The Truth About "Obamacare"
An excerpt from volume 2 of my book "Pack of Lies". Published exactly one year ago today - Oct 2, 2012 - and timelier than ever (alas):
LIE # 11: “OBAMACARE” IS A GOVERNMENT TAKEOVER OF HEALTHCARE
LIE # 11: “OBAMACARE” IS A GOVERNMENT TAKEOVER OF HEALTHCARE
"This is, to my
mind, the most blatantly obvious case of politics trumping policy I've ever
seen in my life. Because this is
an idea, that four or five years ago, Republicans were touting. A guy from the
Heritage Foundation spoke at the bill signing in Massachusetts about how good this bill
was… Basically, you know, it's the
same bill. [Romney] can try to
draw distinctions and stuff, but he's just lying.” – MIT professor JonathanGruber, principle architect of both Mitt Romney’s Massachusetts healthcare plan
and “Obamacare”
CONSERVATIVES
CLAIM:
The Patient Protection
and Affordable Care Act, known as “Obamacare,” is a major power grab by the
federal government, which will now insert itself into the healthcare decisions
of millions of Americans. Federal
bureaucrats will decide what doctors you can see and what procedures you are
eligible for. The government will
establish “death panels” which will review cases and make life and death
decisions about who may receive treatment, potentially denying life saving
coverage to elderly patients.
THE REALITY:
The Patient Protection
and Affordable Care Act is in no sense a government takeover of the healthcare
system. The government will not
take over hospitals, nor establish new government-run hospitals. The government will not take over
private medical practices, nor establish new government-run practices. The government will not take over
pharmaceutical companies, nor establish new government-run companies. Doctors will not become government
employees, nor will they be required to consult with the government about
treatment they can provide. The government will not compete against private
health insurers by establishing a public alternative to private insurance.
“Obamacare” is based,
almost exactly, on the healthcare law passed in Massachusetts under Republican
governor Mitt Romney in 2006, which was based on a plan developed by the
Heritage Foundation, a conservative think tank. The distinctive quality of both laws is that they rely
primarily on the existing private sector, by helping citizens to afford private
insurance rather than by providing a government-run alternative. In other words, the defining feature of
“Obamacare” is precisely that it is not a government takeover, but
rather a set of free-market solutions.
That is why liberals have never liked the approach, while conservatives
loved it until the very day that Democratic president Barack Obama embraced it.
In a nutshell, “Obamacare”
makes private insurance cheaper and available to more people. The law achieves this in two ways which
depend on one another in order to work: 1) by legally requiring for-profit
insurance companies to cover more people than they did previously, such as those
with “pre-existing conditions”; and 2) by requiring members of the public
either to purchase insurance, or, if they chose not to, to pay a penalty.
The logic behind these
two interdependent provisions is simple: the additional expense to insurance
companies of covering people who are more likely to get sick (i.e. those with
pre-existing conditions) is offset by the millions of new customers flooding
into the market. Since everyone –
young and old, healthy and unhealthy alike – is required to participate in the
universal free-market, health insurance companies receive plenty of healthy new
customers who will pay regular premiums while demanding less in the way of
reimbursements for treatment. This
is a free-market solution designed to keep healthcare coverage in the private
sector; it explicitly avoids the public insurance option (think “Medicare for
everyone”) that liberals would have preferred, and which is available to
citizens of every other developed nation.
One thing “Obamacare”
definitely isn’t is “socialized medicine.” As New York Times columnist Thomas Friedman put it: “Obama
is being called a Euro-Socialist.
No, no, no, no, no.
Socialism, in health care, is what we have now. I get sick, I have no health care, I
just walk down to that Tampa hospital, right there, I go into the emergency
ward, they treat me, and then they put it – basically, they divide up the cost
on everyone who has health insurance.
That’s called socialism. What Obama is saying is that I want everybody
to have to buy insurance, basically, and we’ll subsidize people who can’t. That’s called capitalism.”
A WORD ABOUT “DEATH
PANELS”
The claim that there
are “death panels” in “Obamacare” is an outrageous lie and a vicious slander
against a policy that will provide real relief and care to tens of millions of
Americans. There is nothing in the
law to support that accusation, which is based on a complete distortion of a
provision of the Act that covers consultations about “end of life” care – in
other words, “Obamacare” will require insurance companies to reimburse you if
you wish to meet with your doctor to discuss treatment options and make plans
for how you will be cared for if you or a loved one should become incapacitated
by old age, terminal illness, or a catastrophic accident. That is the closest thing to a “death
panel” in the PPACA.
On the other hand,
conservative critics of “Obamacare” have nothing to say about the actual death
panels whose verdicts many millions of Americans have endured for decades:
those departments within private health insurance companies whose sole purpose
is to review claims in search of reasons to deny coverage. How many stories have we all heard of
people who died because they could not get their insurers to pay for
potentially life-saving treatments or operations? With the passage of “Obamacare,” those “death panels” will
have less power to refuse coverage to those who have the greatest need of it.
WHAT EXPLAINS THE
DISCONNECT?
IGNORANCE
“Obamacare” is relatively simple in
principle, but the law itself is hundreds of pages long and dauntingly complex
in its details. As a result, few
people have actually read it and there is a widespread failure to understand
what the law actually does.
FEAR
Healthcare is a life
and death issue. It’s natural to
be worried about the potential effects of a new law that will affect the way
most people in the U.S. receive their medical care. Although tens of millions of Americans were uninsured for
years, and millions who had insurance were routinely denied coverage, the
system before “Obamacare” was at least a known quantity – what if this
controversial new system was even worse?
With all the conservative talk about “death panels” and “socialized
medicine” it’s not surprising that many feared things would get even worse
under the new healthcare law. The
devil you know…
MALICE
The passage of a universal
healthcare law represents one of the major legislative achievements of the past
fifty years, both in terms of the heavy parliamentary lift and the sweeping
social impact of the law.
Conservatives did not want to see a Democratic president, in collaboration
with Democratic majorities in both the House and the Senate, get credit for a
landmark success that will be remembered for generations to come.
Jon Gruber, who was
the principle architect of both the Romney plan in Massachusetts and President
Obama’s national plan, put it this way: "Look, if this succeeds, then
Obama becomes F.D.R. This is the
most important social policy accomplishment since the 1960s. And if this
succeeds, this could be the kind of benefit to the Democratic Party that Social
Security was. So if I was the
Republicans, I'd be screaming and kicking and scratching to kill it too, on
purely political grounds… On politics, this is your Waterloo. You've got to
fight this tooth and nail. And so they're fighting it tooth and nail. "
That makes political
sense. But it is vile to pursue
partisan political advantage at the expense of the well-being of tens of
millions of citizens.