Washington D.C.—Senator Ted Cruz delivered a marathon all-night speech last night on the floor of the Senate. He spoke on the vile putrescence that he believes the Affordable Care Act, also known as Obamacare, will bring to this country. Parts of the law are set to go into effect this October, with the rest settling in come January. Both parties have praised or maligned Obamacare to death. The polarization in Washington has blurred the facts. No one knows which way is up anymore. The question is, is Obamacare good or bad?
Republicans have vilified it so many times. The Obama administration, despite wheeling out Bill Clinton every so often as “The Great Explainer,” has not clearly elucidated Obamacare, leading to a standoffishness by the public. So the question remains.
Do we need universal health care? The price of healthcare has skyrocketed. One visit to the emergency room today on average costs over a thousand dollars. For a serious illness like cancer, the bill will be anywhere from seven to thirty thousand dollars. In the U.S., out of control healthcare costs are the number one reason people file for bankruptcy. If you have a recurring health problem and lapse in insurance, the insurance companies won’t even cover you. This is called having a pre-existing condition.
There are government programs in place, Medicaid for those who make too little, and Medicare for the 65 and older crowd. But if you are younger than 65 and make just above the poverty rate, you can’t get either of these. 44 million people do not have health insurance in America, the richest country in the world. People who do not have insurance do not go to the doctor. They forgo checkups, preventative treatment and end up in hospital emergency rooms, putting their lives at risk. Then, since they can’t afford the bills, the cost is passed on to everyone else, raising the price of healthcare for everyone. There is a healthcare crisis in America and it has to be fixed. Everyone agrees on that.
Parts of the Affordable Care Act have already been implemented. Children can be under their parent’s insurance up to age 26. This is important because of how difficult it is for young people to get jobs, especially a job that offers health insurance. People in their 20’s and 30’s are living at home longer now, due to the recent recession. If a person gets sick and it costs a lot of money, the insurance company can no longer drop them. Companies can’t raise their premiums without state oversight. Seniors can now get preventative care visits free of charge.
Starting in 2014, if your employer doesn’t supply health insurance, you must purchase it on your own or pay one percent of your income as a penalty. Health insurance exchanges will be run by your state or by the federal government. Go to your state’s website or search the White House’s site if you need to purchase insurance. There will be a portal with instructions. Check and see if you can get tax credits while you are there. These exchanges are to provide more competition and drive down costs.
When the new parts of Obamacare are implemented next year, Insurance companies have to provide certain essential benefits. Things like emergency room care, outpatient care, preventative care, maternity care, mental health treatment, lab and pediatric care. Lastly, if you don’t have insurance and can’t afford it, the Medicaid threshold has been lowered and you will be able to get it. Also, premiums could even be lower than first projected, sans tax credits. With tax credits, insurance could be even more affordable.
The drawbacks are that three to five million Americans may lose good health insurance. Their companies might find it cheaper to go with the exchanges rather than the plans they already have. This is a small number however, to the overall population and the number forgoing insurance today. Then there is the ideological reason that the government shouldn’t force a person to buy healthcare. That it is their money and they should be able to do what they want with it. The trouble is that without everyone being insured, the price of healthcare ramps up. Another issue is with small businesses. If a small business has fifty employees or more, it will have to provide them health insurance by 2015 or will be taxed two thousand dollars per employee, not including the first thirty employees.
A different projection states that Obamacare may increase healthcare costs as people who go for preventative care treatment could find out that they have a serious illness. Another drawback, a little over one percent of the population may end up paying the tax penalty rather than get insurance, as they fall between the cracks of Medicaid and Obamacare. If you make over $200,000 you will pay a slightly higher tax. Pharmaceutical companies may pay more, over $80 billion, and could pass that on to the consumer, raising drug prices. Manufacturers who supply medical devices would pay a slightly higher tax, just over two percent, which could make them second guess whether they should hire someone, but this seems an insubstantial argument.
So is Obamacare good or bad? It is likely the benefits far outweigh the costs to the majority of American society. The chances of prices skyrocketing are slim. This hasn’t happened in other countries. In fact, pharmaceuticals and procedures in countries with universal care are far more reasonable, leading to an increase in illegal online drug purchases and the rise of medical tourism—where people travel to where surgery is cheaper.
The impact on the jobs market seems limited, even though many Republicans say it will kill jobs. The most costly thing for any business is hiring employees and all businesses stave this off to the last moment. So they hire when needed, which means their healthcare costs, while a factor, is not going to change hiring practices overall. As for the overall cost of healthcare, projections are all over the place. We can’t tell with certainty at this juncture whether the Affordable Care Act will make healthcare prices go up or down. It is a new system and may need readjusting. But most moderate analysis seems to project a decrease.
This is not a new idea. Twenty other countries around the world have universal healthcare: Canada, most Western European countries like Sweden, Britain, Belgium, France, the Netherlands, Germany, and many others. Even countries farther afield like South Korea cover all of their citizens under a healthcare umbrella. In these countries, access to healthcare is better. The whole process runs smoother. And their life expectancy is higher. The average person in Sweden spends less than half of what an American spends in healthcare per year. And the Swedes are very happy with their system. This is not the exception but the rule. Americans spend more than most other countries. Two decades ago Switzerland had a system much like America’s but it adopted one much like all other European countries have.
Regardless of how the Republicans feel, it seems Obamacare is here to stay. Senate minority leader Mitch McConnel has given up this exhausting fight. Yet, the fear of a government shutdown looms, again. It’s like the sequel to a terrible horror movie, threatening our tenuous economic recovery just when Americans were beginning to get up off the floor and dust themselves off.
It seems like the Affordable Care Act is not the gloom and doom conservatives portray it as. Pharmaceutical companies and those making over $200,000 a year are going to pay more. This might be what the Republicans are hemming and hawing about. Aren’t these their constituents and campaign contributors?
The GOP has tried to shut down Obamacare a record 42 times and failed. The ranks are breaking. The Republicans are stuck between the old party and the Tea Party, playing handmaiden to both and satisfying neither. This schizophrenia may lose them more seats in 2014. Republicans are on the run. The browning of America, that is to say the influx of Asian and Hispanic Americans, have tipped the scales in favor of liberals and the Democrats. Certain portions of the population, traditional, conservative white males, are not going to bring the Republicans into office en masse any longer. The Republicans are facing growing pains and an identity crisis at the same time.
What isn’t being said is that the Republicans fear the Tea Party splitting off. This Frankenstein’s monster created by the Koche brothers is running amok. If the Tea Party becomes disgusted and forms its own party, the Republican base will be splintered. They will get even less votes, sweeping Democrats into office again and again. This isn’t just bad for Republicans, it’s bad for democracy. The last thing we need is a one party system. This two party system has more than enough problems. So the lengthy rant by Senator Cruz is only for show. It’s just for him to be able to return to his constituents, look them in the eye and say “Look how hard I tried.”
What should be said but isn’t, is what are both parties doing about the labor market right now? Full employment should be the end goal of American society. Too many people are still suffering in poverty, unemployment or underemployment. Instead of tackling real issues, Congress, the least productive perhaps in American history, is setting up a series of logjams and controversies to distract us from our financial woes.
Congress does not want to tackle full employment because that means confronting corporate America, their main source of campaign contributions and lobbying goodies. As Americans, we need to stop letting them play this divide and conquer game. Whether you are for or against the Affordable Care Act shouldn’t matter as much as they make it out to. Over twenty countries in the world have a similar system and they are productive, sound and peaceful.
It shouldn’t matter so much whether Obamacare is good or bad anymore. It is coming. The American people should instead come together, stop being so easily distracted, sucked into controversy and made so easily belligerent. It stops us from taking part in dialogue and compromising the two things that have held this country together since it’s founding. Instead of holding our leaders to task and forcing them to bring results on the labor issue, we will watch and argue, go back to our camps and face the same dim prospects in the labor market until it fixes itself.
By: Philip Perry