Nothing lays bare the ideological divide between conservatives and liberals like a healthcare debate. We are now in the third major debate in my lifetime. The first happened when Bill and Hillary Clinton failed to implement healthcare reform in 1993. The second occurred just eight years ago when Barack Obama pushed through his Affordable Care Act. Now, we’re in another knock-down-drag-out over what to do with the program initiated by Obama.
Conservatives have argued that government should get out of the healthcare business altogether and let individuals decide whether they want to buy health insurance. They want the market to dictate the cost of care and insurance. For them, it’s a question of freedom of choice and keeping government out of our lives. Obama’s mandate was an anathema to them and the expansion of a big government program like Medicaid offended their small government sensibilities.
Liberals have argued that a minimum level of healthcare should be a right. Most support a Medicare-for-all type of single-payer system but have agreed to the compromise, free-market based system that defines Obamacare. They believe that eventually the country will adopt the single-payer system that they want and that, in the instance of healthcare, government can make people’s lives a little better.
In the middle are the American people–in particular, the mainly working-class families who have struggled to keep up with rising premiums and health care costs. Like conservatives, they instinctively don’t like the government mandate, but they also don’t mind government interference in the system. They just want health care that they can afford and coverage that doesn’t leave them deeply in debt. As the details of the GOP’s ACA repeal plan come into focus, Americans are realizing that they will pay more for care and many will lose coverage altogether.
Conservatives have lost the big argument. Most Americans aren’t willing to be left to the mercy of the free market when it comes to healthcare. Even the Republican standard bearer, President Trump, has advocated for government intervention. He’s promised universal coverage with lower premiums and better care. And what’s clear, his supporters believed him. That’s part of why they voted for him.
The argument has gone on for almost twenty-five years and a resolution is finally coming clear. In the 1990s, Republicans scared Americans into believing reform would cost them more and take away their care. But the problems that instigated the initial debate didn’t go away. An increasing number of people lacked adequate access to care and more people were going broke because they got sick or injured. Implementation of Obamacare over the past eight has given the American people insights into the complexity of the issue. People aren’t willing to give up what they’ve gained to satisfy the ideological impulses of conservative politicians.
The current debate over healthcare is doing more to make the Affordable Care Act popular than all of Obama’s promotion during his presidency. Despite Republican bluster, the program is not imploding. More people have care than ever before. While premiums went up for some people, the rate of increase overall is slower than predicted before the Affordable Care Act. There’s certainly work to be done, but the plan Paul Ryan and company are offering doesn’t look very good.
Americans know they don’t want to go back to the system we had and they’re now seeing what alternatives look like. They’re more concerned about having access to affordable healthcare than what Republicans call freedom. If the GOP doesn’t see that, they’re likely to suffer the same type of rebuke in the 2018 midterm elections that Democrats did in 2010.
Thomas Mills is the founder and publisher of PoliticsNC.com. Before beginning PoliticsNC, Thomas spent twenty years as a political and public affairs consultant. Learn more >
I would add that the As If I Care bill does not go nearly far enough to suit the extreme right-wing, such as Rep. Mark Meadows, our District 13 Congressman.
Have read all the comments with interest. When the loss of health insurance means death, and I am quite serious when I write this, for someone you love, all of this becomes very different. If you have witnessed the death of a loved one due to lack of early care because there was no insurance or money, the question is not about politics.
I could be very pragmatic about all of this, but no longer. Without health care, it is not possible to use the freedoms and opportunities specified in our Constitution (and many state constitutions). The arguments about health care insurance are only about two things: profits for insurance companies and ideology about type/size of government. Neither is valid economically, nor morally. The loss of lives to poor heath and early death and the costs of even minimal care for those whose illnesses are allowed to become either chronic or deadly is a terrible drag on the economy. Just consider for one moment what happens to a family when a parent becomes unemployable due to illness. Bankruptcy often follows. As for the moral issue, I defy any Christian, Muslim, Jewish, or member of any religious faith to justify denying medical care to someone because of the need to make money. It is only for the latter reason that any insurance entity sells health insurance, and it does not take a genius to figure out that a health insurance policy is just as often designed to deny one care as to provide it. (The ACA made that a lot better for many policies, but not all.)
We seem unable to acknowledge that other countries do a better job on many things than we do. Education, health child birth, safe & affordable child care, and yes, health care — to name a few.
There is plenty of blame both the Democrats and the Republican conduct and there has been for decades. The Democrats use “pragmatism”, which is one reason why the ACA has so many problems. The Republicans tout nonsense about “choosing” the insurance plan that one wants, as though that is possible for everyone. One is a cop-out and one is hypocrisy.
I want health care for everyone. I care not one whit for the insurance companies, nor their profits. Single payer works well in dozens of countries and has for decades. I have concluded that as a country we are either too stupid or too proud to learn from others.
What do you suppose would happen if you labelled the current GOP Health Care proposal:: “Trumpcare” or “Ryancare” and polled North Carolina voters on this? Right. The same thing that occurs when you poll on the current Affordable Care Act but call it “Obamacare.” Voters tell us they want the provisions of the ACA but are slightly more skeptical when you call it Obamacare and large majorities favor the key elements of the ACA.
Thomas is right: the key issue here is whether the American people should have health care as a right or a privilege held and sold to us by private insurance companies. I believe–and the polling and congressional constituent meetings confirm this–we have passed that point and the voters tell us that over and over that health care is an integral part of being citizens living of the United States.
When you get old and are told that you may lose your health care, it becomes a terrifying and deadly existence. Peace.
Actually, I like SNL’s slant on it. “DONTCARE.”
When John Edwards was campaigning against Hillary Clinton and Barack Obama for the Democratic nomination in 2008, he correctly spoke out about the number of folks who would remain uninsured under the healthcare plans put forward by his opponents. Edwards’s plan was designed to provide universal coverage. During the debate on the Affordable Care Act, Howard Dean warned about the toxicity of the mandate for those who were not eligible for subsidized insurance. Keith Olbermann was on MSNBC every night arguing that single payer was the only solution. So here we are, those who must buy ACA compliant health insurance in the open market w/o subsidies are left with high premiums and high deductibles. I know some of them. They are vociferous and their stories resonate. In states like North Carolina where MEDICAID expansion was rejected, the number of people in the unsubsidized market is larger than it would have been otherwise. It truly seems that the free market compromise does not work.
I am inclined to sit back and let the Republicans screw around with whatever they wind up doing. Perhaps enough low income folks will lose their medical care that they will have an impact on the next election. Rand Paul seems nervous about that as does Tom Cotton in Arkansas. Kentucky and Arkansas both expanded MEDICAID. North Carolina did not expand MEDICAID so Tillis and Burr seem unconcerned since we don’t know what we are missing in North Carolina, except for those of us who listen to William Barber as I do. Not enough of us, however!!
A viable solution proposed by some is to lower the age for MEDICARE to 55 coupled with restoration of MEDICAID funding. If the Democrats ever do recapture Congress and the Presidency, that seems like a great option along with government assistance through MEDICAID for folks with preexisting conditions. The younger folks who are willing to settle for catastrophic health insurance can be left to their own devices.
Problem with leaving it (AHCA) alone is that Ryan and Meadows and the rest of the ignorant republicans want to eliminate all the safety net. The money in these plans will be stolen to enhance these crooks. Yes, I too am disgusted that NC voters don’t look beyond themselves, but as much as it sounds like a good idea. I think we all lose in the end.
Ah hell, why worry about it, climate change will probably kill all of us before the problem is anywheres near solved.