by Carol A Westbrook
Before you, progressive reader, quit in disgust after reading the title, or you, conservative reader, quit in disgust after reading a few more paragraphs, please hear me out. I'm proposing that we repeal Obamacare (The Affordable Care Act, ACA) but not replace it with another medical insurance program. Instead, I propose that we re-think the entire concept of how we provide health care in this country.
The ACA's stated purpose is "to ensure that all Americans have access to high-quality, affordable health care." Regardless of whether or not you believe good health is a fundamental human right, it is inexcusable for an affluent, first world country like ours not to provide it for its citizens. The good health of our nation is vitally important to its success, guaranteeing as it does a capable workforce, a strong military, and a healthy upcoming generation. However, I have seen the results of Obamacare from many perspectives, including that of a physician provider in a rural community, as well as that of a personal user of both insurance and Medicare. I do not believe the ACA succeeded in meeting its objectives.
It is true that the ACA provided health care insurance for millions of Americans who didn't have it previously, expanded Medicaid for the uninsured, got rid of the pre-existing condition exclusions, allowed our grown adult children to remain on our policies longer, and started the ball rolling on electronic records. These are great results.
The late economist Hyman Minsky wrote that after fortunes inflate on the back of a speculative bubble, and after investors’ irrational optimism and overvalued assets inevitably collapse, an economy enters a “period of revulsion,” when people remember that it’s risky to bet big on an uncertain future. Likewise, it’s always during the depths of a hangover that a drinker remembers how whiskey invites its own overconsumption and swears that the only way to avoid another descent into this purgatory is to never touch the stuff again. But after the fog leaves and with a clear head regained, he forgets the pain after the party and declares another Manhattan to be an eminently reasonable investment. Of course, the trick is to recall at just that moment how miserable you’ll be after another three. A pessimistic economist faces the same cyclical popularity as a tee-totaling friend; a consoling voice the morning after becomes a buzz killer as soon as night falls again.