It shouldn’t be called Obamacare or Romneycare or even Hillarycare. It also shouldn’t be called health care reform or a government takeover of the health care system. It’s the Affordable Care Act, and it’s the official law of the land – until it isn’t. After November, if Willard Romney takes the presidency and the Republican political machine gains control of Congress, it probably won’t be.
But a full sweep of the power positions in Washington just isn’t gonna happen for the Repubs this year, so for now we have a package that offers something for everyone to love or hate.
Dems get to proclaim that they accomplished meaningful health care reform, even though they didn’t. Repubs have a government mandate they can campaign against, even though it began as a Republican proposal 20 years ago. Insurance companies get a ton of new customers in return for a few minor concessions to their total control of the system. And the general public gets…not much, really.
Parents can keep their kids on a family health plan well into adulthood, so they’ll probably be picking up the tab for what’s left after insurance pays its portion. People who are already sick can buy insurance to help pay for treatment instead of being denied coverage. Folks who don’t want to buy insurance can pay a tax instead and get subsidized medical care when they need it.
The big winner is, as always, Big Business. Corporations that offer health insurance just got 20-30 million new customers to target with television ads. Broadcast networks will see revenue jump above the $4 billion for airspace the industry pays out now just to sell auto insurance.
The industry will continue to spend a lot of money on lobbyists and pay executives very generous salary and benefit packages. That money will now come under a 15 percent cap on profits and administrative costs, a limitation the industry agreed to in return for a national mandate for all citizens to purchase insurance or pay a health care tax.
And why not? They stand to make far more profit under the ACA than they were making before. Big players in the business get deeply involved in every federal and state attempt to improve health care systems, and they generally get what they want in the end. In this case they pressed hard for the individual mandate because it was in the best interest of their industry, not the consumer or the citizenry at large.
The future of the ACA is unknown. The recent Supreme Court ruling upheld most of the law as being constitutionally correct, but every provision in the act is subject to being changed by Congress at any time. Four of the nine Supremes believe the entire ACA is unconstitutional; the Court could take a second look at the law if Chief Justice Roberts starts to doubt his decision.
As written, the ACA is fully paid for through a combination of budget cuts and tax increases. It probably won’t work out that way, because government programs usually cost more than is estimated. By comparison, Romney’s proposed tax cuts would cost about three times as much as the ACA, but that doesn’t matter to folks who believe that less government is always better, except when it comes to Medicare and Social Security – two genuinely socialist programs that almost every American supports.
And the ACA isn’t going to do much towards bringing down the cost of health care services. Patients won’t see a direct improvement in the quality of care, either. Those are the only aspects of health care reform that really matter, but we won’t be seeing those improve any time soon.
There are 25 countries that do health care better than us. Their systems spend less per person while their citizens live as much as four years longer and generally enjoy better health than Americans do. There are 48 countries where newborn babies have a better chance of surviving their first year than in America. We do, however lead the planet in the cost of care at about $6,500 per person per year.
Our best opportunity to accomplish meaningful reform already exists, but won’t be pursued. By simply expanding Medicare into a universal single-payer system, we could cut costs for patients to a level matching the more civilized countries on our planet. But despite being popular with citizens, having no advertising budget, not offering big pay to executives and operating with just 2 percent administrative costs, it has been deemed somewhere, somehow, that Medicare is not the answer.
What will remain are the private practices of doctors, hospitals and clinics. Some patients may benefit from more choices as to who will provide their care, but most will still be offered only the same providers that their insurers prefer now.
One way to evaluate the effectiveness and relative cost of Medicare is to ask someone who uses Medicare if they would go back to using private insurance if they could. Good luck finding anyone who wants to pay more for the same care they’re getting now. But that’s pretty much all the ACA has to offer those who have insurance already.
So the next time you encounter someone who either praises or condemns the Affordable Care Act, you can tell them to relax. The primary change in how America deals with health care is there are now more players in the game. The rules remain largely the same…
If you like writing about U.S. politics and the 2012 campaign, enter "The American Pundit" competition. Allvoices is awarding four $250 prizes each month between now and November. These monthly winners earn eligibility for the $5,000 grand prize, to be awarded after the November election.