have coverage, the coverage I get wouldn’t include the bulk of the medical expenses I rack up.
The employment thing is a two-way street. Another scare tactic that the right has been throwing around is that employers are going to stop offering coverage (never mind that the legislation actually will force more of them to offer coverage or else pay a penalty). But suppose they do? If you can buy coverage on your own for more or less what you’d pay if you were buying it through your employer, then what difference does it make?
Let me make one thing real clear here. I’m not bashing employers. The way the healthcare system has evolved in this country has put too many of them in a real trick bag. For a variety of very complex reasons, health care in the US costs way more than it does in other countries, and that cost keeps going up faster than the rate of inflation. So the cost of providing insurance as an employee benefit keeps going up, too. To stay competitive in the talent market, employers have to figure out a way to afford that. I don’t blame them for wondering how your health care became their problem. If, eventually, Obamacare ends up weaning employees off the employer tit, if it ends up making your health care decisions independent of your employment decisions, I say that’s a good thing. Good for you and good for your employer.
And here’s another thing. If, in the long run, Obamacare ends up defragmenting the heath care market in the US, if it ends up providing an overarching structure that will finally allow market forces to force some rationality and consistency on to health care pricing, then our ridiculously expensive and Byzantine health care industry might get less expensive simply because it will get less Byzantine.
Yet another thing – the name. See, it’s really called The Affordable Care Act. The Tea Party types dubbed it Obamacare in the mistaken belief that their reflexive antipathy to every action taken by the black guy with the funny name was universally held and that, by tying the plan directly to the man they could insure its defeat. Didn’t work out that way. Ironic, really. The basic design of Obamacare was the product of the Heritage Foundation – a right-wing think tank. It was famously instituted in a very similar form in Massachusetts by a republican governor, Mitt Romney. And why not? The inexorably intertwined issues of health care coverage for all Americans and our irrationally expensive health care system have been begging for an effective policy response for decades. If Obamacare works, and the early signs are that it just might, it will go down in history as one of the most important public policy initiatives in the post-war era. It could have been a policy that the right claimed as its own, or at least one of bipartisan lineage. Instead, the far right has given full credit to the man they hate the most.
One final thing. Like it or not, Obamacare is the law. It was passed by the house and the senate. It was signed by the president. It was ruled constitutional by the Supreme Court. The right doesn’t like it. Everybody understands that. The Tea Party wing that has hijacked the Republican party has attempted over and over to repeal the law without success. They did their best to make the last presidential election a referendum on Obamacare. They lost. Unable to scuttle Obamacare through the democratic process, they are now threatening to shut down the government and even default on our nation’s obligations – every penny of which Congress had to vote to incur – in an effort to try to stop Obamacare. They are willing to risk tipping a still-fragile economic recovery back into recession because they can’t get their way at the ballot box. They are holding an economic gun to your head.
We have a name for people who try to frighten populations into complying with the will of the minority by threatening their well being.
We used to call them terrorists. Now, I guess, we can start calling them republicans.