Crossville Chronicle, Crossville, TN


November 19, 2013

Lion and the Lamb: Obama's biggest mistake

CROSSVILLE — The president has made a number of big mistakes along the way: his personal involvement in choosing targets for our nation's drone kill list and his refusal to hold the big banks accountable and subject to penalty for their role in our nation's financial meltdown. 

But Obama's biggest mistake of all was his decision to introduce and support the Affordable Care Act as his vehicle for addressing the critical health care problems in our nation. There was enough warning about what lay ahead in the ACA approach, however, by noting the sheer volume of paper it took to present the ACA plan: over 2,000 pages. In deference to the healthcare insurance industry, the plan tries to deal with our nation's confusing mix of public and private health insurance programs and with factors such as employment status, income, place of residence, and age. It contains very weak cost controls over medical and pharmaceutical providers, however, letting free market principles play out as much as possible.

Obama would have been much further ahead at this point if he had developed his healthcare proposal on the basis of one of our most popular national programs, Medicare. In a Medicare-for-all system, we would get a card the day we were born and would keep it all through our life. As with Social Security, another one of our most popular national programs, there would be very low administrative expenses. According to Dr. Steffie Woolhandler, visiting professor of public health at Harvard Medical School, we would save about $400 billion per year. We are now paying twice as much per capita as other industrialized countries, and have poorer health and lower life expectancy.

The initial setting up process of the ACA system, however, has not been very user-friendly. Opposing forces such as the Koch Brothers and the Tea Party, taking advantage of the glitches and frustrations, continue to call for the elimination of the ACA. Even House Minority Leader Nancy Pelosi was heard to comment several weeks ago "We should have done single payer."

There are other ACA problems looming ahead. Amy Goodman reminds us that the Supreme Court ruling gave states the option to opt out of the Medicaid expansion, which 26 states with Republican governors have done. "A New York Times analysis of census data showed that up to eight million people, mostly African-Americans and single mothers, and mostly in the Deep South, will be stranded without insurance, too poor to qualify for ACA subsidies, but stuck in a state that rejected Medicaid expansion."

This is a terrible legacy of injustice that will happen even if the ACA, glitches and all, gets up and running. Would it be a mark of ethical goodness and greatness if our nation would chuck the ADA in this moment of rancor, even if it had already been voted into law, and then vote a single-payer, Medicare-for-all, system into operation?

Of course, these are only pipe dreams, the kind not smoked by the Koch Brothers or the Tea Party.

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