This is my column published in the Spectrum on 5/15/1
The Affordable Care Act has been the target of political attack since its adoption in 2010. The early Republican mantra was “repeal and replace.” That quickly faded into “repeal” because of the inability of Republicans to propose any serious alternative legislation.
T. R. Reid articulated the fundamental moral reasons for reform of our extraordinarily complex health care “non-system” in his 2010 book “The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care.” Surveying health care systems in other developed nations he found that we are the only industrialized nation that has not found a way to implement universal health care at an affordable cost.
Currently we lead other developed nations in per capita cost and spending as a percentage of GDP ($7960 and 17.4% here versus $3978 and 11.8% in France for example) and with poorer outcomes measured by objective standards.
David Frum, conservative columnist and writer, argued that Republicans missed an opportunity to shape the law in 2009-2010 by their unwillingness to seriously engage in the months long Senate committee process that produced the legislation. In an October column in This Week Magazine Frum argued that repeal of the Affordable Care Act is unlikely to be successful and a more constructive approach for Republicans would be to attempt to modify those provisions found most objectionable to conservatives. He made specific policy proposals.
Ironies abound in our current political climate. Many of the most objectionable features of the Affordable Care Act were originally proposals put forth by conservatives. Governor Romney’s Massachusetts’ health care reform, including the individual mandate, was a model for the national plan. Some of the loudest opponents of government run health care are on Medicare, in the VA system, or covered by the Federal Employees Health Benefits Plan.
There are no easy reforms. Whatever we do will involve decades of hard work and compromise by many stakeholders. Let us not return to the status quo. The Affordable Care Act for all of its flaws is a start. Implementation of many of the early provisions has begun. Coverage can no longer be denied young children because of preexisting conditions. Insurance companies cannot dictate lifetime coverage limits. Young adults between 19 and 25 can remain on their family’s policies. A total of 52 reform provisions are already in effect.
Details of the implementation timeline for the many provisions of the ACA can be found on the Kaiser Family Foundation Health Reform Source web site at: http://healthreform.kff.org/timeline.aspx
Does an “exceptional nation” allow thousands of our citizens to die each year because of limited access to reasonable health care while tens of thousands are forced into bankruptcy because of excessive health care costs? Is it enough that 83% of us have access to reasonable health care? Can we ignore the remaining more than 50 million who are uninsured?
The moral challenge of our health care non-system is largely ignored in what passes for political discourse in our hyper partisan political environment.
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