Whatever we feel about the Affordable Care Act, it has just withstood it’s first major battle against many enemies. It now becomes the president’s legacy, firmly nailing his name in American history. Unfortunately, that ignores everyone else who was involved. All the people who worked tirelessly to create it, defend it and those who risked their political careers to pass it. It’s fitting that the Supreme Court not only upheld most of the ACA’s provisions but also found a new way to do it. It's definitely a stunning accomplishment on everyone's part.
On our local level it may not seem so stunning. Most people are not quite sure what the ACA really means for those of us with plain, ordinary day-to-day lives. While there are some who seem convinced they do understand what it means, they're pretty much split between disaster and salvation. For most of us in Morris county, it probably won’t make much difference at all. We already have access to some of the world's best healthcare, we live in a state that demands that insurers cover our children even longer than the ACA does, and most of our insurance plans already allow pre-existing conditions. Of course, the key word there is “most.”
The way the Supreme Court’s decision really affects us is by continuing the conversations we’ve all been having about healthcare. Is it a right? Is there a way to do it more cheaply and efficiently? Were we better of before the ACA?
I certainly don’t think we were better off. The ACA may not be anything more than a loosely patched up Republican plan from the 90s, revived with sticks and bailing wire, but it’s a plan. After 60 years (some would say more like 80) we’ve finally done something about one of the hardest problems in the industrial era, providing humane care for Americans who just can’t afford it and putting a barrier between those of us who can and sky-rocketing costs.
That's because I know exactly how much good healthcare costs. I look at the bills, the original ones, not just the ones the insurance companies finally pay. I had three children with my late wife, if we’d had to pay for all those doctors and hospital services ourselves we’d still be paying them off. If I’d had to cover all the medical expenses of my wife’s 15 year battle with breast cancer, well, I couldn’t have, not in two lifetimes.
However, the wonderful woman I’m currently married to had a relatively simple back operation about four years ago. The hospital bills alone came to more than $120,000. But somehow, in some magical insurance company way, it was only $16,000 when our health insurance paid the bill. Hmmmmm ... But that’s how a lot of us see the local impact of American healthcare, as a series of frightening and mysterious dollar amounts that we hope no one will ever ask us for. How many of us even routinely ask our doctors and nurses “What’s this going to cost? Can I get that itemized?”
Recall the Affordable Care Act? Nah, not unless you have a better plan. If you’re telling me anything is better than the ACA, I’m not buying it; I’ve seen the bills of “anything.” We’ve finally made the move; it’s time for tuning not recall. If you’d rather fix the ACA and move forward, I’m right there with you. If you want to implement the sense and economy of a single-payer system, I salute your courage, but I don’t think we’ll live to see it. Too bad.
As the conversation on healthcare moves on, it looks like my party will continue on the hysteric rather than the historic side. This is a piece of legislation that does pay for itself without hammering middle class taxpayers, but that’s dependent on a congress that will do what needs to be done. With the congressional conservative anger-froth currently knee deep, I have my doubts about that. Too much of the conversation is based on deliberate chicanery and mis-information. Why anyone, even a congressman, would resort to mythical “death panels,” irresponsible wild tales of “evil government controlled health care” and fictitious tax burdens for the middle class is beyond understanding. This only demonstrates a complete ignorance of the details of the Affordable Care Act as well as making it even more obvious that they have no concept of who the middle class actually are. It’s a triumph of ideology over sense. I wonder what you win for that?
Still, I’m holding on to the thin hope that we’re seeing the wild, spastic death throws of over 30 years of failed “the free-market solves everything” dogma. The conversation needs to continue, but in a constructive way. At least I hope we’re all sick to death of “let’s throw everything out and then resolve to: wonder what to do.”