Granted, most Californians, and even most Americans, are not concentrating on the day-by-day activities of the Barack Obama administration. You may be among those who love the president and his great example, or you may be in the Tobacco, Tea, or Don’t Tread on Me fringe groups. Either way, the recent breathless reporting and passionate oratory of the media notwithstanding, most of us have enough trouble on just-getting-by everyday living tasks to pay careful attention to the specifics of Washington lore. When there are big, pressing or trail-blazer issues, sure, we all want to be clued in. Otherwise, getting back and forth to work, if we have a job, or getting any forward movement towards one if we don’t, and other related activities–childcare, bill paying, securing relief from underwater mortgages, etc.,–tends to occupy our time.
One result of that phenomenon is a dependency on the media summaries for what’s going on and what’s in a particular piece of legislation. The number of actual readers of the new American Healthcare Reform Act, and its companion reconciliation “fix-it” bill, for example, are quantitatively and proportionally few. That is not easy reading. So, when we keep hearing the same pronouncements over and over again about what’s in the legislation and what’s not in it, we tend to accept or reject based on the credibility of the messenger rather than because of a fact check of the actual document (s).
As analyzed very well recently by Ezra Klein in the Washington Post, dealing with the partisan issue first, when one checks the Republican website that lays out the party’s “Solutions For America,” it is easy to identify the Republican Party’s big four agenda items for any kind of healthcare reform: families and businesses need to be able to buy health insurance across state lines in order to pressure insurers to lower their rates; businesses and trade associations should be able to pool their resources and buy insurance at bulk rates; states should be assisted by the federal government to come up with their own reforms; and something relevant should be done about tort reform (too many malpractice suits). In spite of Republicans and others railing about the lack of bipartisanship, every one of these items is now included in the healthcare law just signed by President Obama, to the chagrin of a great number of Democrats. In addition, the law goes even further and includes a cap on high-end employer sponsored insurance plans (similar to what Republicans did under former President Bush), and the core of the healthcare plan is still private market driven (the insurance companies are still in charge), rather than a Medicare-for-all program that most liberal Democrats wanted. There was plenty there for Republicans to vote for. They didn’t, but not because the whole effort was not bipartisan.
President Obama’s “change in America” may now include an alteration of the very definition of bipartisanship–it may no longer simply be measured by who votes for what–but very clearly, the party of No voted that way for reasons other than lack of bipartisan inclusiveness. They are disingenuous, when they claim otherwise and have no serious evidence to support that assertion.
Regarding the new healthcare law being a government takeover, again that is frivolous to say the least, and pure mendacity at worse. Granted, a significant number of Democrats in the House and Senate wanted a single-payer system as the basis of healthcare reform. Congressman John Conyers had already worked up a preliminary single-payer bill well over a year ago, and had over 100 sponsors for that legislation, and a companion Senate bill was already in committee. But, as we all know, that died rapidly on the vine, to be replaced by the public option concept. Both were vehemently opposed by Republicans and by a large proportion of the health insurance industry. As it turned out, the idea of insurance exchanges replaced both of the government insurance proposals, yet the same rhetoric was again used to attack the private market exchanges idea, to wit, that it was a government takeover.
The single payer system would have worked like this: The federal government would not own hospitals or deliver medical services. Instead, one or several federal agencies would organize national health financing to pay for medical services, but delivery of medical care would remain in private hands, i.e., physicians in private practice, hospitals and clinics. Under a single-payer system, all Americans would be covered for all medically necessary services. These services would include doctor care, hospitals, both preventive and long-term care, mental health, reproductive healthcare, dental, vision, prescription drugs and medical supply costs. Patients would have their free choice of doctors and hospitals, and doctors would retain their autonomy over patient care (the government would not determine what procedures to do or who got them). Insurance companies would have become redundant and virtually unnecessary.
The public option would have given us the chance to buy insurance through a government-run agency, like the Federal Employee Health Benefit Program. This option would have competed in the marketplace with the private insurance companies. However, even that government option would mean organizing the buying of insurance from private companies probably at lower rates the federal government would pay . But again, the federal government would not have become an insurance company and disparities in coverage would have been reduced but not eliminated.
So, what did we get? What are these insurance exchanges? Essentially, they are government organized bundles of insurance company options so that the American public can look at them all together, compare rates, and shop for affordable insurance. Since 32 more million people are coming into the system, the cost of buying and keeping insurance is supposed to go down, and those who can least afford a plan will receive federal government subsidies to assist such purchases.
Political rhetoric, whether shrill or gentle, has to eventually give way to fact checks. The new healthcare law is far from perfect, but it is also far from the ogre in the woods profiled by Republicans and other critics. We must keep our eyes wide open and our ears perked, folks. Lies told and told again don’t become truth; they stay what they began as, lies.
David Horne, Ph.D., is executive director of the California African American Political Economic Institute (CAAPEI) located at California State University, Dominguez Hills.
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