Sunday, September 2, 2012

Who Does the Affordable Health Care Act Actually Benefit?

Is the Affordable Health Care Act the best solution to our health care problem, a good start, the best we could do at the time, or something else altogether?

A quick history: In the late 1980s, members of the right leaning Heritage Foundation proposed the individual mandate, which would eventually become the lynchpin of Obamacare. In 1993, Republicans included the mandate in their alternative to “Hillarycare.” Hillary was against the individual mandate at the time. After becoming Senator (and after becoming the second largest recipient of health industry contributions in the Senate) she reversed her stance and argued FOR an individual mandate.

You see, getting the government to pass a law so everybody has to buy your product is pretty savvy business. In Jersey we call it "pay to play" and it's ill-freaking-legal.

In 2008, Senator and Presidential candidate Barack Obama also argued against the individual mandate - quite eloquently. “If a mandate was the solution, we  could solve homelessness by mandating everybody to buy a house.” Bazinga! Obama was right (before he was wrong) – against it before he was for it (just like Hillary). And in a wonderfully amusing twist, his opponent Mitt Romney was for it before he was against it.

A few months later, after becoming President, Obama included the mandate in his healthcare plan. Coincidentally, the healthcare industry had become Obama's third largest source of campaign contributions (right behind lawyers and big banks).

But what do healthcare industry donations have to do with it? Isn't Obama fighting against the big corporations?

Written primarily by corporate lobbyists, the Affordable Health Care Act provides nearly a half a trillion dollars in subsidies for the insurance, health care, and pharmaceutical industries, and forces citizens to purchase a product from those same corporations. The Affordable Health Care Act is really just more corporate welfare hiding behind the facade of providing universal healthcare.

What the health care issue has highlighted is that very few of our politicians have a core. Republicans are against everything Obama is for, even if it's the same Patriot Act they were FOR when Bush was President. Democrats support everything Obama supports, even if it's spying on, and even assassinating U.S. citizens, forgetting how loudly they protested when Bush was only torturing suspected terrorists. Personal integrity hasn't survived the onslaught of political division any more than governmental integrity has.

But wait! We were talking about health care.

There are three basic methods of health care delivery:
  1. Free market
  2. Single payer
  3. Corporate/Corporatist
I'm a free market guy, so I like #1. Before the 1960s, the US had a semi-free market health care system, but it's always been manipulated to some extent - either by government or by corporations that had become monopolies. While I like the theory, I don't think this method has any foreseeable political momentum... so next.

The option we've been implementing since the 1960s is #3. It's kind of a hybrid of the first two, but it uses the worst components of each. The AHCA is a continuation of this method. Corporations give money to politicians, who then make laws that favor those industries that gave them money (it used to be called bribery). I think it's safe to say that this method should be ruled out as a reasonable option.

What about the single payer option? Now I know I may get some heat from my libertarian friends, but I wouldn't fight a single payer system for a New York minute. There are far worse things that our government does, and far more important issues to get worked up over like... oh, I don't know... never ending war, and the imminent collapse of our economic system.

While I would have serious concerns about cost, efficiency, and availability under a single payer system, we could figure it out, especially if we retired the chin deep fecal pile of regulations and programs that we currently live under, and started from scratch. The simpler an engine the less oil it needs. Likewise, the simpler a health care system, the more efficient it will be.

What we have now is an enormous tangle of government regulations, reimbursement programs, advisory boards, employer mandates, corporate welfare, investigative panels, and backroom deals - and it's got to go!

Ask yourself what is the only part of our current medical system that actually functions with a modicum of efficiency? Medicare. And guess what folks, it's single payer.

Public healthcare advocate, Dr. Margaret Flowers, makes the point much more eloquently than I ever could, “If the U.S. Congress had considered an evidence-based approach to health reform instead of writing a bill that funnels more wealth to insurance companies that deny and restrict care, it would have been a no-brainer to adopt a single payer health system much like our own Medicare. We are already spending enough on health care in this country to provide high-quality, universal, comprehensive, lifelong health care.”

Regarding the goodies in Obamacare: requiring insurance companies to cover people with pre-existing conditions is fine by me, and I'm happy as a clam in a pool of rum that my 17 year old daughter will be able to remain on my insurance plan for another decade. There is a shiny object or two in this plan for almost every crow, but sadly, like most things that come out of Washington, the cost/benefit ratio would make any business owner either laugh out loud, or fire whoever proposed it.

Perhaps Chris Hedges, journalist and self-described socialist, said it best, “It is the very sad legacy of the liberal class that it proves in election cycle after election cycle that it espouses moral and political positions it will not pay a price to defend. And since we will not punish politicians like Obama who betray our core beliefs, the corporate juggernaut rolls forward with its inexorable pace to cement into place our global neofeudalism.”

Similar admonishments could be made of the conservative class. After all, Republicans and Democrats are all cut from the same cloth, the only difference is some is wearing red and some is wearing blue.

~ Bob Akimbo