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Jeff Madrick

Lo and behold, Mitt Romney says he will now support parts of the Affordable Care Act, which the Republicans disdainfully call Obamacare. The Financial Times called it a u-turn. My prediction is that the word Obamacare will conjure up the same positive connotations as Medicare now does.

Has Obama immortalized himself? It may be.

A lot of progressives profoundly criticize Obamacare.  I fervently disagree with them.   They wanted single payer and so do I, but we weren’t going to get one. They wanted serious cost controls. So do I. Maybe they are still coming.   But what we got was  some kind of healthcare for thirty million people who lacked it, and many more benefits for those who already had it but were being abused by their insurance companies.

According to recent reports, Obama is now going to run his election on these healthcare benefits, trying to divert attention from the high unemployment rate.  My guess is that it will work. And Romney’s recent cave-in—perhaps the beginning of the etch-a-sketch strategy to move to the center—will show what a weak candidate he is.  What it is showing at the moment is what a strong piece of legislation Obamacare was.

Only now are the highlights of Obamacare becoming clear.  This delay is in large part the president’s fault. He seemed to be afraid to talk about it because the Republicans had made it a rallying cry of government interference and their much-exaggerated loss of freedom.  Good health is a great provider of freedom, by the way.   Try to be free with a major ailment.

What does Obamacare do?  It already is starting to close the famed doughnut hole in the senior drug plan.  It is providing preventive healthcare services with little or no co-pay, including contraception and well-being visits for women.  There is no lifetime cap on how much you can be reimbursed for expenses, as so many insurance company plans had.  It allows children up to 26 to stay on their parents’ medical plan.  The Centers for Disease Control and Prevention just reported a sizable drop in the number of young who don’t have insurance as a result. That’s fast work.

In 2014, no insurance company will be able to turn away applicants who have a pre-existing condition. Romney would apparently retain that one.  There will be no annual caps on reimbursement, as there now are in so many plans.And business will get subsidies to provide insurance to their employees—a requirement for those with fifty or more.

Of course, there is also the individual mandate.  This was once a Republican idea, which raises the ire of some on the left.  But this was a political trade-off.  We’d have nothing without it.  And it may work.

Perhaps most important, about fifteen million new individuals will be covered under Medicaid.  Some think Medicaid covered all poor. But it used to be only for families, not individuals. Now it will cover anyone, and the cut-off line has been raised. It used to be on average only 60 percent of the already-low poverty line.

The plan’s main weakness is in cost controls.  But a true public option could be added, once the country begins to actually like Obamacare.   The public option could ultimately offer lower cost full-service insurance, nearly at Medicare rates.  That would be the best method for keeping down prices.

Incentives for preventive medicine could also be strengthened down the road.

Romney doesn’t say, as usual, how he would pay for thoses parts of Obamcare he’d like to retain.  Currently, the package is being paid for with higher payroll taxes on better-off Americans, cuts in provider payments and cuts in the medicare Advantage plans, which are high cost plans for seniors.

I did some work for Senator Kennedy and he had learned in the 1970s that America would not get a single-payer system.   He began to compromise, and he supported Obamacare strongly before his death.

So many are already benefitting from Obamacare that it could be the guarantor of an Obama victory. In any case, I think Romney is now running scared.  But Obama has to be willing to speak boldly about it.   And then he has to build on it.  A jobs program?  Higher minium wages?  A real pre-K system in America? There is so much still to do.   And by the way, The passage of the ACA was in the end an act of bi-partisanship in the real sense.  In other words, a harsh battle that ended in useful compromise.

Kennedy’s dream had been Medicare for all. Few probably know that Medicare for those 55-64 almost made it into the bill.  Maybe next time.

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One Response to “Obamacare a boon after all”

  1. jacksmith says:

    “Give me Liberty, or Give me Death!” – Patrick Henry

    What a brilliant ruling by the United States Supreme Court on the affordable health care act (Obamacare). Stunningly brilliant in my humble opinion. I could not have ask for a better ruling on a potentially catastrophic healthcare act than We The People Of The United States received from our Supreme Court.

    If the court had upheld the constitutionality of the individual mandate under the commerce clause it would have meant the catastrophic loss of the most precious thing we own. Our individual liberty. Thank you! Thank you! Thank you! Supreme Court.

    There is no mandate to buy private for-profit health insurance. There is only a nominal tax on income eligible individuals who don’t have health insurance. This is a HUGE! difference. And I suspect that tax may be subject to constitutional challenge as it ripens.

    This is a critically important distinction. Because under the commerce clause individuals would have been compelled to support the most costly, dangerous, unethical, morally repugnant, and defective type of health insurance you can have. For-profit health insurance, and the for-profit proxies called private non-profits and co-ops.

    Equally impressive in the courts ruling was the majorities willingness to throw out the whole law if the court could not find a way to sever the individual mandate under the commerce clause from the rest of the act. Bravo! Supreme Court.

    Thanks to the Supreme Court we now have an opportunity to fix our healthcare crisis the right way. Without the obscene delusion that Washington can get away with forcing Americans to buy a costly, dangerous and highly defective private product (for-profit health insurance).

    During the passage of ACA/Obamacare some politicians said that the ACA was better than nothing. But the truth was that until the Supreme Court fixed it the ACA/Obamacare was worse than nothing at all. It would have meant the catastrophic loss of your precious liberty for the false promise and illusion of healthcare security under the deadly and costly for-profit healthcare system that dominates American healthcare.

    As everyone knows now. The fix for our healthcare crisis is a single payer system (Medicare for all) like the rest of the developed world has. Or a robust Public Option choice available to everyone on day one that can quickly lead to a single payer system.

    Talk of privatizing/profiteering from Medicare or social security is highly corrupt and Crazy! talk. And you should cut the political throats of any politicians giving lip service to such an asinine idea. Medicare should be expanded, not privatized or eliminated.

    We still have a healthcare crisis in America. With hundreds of thousands dieing needlessly every year in America. And a for-profit medical industrial complex that threatens the security and health of the entire world. The ACA/Obamacare will not fix that.

    The for-profit medical industrial complex has already attacked the world with H1N1 killing thousands, and injuring millions. And more attacks are planned for profit, and to feed their greed.

    To all of you who have fought so hard to do the kind and right thing for your fellow human beings at a time of our greatest needs I applaud you. Be proud of your-self.

    God Bless You my fellow human beings. I’m proud to be one of you. You did good.

    See you on the battle field.


    jacksmith – WorkingClass :-)

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