The resistance to the Affordable Care Act in the United States is a manifestation of how a certain segment of the electorate has been captured by the extreme right. A magnanimous policy of providing healthcare for the uninsured was perceived by the Republican Party as “socialized” medicine and an overreach by the Obama administration.
The expansion of healthcare led to a call to arms. From its inception, the debate vis-à-vis the Affordable Care Act was characterized by intellectual dishonesty. Michelle Bachmann, the Congresswoman from Minnesota, led the charge that death panels would determine who would be eligible for healthcare. The black medical practitioner and ultra-conservative, Ben Carson, argued that the Affordable Care Act was tantamount to slavery. A parade of charlatans on Fox News tried to make the case that no one was signing up, millions were dropped from their insurance and the cost would bankrupt the country.
America is one of the oldest democracies in the world but it has become reknown for demagoguery. Discussions or debates are not evidence based and ideological rigor mortis has set in. Congress is no longer a deliberative body but has become a citadel for unscientific thought.
The first phase of the Affordable Care Act has come to a close. March 31, 2014 ends the first enrollment period and those who failed to get on board will not get an opportunity to acquire healthcare through the exchanges until November 2014 that will take effect in January, 2015. The preliminary figures indicate that over 6 million folks signed up on the exchanges. Many states like Oregon and Maryland had websites that were dysfunctional. States like Kentucky, Connecticut, California and New York exceeded their enrollment targets. As was anticipated, the last days to register produced millions trying to obtain health insurance.
The Affordable Care Act adds a new dimension to America’s costly system of healthcare. Rather than opting for a system of universal health coverage, America chose to take a series of baby steps. Healthcare for the elderly was extended as an outgrowth of the Great Society Programs that took place in the 1960s under President Lyndon Johnson. Later on poor people with children were covered by the Medicaid Program. The Federal government runs the Veteran Hospitals for veterans of the armed forces.
Most Americans obtain their health coverage through an employer based system. That system lacks portability and when an employee changes jobs, that employer based insurance coverage does not follow the insuree.
America’s health care cost in comparison to other OECD countries is extravagant. Most OECD countries like Canada, Sweden, Switzerland and Denmark spend less than 10 percent of their GDP on healthcare cost. The United States spends approximately 17 percent of its GDP and approximately $8,000 per capita. The average per capita for OECD countries is $3,000.
Healthcare outcomes in the United States, when compared to other OECD countries, are not that impressive. On matters of longevity and infant mortality rates the United States lags behind. Where the United States is in the vanguard is in research and development. On the cost of prescription drugs, the American consumer pays through the nose.
Since the passage of the Affordable Care Act in 2010, healthcare cost in the United States has trended down. The escalation of healthcare cost for Medicare and Medicaid in the Federal Budget has slowed significantly. The Affordable Care Act pays for itself and does not exacerbate the federal deficit.
The Affordable Care Act is a conservative extension of healthcare. Rather than opting for single payer system, like what exists in Canada, the Obama administration and the Democratic Party opted for extending coverage to the uninsured by preserving the private insurance system although forcing insurance companies to comply with new federal regulations. The concept of the Affordable Care Act was initially proposed by the American Enterprise Institute, a conservative think tank and operationalized in Massachusetts under the Republican Governor Milt Romney. Running for President in 2012, Romney disowned his seminal achievement as the Governor of Massachusetts.
In saner times, the Affordable Care Act could easily have brought the country together in a bi-partisan manner. The expansion of healthcare represents the further humanizing of American society. Even in the George W. Bush years, the Republican President extended prescription drugs for those on Medicare.
In the post Bush years, America has grown increasingly callous and cruel. In the 1960s, the country proclaimed a War on Poverty. In the second decade of the twenty-first century, the right wing of America has embarked on a War Against the Poor. Such a war is unworthy of an opulent democracy. What is stunning is the preliminary evidence that in the pending election of 2014, the country will turn even further right. Obviously, something is rotten in the state of Denmark.
