The Pre-Obamacare Trainwreck

Obamacare-symbolSome of my friends are conservatives. Shocking, I know. They occasionally post things to social media that are critical of people whom I support, and policies with which I agree. Occasionally, I will argue or even troll, but once in a blue moon, I will try to present a reasonable counterargument that is factual and not particularly argumentative. Rare, but it happens. 

On Tuesday, I saw a post linking to this article. My Facebook friend annotated his post by declaring that “progressives…really do all suck”.  I read the article, which detailed the travails of a single mom trying to buy insurance on the Washington State exchange, and having problems with bad advice and equally bad results. I feel horrible for her and anyone else similarly situated. The new insurance mandate, and the fact that the policies have to maintain a minimum standard of coverage means that some people are paying more, and the subsidy schemes are complicated. 

But it’s the “Affordable” Care Act. Not “inexpensive”, not “cheaper”, not “free” – affordable. But once you argue the semantics, you’ve lost. People’s perception is that everyone’s cost would go down, and whenever this proves not to be the case, it gets blown up into a scandal. 

So, let’s take a step back for a second. The Affordable Care Act – Obamacare – is not what I think is best or perfect for this country, but it’s 1,000x better than the utter trainwreck that preceded it. Here’s what I posted as a comment to my friend’s Facebook indictment of “progressives” in general and Obamacare in particular: 

At some point between 1990 – 2009, the Republican Party decided that universal health care coverage was no longer a societal goal, regardless of how it was to be implemented. When “HillaryCare” was proposed, conservatives pushed as an alternative the model now known as RomneyCare and ObamaCare – a regulated and partially subsidized marketplace of private insurance policies that you are (a) mandated to participate in if you have no employer-based coverage; and (b) meets some minimum standard of what qualifies as “insurance”. 

Now that we have Obamacare, which is a regulated individual marketplace of policies, different in each state, conservatives have not just refused to go along with it, but have actively and passively worked to sabotage it. 

Big laws that do big things aren’t going to be perfect in an imperfect world. Under normal circumstances, we would at least have consensus on “everyone should be insured” as a societal goal. We don’t even have that starting point, so everything else must fail. But even if, hypothetically, Republicans did agree that we should all have decent health coverage, under normal circumstances and in a responsive representative democracy, they would work to help fix problems that arise. This, too, we don’t have. That’s why things that have come up as problematic now have to be amended through regulation and executive rulemaking. 

If the right wanted to present an alternative to Obamacare – which is itself the alternative to HillaryCare – then they should have done so. They never, ever did. All they’ve done is try to block it, then sabotage it when they weren’t done repealing it. Oh, sure they bleat on about “tort reform” and the anti-federalist notion that policies should be one-size-fits-all across the country to enhance “competition”, just like the Telecom act of 1996 enhanced cable TV “competition” and the breakup of Ma Bell enhanced telephone “competition”. Just like the merger of Exxon and Mobil or United and Continental enhanced “competition”. 

In the end, government exists, in part, to fill in the holes that private industry can’t – or won’t – fill. Our private health insurance system in this country is unique in its user-dissatisfaction, physician time-sucking, inefficiency, and waste. It has proven to be almost completely unworkable in contemporary society, and its problems are underscored by the fact that no other country in the world sees fit to implement anything resembling it. 

By the same token, the German, Swiss, French, British, and Canadian models are also imperfect. They do, however, produce better results for far less money – and they do it in a way that satisfies the health care consumer. 

ObamaCare’s lack of situational perfection doesn’t take away from the fact that you no longer face lifetime policy maximums; you can no longer be denied coverage due to a pre-existing condition; insurers can no longer arbitrarily drop you when you get sick and use your coverage; preventive care and immunizations will be free of charge with no co-pay or deductibles; females are treated equally now; myriad consumer protections are put in place to help people appeal adverse insurance decisions. All of these changes are significant – so much so that it’s disgusting that these sorts of things were not implemented before. 

But, you know, glitchy website. 

Yes, I’m disappointed that ObamaCare isn’t perfect. But that disappointment is tempered by my disgust with the pre-ObamaCare status quo. I would much prefer a hybrid NHS single payer system that had public care with private sur-care policies. This will not happen in this country in my lifetime unless it’s proposed by a nominal conservative. In the meantime, have fun pointing out the problems that 1/300,000,000th of the population has with an individual policy under a state-run scheme and not only indict the federal program, but anyone who supports it, as horrible.


  • Remember, we live in a society where a significant percentage of the population — if not an outright majority — believes that it is inherently better to be screwed by the “free market” than to not get screwed by the government. That’s why we cling to the idea that “the market” and “competition” will make all these things work better, even though there are zero countries that do things in such a way so as to offer an example, versus many countries that use a LESS ‘market-based’ approach and yet still get better results for less money. When the free-market worshippers come up with a convincing answer to the simple rejoinder, “If what you say is true, then why is no one doing it that way and proving it?”, I’ll listen. I’ve yet to hear an answer that doesn’t involve placing faith in Free Market Jesus.

    • No need to bring Jesus into it Kelly. What I’d like to know is how a plan with 5-8 thousand dollar deductibles are “affordable”. How many folks do you know that have 5 G’s to pull out of their pocket every year before their insurance kicks in? It’s like not having insurance at all. Poor folks can’t afford the premiums and they damn sure can’t afford the deductible. I was promised FREE health care for life as 20 year active duty military or the spouse of one. I have a no-premium plan with a 300.00 family deductible and 3000.00 catastrophic cap. It’s damn sure not what the government promised. They have to make me pay so people who have not made the sacrifices I made for our country–to say nothing of ever having got off their dead behinds to get a job, can have the free stuff. But it’s a damn sight better than anything the ACA offers. The wife got acute bronchitis earlier this month and the bill was 23,000. I already hit the deductible in October, so I owe about 2500.00, and the government pays the rest. We’ll pay the hospital what we owe. But I don’t see anyway I could have paid the first 5-8K, and pay the incredible premiums the ACA charges. You know, there were a lot of people that were perfectly satisfied with the healthcare coverage they had. Happy with what it covered, happy with what they were paying. Then Barry comes along and says “You’re being Screwed, we know better what you will like than you do”. And way too many of them are disappointed—the poll numbers prove that. The “Great Uniter” isn’t on too many hit parades lately. I disagree with Alan. The “Trainwreck” is not the ACA, and it isn’t what most people had and liked. The REAL trainwreck is what’s going to happen when this program falls flat on its face. I’m not hoping it will, but I don’t see it succeeding either. What I do see is a lot of financial difficulty for the people who voted for this “Change”. I get no satisfaction from the suffering of people who were doing fine before.

      • “They have to make me pay so people who have not made the sacrifices I
        made for our country–to say nothing of ever having got off their dead
        behinds to get a job, can have the free stuff”

        Wait, how do you know that? Isn’t it a lot more likely that vets like you are
        getting screwed on your promised VA benefits in order to buy additional
        billion dollar fighter jets that we will never need? But you automatically rush to blame the poor folks.

        Republicans are completely convinced that they are getting robbed by the poor, rather than by the corporations who actually run our government. I invite you to stroll the ghetto sometime and see if you can spot all the stolen wealth.

        • Exactly, the right has convinced the uninformed that poor people are the problem. The bottom 50% of Americans share together just 1% of our nations wealth, their impact on our economy is chump change.

      • Yeah those poor people get everything!!!!!!11111111111

        Also, it’ll never stop being funny that right wingers accuse of Obama of not being a uniter because the GOP viscerally hate him.

    • I have a statue of Free Market Jesus on the dashboard of my car.

    • If you believe we’ve been screwed by the free market you are delusional. We haven’t had anything close to a free market for many decades.

    • As Winston Churchill often said…”my greatest argument against the idea of democracy would be a 5 minute conversation with the average voter”……

    • such a great point

  • “…conservatives have not just refused to go along with it, but have actively and passively worked to sabotage it.” Curious statement.
    Aside from the odd concept of “passive sabotage”, I’d be grateful for an explanation of how conservatives are responsible for the absolute disaster of a website created by the company controlled by Michelle’s college roomie and Barry’s campaign bundler.
    Or for the regulations which forced insurance carriers to cancel virtually all existing policies, as “non-compliant”.
    Or for the very terms of the law itself, since not a single Republican voted for it.
    If, by “sabotage”, you mean we are not joining in the lame propaganda efforts for this miserable failure, I guess you’ve got us dead to rights.

  • Positing the argument that the ACA is better than what preceded it is a specious argument at best. Regulations for health care have virtually eliminated any competition for decades. The ACA has federalized and mandated insurance coverage through a limited number of providers. If the Affordable Care Act was actually good, it wouldn’t be necessary to use the force of government action to have people sign up. The bottom line is that neither Democrats, nor Republicans, had the stomach to “fix” the health care system, so they just completely eliminated any other options.

    • The scant regulations for pre-2009 health insurance failed to protect consumers from predatory for-profit companies who seek only to minimize payouts for maximum premiums. To suggest that further loosening regulations to enable companies to widen that gap between quality of coverage and premium cost would result in consumer benefit is nuts. Time and again, the market has proven its fundamental inability to regulate itself and government is forced to step in to protect consumers.

      • The “scant” regulations encouraged predatory pricing through the creation of quasi-monopolies for the insurance companies. That is even worse under the ACA. Nothing will improve without real competition and choice for health insurance.

        • How bout single payer like they do in many other countries?

          • Single payer completely removes the patient from the health care decision process. Costs too high? No problem, cut services. We need to restore accountability between patients and doctors and lessen the role of the middlemen.

          • How is that possible given the fact that the system does not even know the patient needs treatment until the patient has met with the doctor in the first place. Also from what I have read most of the SP systems vary as they are not all of the same mold to begin with…..

          • Completely false. The single-payer system has political and administrative accountability built into it. Under single payer the patient and doctor have complete and utter freedom to contract for care, and the bill is paid by the governmental entity set up to do so, paid for through employer taxes, VATs, and other taxation schemes. Every time you buy something in Ontario, your HST is helping to pay for the free medical ride that the kid in an apron helping you receives, and will continue to receive uninterrupted if he takes a new job.

          • “The single-payer system has political and administrative accountability built into it” – That has got to be one of the most absurd statements I have heard in a long time. Political accountability may work on a small scale, but it is completely devoid of any sense of right and wrong at the federal level for over 300 million people, By the time you throw in the regulatory agencies, you have a total clusterf**k.

          • disqus_g6fqjyhj09

            Unlike the current system, that regularly denies expensive and/or experimental treatments? And if that went unregulated, by how much would those denials increase?

          • Many people are denied potentially live saving treatment because the FDA hasn’t approved it. Got forbid someone makes a decision regarding their own life without government oversight and approval.

  • If any of these commenters really want a better system, then they need to look at what works in other countries where one entity pays the bills and that entity then can negotiate for lower drug costs and eliminate unnecessary administrative waste. We have a system waiting in the wings but the media chooses to ignore it. Type HR676 in your search box and see what you get. Read it with an open mind.


  • Nice job Alan, nice job.

  • Corporations write the regulations under Dems and decide which get repealed under Repubs. Either way, competition is reduced and the prices skyrocket. The relationship between government intervention and prices is historically available. Healthcare will be the next bubble. This is what happens in a cronyist society.

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