Horwitz on Obamacare

I didn’t get around to posting this yesterday, because of the elections, but I recently published an op-ed about the absolute disaster that is the current state of Obamacare. I might make a few enemies for this one, from Civil Affairs via The Justice:

“The two political parties in this country offer two poor options on the topic of health care reform, best exemplified by two seemingly similar pastries. The first pastry, representing the Democratic Party and its health care reform law, was ostensibly created with good intentions, though the unparalleled incompetence of its handlers caused it to become riddled with bacteria and mold. The second pastry, representing the Republican Party’s “no-solution” solution, is simply filled with little shards of glass.

While Democratic politicians are satisfied with this boondoggle of the Affordable Care Act (hereafter “Obamacare”), Republicans simply want to repeal the law and replace it with nothing. This reactionary position assumes unbelievable short-term memory, unable to recall the massive injustice caused in the pre-Obamacare world. In this marketplace, premiums were skyrocketing for the most vulnerable among us. Those same individuals often had their health insurance dropped when they became sick, branded with the scarlet letter of pre-existing condition, wherein they became a leper in the world of health insurance, unable to purchase protection when they needed it most. Simply put, the unregulated health insurance market was unsustainable.

The Democratic option has been prominently featured in recent weeks, as Obamacare has seen a series of setbacks causing nothing less than unmitigated disaster ranging from online glitches rendering enrollment nearly impossible to long standing promises involving “keeping your own insurance” by the president that have been broken. A few months ago, almost prophetically, Sen. Max Baucus, D-Mont., warned that the law was on the express track to becoming a train wreck, citing long standing confusions over the law’s components and mismanagement. However, despite the mediocre provisions of the law and its marvelously inept handlers, Obamacare beats its repeal and replacement with nothing, which was the Republican solution to the problem.

Obamacare first works to improve quality by raising minimum standards for health care insurance and prohibiting discrimination against patients with pre-existing conditions. This is done by boosting enrollment—forcefully—through the individual mandate, in which all financially able individuals are legally required to purchase health insurance. This much makes sense, with an excess of healthy participants financing coverage for the sick, and has been working decently well thus far.

The way these provisions are able to function, however, is the insurance exchanges, highly regulated marketplaces where most Americans will receive subsidized premiums. These subsidies in the exchanges would theoretically keep price down. The exchanges —though not the insurance policies themselves—are run by the government, and began offering open enrollment on Oct. 1.

This is where the problems began. The website that is so important for individuals to sign up for the insurance is a calamity. The failure of whoever was tasked to create a functional website casts serious doubts on the viability of the other components of the legislation, including the management of the exchanges themselves. Further, a recent article on Ezra Klein’s blog at the Washington Post, a normally left-of-center opinion, lamented the rising premiums and cancelled policies many will face under the law now, flying in the face of long-held promises even by the president that “you can keep your current insurance.” Promises that, in fact, turned out to be false. This is because the component of the law that requires higher standards of care is compelling many providers to drop the minimum coverage option or raise its premiums. Millions of individuals could lose their current care, insurance they like and were told they could keep. While there is something to be said for such changes, it is wrong that those affected were lied to and assured this would never happen. The problem was foreseeable, though President Barack Obama continued pontificating incorrect reassurances.

Without a functional website, people are not signing up for the exchanges and are unable to do so elsewhere. Without functional exchanges, the program fails as those urgently needing affordable care are unable to receive it. Add that to growing hostility over the aforementioned broken promises involving “keeping your current insurance” by the law’s architects such as costs and health insurance plan security and you have a recipe for disaster. The sad truth, however, is that this is the best solution we have.

In the reality-based world, a much simpler solution could be achieved by allowing most Americans (those not covered by Medicaid) to opt into a Medicare-style service for a fee. Under this plan, the government would pay for the vast majority of health care services without deductibles or co-pays. This would ensure the biggest benefit of Medicare—low costs— would be achieved without the downside of most other nations’ universal health care program. However, as any casual observer of contemporary American politics will note, our politicians do not live in the “reality based” world, so this idea is functionally impossible to achieve in the foreseeable future.

At this time, Americans are faced with a dearth of leadership from Congress and the White House.

The Democrats, obsessed with saving face, are unable to admit the health care reform law has become a calamity, enraging everyone from unions through taxes on high-value plans, to small businesses by requiring employers to offer health insurance. The Republicans, intent upon reaching only a political victory, rather than a total victory for the American people, simply want to do everything in their power to see Obama fail. They have offered absolutely no alternative, nor even any constructive criticism in good faith. The only decent solution to this issue eludes us as long as our politics are dominated by such ideologues more interested in scoring political points than making hard choices.

That being said, Obamacare makes incremental progress toward a noble goal, and should not be weakened without a better alternative.”

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4 thoughts on “Horwitz on Obamacare

  1. Pingback: Texpatriate | Civil Affairs: Obama

  2. Pingback: Texpatriate | The 2013 term closes

  3. Pingback: Texpatriate | Let’s talk about 2016! (Democratic primary)

  4. Pingback: Texpatriate | Let’s talk about 2016!

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