In the event that the Supreme Court overturns the Affordable Care Act (which seems distinctly possible given all the “broccoli” talk that went on during the hearings), it might be prudent to discuss why the Obama administration felt the need to tackle the American health care system in the first place.
Simply put, our for-profit, insurance-based health care system was garbage.
There are a quite a few Americans who would disagree with that, but that’s because the system was working for them. They worked for businesses that covered the costs of their comprehensive health care, or they had the largesse available to cover their own. The Supreme Court has never had an issue with their health insurance provider, because they have premier health insurance plans.
The health plan of the U.S. Congress is also first rate. These folks live in a perspective-free bubble, and have absolutely no idea what the average person had to go through in order to get affordable and effective insurance. I would argue that they probably had no real idea how the health insurance market even worked in this country.
You could tell their ignorance based on the arguments they used against health care reform. In the months leading up to the final vote on the ACA, the catchword was “freedom.” Congressman and Senators who were against health care reform couldn’t string a declarative sentence together without the word “freedom” somewhere in there.
Veteran lobbying groups masquerading as grass-roots, mom-and pop advocacy organizations toured the country warning us that “our freedoms are at risk.” One Congressman even carried a “freedom baby” on to the House floor as a completely inexplicable example of how terrible health care reform would be for Americans.
The Pavlovian use of this word might very well have stirred up the patriotism and fear in those of us who didn’t know any better, but for a lot of Americans, our health-care system gave us “freedoms” that were not worth getting misty eyed over.
If you were underinsured or couldn’t afford the Supreme Court Justice/Congressman/Syndicated Talk Show host brand of insurance, you had the “freedom” to choose which insurance company would inevitably reject some, most, or all of your medical bills when you got sick or injured. Once that happened, you had the same “freedom” as the uninsured, which was the freedom to choose between death and financial ruin.
The reason most people didn’t have good insurance or any insurance at all is not because they were lazy or thoughtless, but because it was expensive, often prohibitively so. Costs have been going up sharply over the past decade, and wages have been stagnant for twenty years. This isn’t the sort of economic obstacle that gumption and bootstraps can overcome. Many people who could afford insurance could only afford what turned out to be a coupon full of denials and disclaimers rather than actual coverage, and many people couldn’t even afford that.
Americans who are on the ever-widening economic fringes know all about this. When the right began their hysterical talk of “death panels” and the horrors of government bean-counters roaming the hospitals, millions of Americans with bad health insurance policies recognized this as simply a description of the status quo. Every health insurance company in America has at one time or another decided that it would be more cost effective to simply deny claims for one flimsy reason or another than pay for the treatment of someone who was seriously ill, and if that isn’t a death panel then what is?
Apparently having the government between you and your doctor is unacceptable, but having a profit-minded insurance adjuster in the same position is perfectly ok. Death panels, rescission, lifetime limits, dropping coverage for the flimsiest of reasons and arbitrary denial of claims are all apparently examples of freedom in action provided that there is an unnecessary middleman making money out of the deal.
The goal of hospitals and insurance companies in America is to make a profit for their investors. Practicing medicine and insuring people is simply how they go about making that profit. If you run your hospitals and health insurance companies under the same principles as a factory that makes Blu-Ray players, then inevitably you have to make cuts and sacrifices in order to keep profits up and healthy. Except what inevitably gets cut is insurance coverage and what gets sacrificed are the patients.
The ACA essentially forces insurance companies to stop engaging in their worse practices, and in order to make up for any profits that insurance companies might lose by not engaging in monstrous behavior, it makes everyone in the country buy insurance. Is it perfect? Absolutely not. But since we have decided that healing people without somebody getting rich falls under the category of “blood-soaked, communist tyranny,” this is what we’re stuck with. If the Supreme Court is as clueless about health care as they are about campaign finance, then pretty soon we won’t even have that.
If the ACA goes down, I hope that the conservatives in America take a moment to think about what they are celebrating. It isn’t just about a defeat for Obama. It’s about going back to a health care system that has no business being in a country that so loudly declares itself to be Christian, or even in a country that claims to be civilized. But hey, freedom, freedom, and more freedom, right?