14.11.13

Who should be mad about Obamacare? Liberals

“The only difference between Senator Clinton’s health care plan and mine is that she thinks the problem for people without health care is that nobody has mandated — forced — them to get health care. That’s not what I’m seeing around Nevada. What I see are people who would love to have health care. They desperately want it. But the problem is they can’t afford it.” - Barack Obama New York Times, November 16, 2007

While President Obama attempts to save face among the American populous amid the problems with the roll out of Affordable Care Act's online exchange program, the left itself should be the one calling for changes in the reform. The root problem is this: forcing people to buy something is not going to lower the price of that something.



If people had the money to buy health insurance, they would have it. The problem with the mandate is that it sets up insurance companies to charge what they want up to the mandate rate. Yes, people should buy health insurance before they buy iphones and fancy cars (borrowed this from the right-wing anti-food stamp argument) but forcing people to pay to a floor price which maybe be thousands of dollars (including deductibles) for a policy isn't helping them out.

Recently the left has fought back with two weak arguments. First, insurance companies are dumping their really poor coverage plans forcing people to buy better plans with higher deductibles. Some of these stories are certainly fraudulent (how to spot fake obamacare stories), but not all are. Here's the insurance company math. "We are insurance companies, it's for-profit industry, so the only reason for our existence is to make a profit" (this is a pretty underlying problem with ACA depending on health insurance companies in general). "We can make more money if everyone is forced to buy a more expensive profit than the difference of those who will not use our products and pay the fine". Also, if people want lousy insurance, that's still being more responsible than nothing. Yes, insurance companies are at fault here, but there's no law stopping them. Junk insurance is a junk product for them too. Secondly there is this Lawrence O'Donnell "Dirty Little Secret" campaign going around now which basically says that "you can break the Obamacare fine law because it can't be enforced". Telling people to break the law because there's little way to enforce it (unless you have a refund coming in your income tax, then it's coming out of that) does not equate to "there's really no mandate". People would still have to put their taxes in jeopardy for future returns. Eventually the government will get their money (and in my opinion the money from collecting on the mandate from the uninsured isn't really a large stream of government income anyway).

I'm not the lone voice here among liberals who are upset. Take a look at this article from the Atlantic: How Obama Broke His Promise on Individual Mandates . It is a timeline on how Obama went from being anti-mandate during his debates with Edwards, then Clinton, then as president supported them. And the tide in the house democrats may also be shifting. 

While I hear right-wing media comparing Obamacare to "the problems in Canada" (that's a wonderfully biased and generally untrue statement in itself), it's a false comparison; in Canada your tax (penalty?) gets you something - healthcare. I don't agree with the right-wing argument against bigger government, in this case, or people being forced to pay - I do disagree with people being forced to pay for nothing. Our general health in America and access to healthcare for everyone is not as good as Canada. It's closer to Mexico. Healthcare is an issue. When the same medications and procedures cost pennies on the dollar in Europe or Canada compared to here, while there citizens have cheaper, more efficient, and in some cases universal healthcare (something Obamacare does not claim, despite what you hear from the right and the left wishes they heard) - there's a problem with our system. (Great video here by Vlogbrothers which explains this and neither supports nor attacks the Affordable Healthcare Act).

Here's how to fix this system: Make it more "socialist" and closer to "universal". Make the mandate actually buy something. Having the mandate on the individual without the employer provisions of Obamacare results in a regressive tax scheme on the poor who are already unfortunately enough to struggle with healthcare costs. There is a lot of good in Obama's healthcare reform: higher burden of cost on the national government than state governments, the extended benefits for people up to the age of 26, the reform on pre-existing conditions. (Fox News Op-Ed piece here). But if you pay the mandate, you should get the guarantee or a product that, without deductible, is the same price as the mandate - this is why a single-payer is necessary. If the government contracted insurance companies for single-payer policies state-by-state, we'd have this - and better price negotiation, cheaper services. Despite what you read some places, medicare service prices are always cheaper than private health insurance. Why? Negotiated prices. Also, fewer uninsured people. Obama also originally supported this but after the town-hall strategy backfired, it was gone with the yelling about things like "death panels" (private insurance companies don't have them already, do they? Wait, yes they do). When the dust settled, those who hate-at-all-cost had what they wanted, a pretty-weak healthcare reform which made Obama look bad with their base. Rather than take part in the reform, they were content to hide their heads in the sand on the fact that reform is necessary. It continued. Romney's "We'll keep the best of Obamacare" and "We'll completely repeal" campaign of confusions didn't help his cause, nor any stated healthcare improvements in his platform. Liberals should be mad at that. But they should also be upset that the president ran on no mandate and now we have it. He ran on single-payer, we don't have it. The insurance companies won and got something-for-nothing.

No comments: