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.

Erie County Health Commissioner on Breast & Prostate Cancer

Erie County Health Commissioner Dr. Gale Burstein saw what the previous County Executive had to say about how people no longer die from breast and prostate cancer and “some of the other things”, and today issued the following press release: 

BURSTEIN CALLS ATTENTION TO CANCER RATES IN ERIE COUNTY

Prostate, Breast Cancer Mortality Rates Indicate that Residents Still Suffer

ERIE COUNTY, NY— Erie County Health Commissioner Dr. Gale Burstein today issued a statement regarding the incidence and mortality rates of prostate and breast cancer in Erie County, underlining their serious nature and the fact that people still suffer from these diseases. Former-Erie County Executive Chris Collins recently stated in an interview, “People now don’t die from prostate cancer, breast cancer and some of the other things.”[1]

“All types of cancer, including prostate and breast cancer, have significant mortality rates associated with them.  During 2005-2009, Erie County saw an annual average of 826 cases of female breast cancer, with an average of 176 deaths per year. For prostate cancer in the same period, the annual average was 930 cases, with an average of 103 deaths per year.”

“These numbers represent the sad reality that, despite advances in cancer treatments, people still die from these types of cancers.  It is imperative that people not only be aware of the potential risks from all types of cancers but get appropriately screened and checked as recommended by your doctor for breast and prostate cancer.”

For more information on Erie County cancer statistics, visit: http://www.health.ny.gov/statistics/cancer/registry/vol1/v1cerie.htm

For more information on the Erie County Health Department, visit:  http://www2.erie.gov/health/

(Image courtesy Tom Dolina)

Erie County Health Commissioner on Breast & Prostate Cancer

Erie County Health Commissioner Dr. Gale Burstein saw what the previous County Executive had to say about how people no longer die from breast and prostate cancer and “some of the other things”, and today issued the following press release: 

BURSTEIN CALLS ATTENTION TO CANCER RATES IN ERIE COUNTY

Prostate, Breast Cancer Mortality Rates Indicate that Residents Still Suffer

ERIE COUNTY, NY— Erie County Health Commissioner Dr. Gale Burstein today issued a statement regarding the incidence and mortality rates of prostate and breast cancer in Erie County, underlining their serious nature and the fact that people still suffer from these diseases. Former-Erie County Executive Chris Collins recently stated in an interview, “People now don’t die from prostate cancer, breast cancer and some of the other things.”[1]

“All types of cancer, including prostate and breast cancer, have significant mortality rates associated with them.  During 2005-2009, Erie County saw an annual average of 826 cases of female breast cancer, with an average of 176 deaths per year. For prostate cancer in the same period, the annual average was 930 cases, with an average of 103 deaths per year.”

“These numbers represent the sad reality that, despite advances in cancer treatments, people still die from these types of cancers.  It is imperative that people not only be aware of the potential risks from all types of cancers but get appropriately screened and checked as recommended by your doctor for breast and prostate cancer.”

For more information on Erie County cancer statistics, visit: http://www.health.ny.gov/statistics/cancer/registry/vol1/v1cerie.htm

For more information on the Erie County Health Department, visit:  http://www2.erie.gov/health/

(Image courtesy Tom Dolina)

Obamacare. Saving Lives.

A forty-nine year old mother finds out she has stage III breast cancer. She has no health insurance (for a variety of reasons), and discovers that a provision of “Obamacare” that is already active may quite literally save her life.

Fortunately for me, I’ve been saved by the federal government’s Pre-existing Condition Insurance Plan, something I had never heard of before needing it. It’s part of President Obama’s healthcare plan, one of the things that has already kicked in, and it guarantees access to insurance for U.S. citizens with preexisting conditions who have been uninsured for at least six months. The application was short, the premiums are affordable, and I have found the people who work in the administration office to be quite compassionate (nothing like the people I have dealt with over the years at other insurance companies.) It’s not perfect, of course, and it still leaves many people in need out in the cold. But it’s a start, and for me it’s been a lifesaver — perhaps literally.

Which brings me to my apology. I was pretty mad at Obama before I learned about this new insurance plan. I had changed my registration from Democrat to Independent, and I had blacked out the top of the “h” on my Obama bumper sticker, so that it read, “Got nope” instead of “got hope.” I felt like he had let down the struggling middle class. My son and I had campaigned for him, but since he took office, we felt he had let us down.

It continues to astonish that this country can’t get it together to ensure that every citizen has access to top-quality medical care, without regard to one’s ability to pay. That we have a system where, if you lose your job, you can keep your health insurance, but only if you pay an outrageous, often unaffordable rate. Ours is the last first world nation to not guarantee universal access to health care. This was unacceptable after WWII, was unacceptable during the creation of Medicaid in the mid-60s, and remains unacceptable now.

Your health should not be dependent on the money in your wallet or your bank account. Yes, ours is a free country, and we should be free from medical bankruptcies.