Call it Obamacare, call it Republicare, Trumpcare, we need to maintain coverage for everyone…

January 8, 2017

CORRECTION: In my original post I wrote that the Democrats pushed through Obamacare (with Republican help) — I should have left out the Republican help thing in parentheses because a subsequent check of the history shows the final version of the Affordable Care Act, a.k.a. “Obamacare”, received no Republican votes. You can look up the history in Wikipedia and other sites of course — it’s kind of convoluted as most things in congress are. Anyway, I apologize for the error. I try to be accurate — in this I failed.

While I have never been an all-out supporter of Obamacare, I have always recognized the need for some type of universal heath insurance. All citizens need health coverage and it is to the benefit of us all that all citizens have it (and by citizens I simply mean residents of the nation).

Human decency should be enough of a reason. But also there is the issue that the health of one segment of society can affect the rest of us and a productive society must be healthy.

I do think it is necessary or at least helpful that users of health insurance have some skin in the game, so to speak, so that it is not abused, so that emergency rooms and doctors’ offices are not clogged with too many people seeking relief from every little minor ache and pain or sniffle or because they refuse to live a healthy lifestyle and abuse alcohol and drugs, although nothing is liable to control human nature as evidenced by the latter.

The intention of the Affordable Care Act, so-called “Obamacare”, was to provide universal health coverage and to try to hold down costs by requiring everyone to have insurance, thus enlarging the risk pool for private insurers.  And it was thought that involving the private sector rather than simply going to a completely government-operated program would soften resistance and provide the perceived advantages of the private sector. There have been two highly-popular, if not business-like provisions in Obamacare. One is that insurance companies cannot refuse insurance due to pre-existing conditions. In a purely private market this would be insane. The insurance business is the business of taking a risk. The insurer takes a gamble you will not need the insurance or at least not so many people will make claims all at once. Selling health insurance that includes treatments for cancer to someone who already has it, for instance, would not be a very good gamble. However, if everyone has to buy insurance then hopefully not everyone will be diagnosed with cancer and enough money can be brought in to pay for the claims of those who do contract cancer. The other popular provision was to allow adult children to stay on their parents’ group plans for a specified time.

But the Democrats, who pushed through Obamacare, did not win the election and now the Republicans are hot to do away with it. Why? Cynicism for the most part. I think their opposition is more symbolic than anything else. They think it smacks too much of socialism. But then again, so does Social Security. Anyone who ever tries to mess with that does so at his or her own peril.

Whatever, this health insurance issue needs to be resolved promptly, once and for all. You only live once, and the continuum of life does not stand still for breaks in health care coverage. One is not usually in the position of casually shopping for a health insurance plan, free of the threat something will hit him or her or a child in the un-covered interim.

Obamacare does have its problems. First there was the discovery that despite Obama’s explicit promise that “if you like your current plan (pre-Obamacare) you can keep it.” But some people found they could not keep a plan that no longer existed because it disappeared under the weight of Obamacare regulations. And then more recently, the cost of some of the Obamacare plans handled through state health care exchanges skyrocketed. It seems that the large number of sick people putting such a demand on insurance all at once, thanks to the requirement and opportunity to have health insurance, resulted in hefty and not-fully-anticipated rate hikes by insurers who did not drop out of the system.

I read an article in the New York Times that a survey among voters in the rust belt who voted for Donald Trump, who vowed to do away with Obamacare, found those Trump voters actually like Obamacare in general, but they are unhappy about the rising premiums, various uncovered expenses within their plans that have come to them as a surprise, and they don’t appreciate the logic of spreading the risk in the health insurance requirement.

Of course I could sum up the average attitude toward health insurance coverage: “everyone wants to go to Heaven but no one wants to die”. Or everyone just wants free coverage, period. Ain’t going to happen. Somehow it all has to be paid for.

Oh, also, the survey found that people thought it unfair they had to pay premiums while those on Medicaid did not. I can understand that. But then again, there has to be an advantage somehow to not having to depend upon Medicaid — one would think. I don’t think there is much of a percentage in being jealous of the poor.

I should mention, even under Obamacare we have not reached full-universal health care. There are loopholes that leave some without coverage.

It will be fascinating to see if the new administration and if the Republican-controlled congress can actually come up with something better than Obamacare. I would have thought simply improving it would suffice, but the Republicans have backed themselves into a corner by their anti-everything-Obama attitude. But President Obama himself has vowed to support any Republican plan that tops his own Obamacare.

He’s giving them more respect than they will ever give him.


And remember, some of the most ardent opponents of universal health coverage were shamed into supporting Obamacare because they had their own cozy taxpayer-paid plan as members of congress.