Hiding in the Backwaters Just one more blog on the net.

Repeal Obamacare? (in parts)

So life is still pretty hectic. I find I still don't have a lot of time or energy to blog, but I really want to try and post with some regularity. Why? Because I think I need it. Do millions of people read my words? Hardly. Will anything I say here actually sway public opinion? Not likely. Will my thoughts make it to Capitol Hill and change opinion there? Yeah, right. What it does do is give me an outlet, one that requires more thought than cursing at the radio. So here we go...

I recently installed an NPR app on my phone. I felt the urge to become more informed and do something more productive with my commute than listen to music. The local NPR station doesn't always have programming I want to hear when I'm in the car, so the idea was with the app, I could load up a program I'm interested in and play it on my way home. Great idea in theory, but the app crashes a lot. I have yet to listen to a complete broadcast. Here's hoping they update it soon.

The first program I wanted to listen to was an Oxford style debate on whether or not the Affordable Care Act should be repealed, moderated by John Donvan, correspondent for ABC News' Nightline. The plan is to take quotes from the broadcast that stand out to me and share my thoughts.

Before I get started on the words of the participants, let me start by saying that stating the premise in derogatory terms, "Obamacare," was not a terribly professional or neutral way to start the debate. They should have used the correct name of the bill, the Affordable Care Act. On the other hand, from where I sit, it doesn't seem the bill does much about making health care affordable. Yes, it does insure millions who were previously uninsured, but I haven't heard a whole lot of discussion about middle class folks like me whose premiums go up every year, while coverage goes down. Maybe that will come up during the debate. We'll see.

The first gentleman to speak was former AZ congressman, John Shadegg, who was arguing in favor of the proposal to repeal the Affordable Care Act.

Donvan: ...a reference to the Obama reform program as Soviet-style, gulag health care. I want to say, "Come now." Do you stand by that?
Shadegg: No. I think it is a part of the dialog that you try to get attention. That was an attempt to gather attention.

I'm calling bullshit on that. Getting attention isn't part of any genuine dialog. Getting attention in this way—using inflammatory terms calculated to exploit the fears of the ignorant—is all about shutting down real dialog. I'm starting to think the secret Republican agenda is to underfund education because an educated populace is not their friend.

Shadegg: [Obamacare] will drive up your premiums.

I think he's right about this. Even if there is a way for insurance companies to provide additional coverage without raising costs, they won't take it. It's too easy to justify raising rates for additional coverage. I've already bumped into this when trying to get individual coverage again. The insurance company was willing to offer coverage, but only if I was willing to exclude a preexisting condition for a minimum of two years. I was offered a preexisting condition plan. What do you suppose the premium on that would have been? I didn't even bother to find out since I don't see my preexisting condition as causing me undo trouble in the near future.

Shadegg: [Obamacare] moves health care decision making away from employers and the insurance companies they hire, but it doesn't give those decisions to you and me it gives them to the government.

Am I missing something? I don't remember federally mandated health care ever being a part of the dialog. Even when the public option was still on the table, it was just that: an option. Insurance companies have been dictating which doctor I can choose for years. Even if this statement is true, one thing I've never understood is the basic assumption by Republicans that corporate bureaucrats are intrinsically better than government bureaucrats.

Perhaps he's talking about the mandate that everyone has to have health insurance. Again, I don't understand why this is such an issue for people. We mandate  auto insurance so that someone else isn't left holding the bag if you cause an accident and don't have the financial resources to compensate your victims. Why is health insurance really all that different? One of the things that is driving up health care costs is the people who cannot pay their bills, and people who use the emergency room for treatment because they can't afford a doctor and an emergency room cannot, by law, refuse treatment. If you don't think you need coverage, get one of these minimal "consumer driven health care" plans, bank most of your money, accept the fact that living in a complex modern society requires that you make some concessions to the group as a whole, and stop whining.

Shadegg: The president told us ... if you like your plan you can keep it. Not true. He said if you like your doctor you can keep it. Not ture. And he said Obamacare would bend the cost curve down. None of those promises, as we examine the plan, turn out to be true.

How does he figure? The only entity forcing me to change my plan is my employer (or lack thereof) as they struggle to reduce costs and change plans on a nearly annual basis. The only entity who forces me to change my doctor is my insurance company if they do not do business with my doctor. Even then, as many times as I've had to change insurance plans over the years, I've never had to change my doctor. That probably has more to do with my doctor being willing to accept any kind of insurance.

As for the cost curve, I can't really speak to that. The health care bill addresses lots of Medicare spending concerns, but doesn't talk a whole lot about private insurance costs. There is one provision that states companies need to spend more on health care and less on administrative costs. Who knows how effective that will be. Sounds like a bit of fluff to me.