Friday, September 13, 2013

I had a Twitter conversation...

...with one of my readers the other day about the Affordable Care Act. He's the father of a high school football player I wrote about last year and a quick glance at his Twitter page reveals he's no fan of either President Obama or Obamacare. Fair enough; I realize not everyone thinks like me. (Thank God!) I'm happy to talk to him, though (even via Twitter), because the few "conversations" we've had have been cordial. But I also quickly figured out that Twitter, with its 140-character limit, is not the ideal forum for discussing a complicated issue such as health care reform. With that in mind, I'd like to make just a couple of points as to why this boring old white guy supports the law.

For starters, it's important to remember that every other developed country in the world has universal health care. Every one. This isn't some crazy socialist plot. It's the norm all over the civilized world. And that doesn't mean one-size-fits-all, either. While Canada has a single-payer system like Medicare in the United States, the UK has socialized medicine, i. e., the government owns all the hospitals and employs all the doctors, nurses, etc. Patients don't even get a bill; they just see their doctor or go to the hospital and then go home afterward. But that's not all. Germany, France and Japan, to name just a few, have systems that resemble Obamacare: everyone is covered cradle-to-grave by a private insurer who is regulated by the government.

(Switzerland, by the way, was the last developed country to adopt health care reform in the early 1990s and they argued over it bitterly, just like we did back then and are still doing today. But now, after about twenty years' experience, the Swiss love their health care system and can't imagine going back. In fact, many wonder what all the fuss was about all those years ago.)

Now, I know what you're thinking: Okay, so all these countries have universal health care. What about the cost? And what about the quality? Well, it's worth mentioning that the U. S. spends over twice the average of the developed world and far more than the second-place finisher, Switzerland. (Again with the Swiss.) But doesn't the U. S. have higher-quality health care as a result? Not necessarily; by many measures health care in the U. S. is lagging behind other developed countries. Under the current system, we're paying far too much for good, not great, health care.

The second point I'd like to make is that the Affordable Care Act is based on the Republican health care plan of the 1990s. While Democrats always wanted to adopt a single-payer system, i. e., Medicare-for-all, Republicans insisted on a system based on private insurance. For years Democrats got nowhere (they even prevented Nixon from introducing a system that would have been more progressive than Obamacare!) but finally in 2009 they said, "Okay; you guys win. We'll do it your way." To which the Republicans in Congress could have said, "Beautiful! Glad you finally see it our way. We'll even help you write the bill. Where's that Mitt Romney guy? He did it up in Massachusetts." But instead, the GOP shouted, "SOCIALISM!"


And now, more than three years after its passage and before it has even been fully implemented, Republicans are still trying to undermine the law they first envisioned. Does that make sense to you?

One last point: Remember all those developed nations that adopted universal health care? Not one of them wants to go back to the old way. Not one. In fact, I read just this week that China is rolling out a universal health care system of its own. Seems they want to provide basic health care for their people,  too.

P. S. The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, by T. R. Reid, above, is an excellent (and very readable) book on the subject.

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