The History, Facts, Myths, Pros and Cons of ObamaCare

HSTQuoteAs we near January 1, 2014 and the full implementation of the Affordable Care Act, many are grasping for any straw they can to dissuade Americans from trusting or supporting a law that has already been written, enacted, signed into law and upheld by the Robert’s Conservative Supreme Court as Constitutional. Many on the right cite now that President Obama “lied” over saying you can keep your insurance, even though the insurance you keep ends up costing you more in premiums than what you ever get back in coverage, otherwise known as “junk” policies.

The Republican Party went so far as to shutdown our government for what Ted Cruz coins as a “Train Wreck” destined to cost jobs, freedoms and money. Forget the fact his orchestrated shutdown of government cost the United States economy in those two weeks $24 billion in lost economic activity and 120,000 private sector jobs. It would appear that if ObamaCare won’t endanger the economic health of the nation or cost jobs, the GOP will create the losses themselves fighting it. Somewhat ironic but true.

What follows is a brief history of what led us to the Affordable Care Act, the facts regarding the law, some of the myths and the pros and cons about implementation of the law. I will include links to the sites I used for this rant for your own edification.

A Brief History:

The debate over our government mandating healthcare actually goes back to our founding. In 1790 the first Congress that included 20 of our “framers” mandated that ship owners buy health insurance for their seamen. It was signed into law by George Washington. In 1798 it amended the law requiring the seamen to buy insurance themselves. This was signed into law by John Adams, considered today to be the first “conservative” president of the United States.  This comes from Harvard Law Professor Einer Elhauge:

http://www.newrepublic.com/article/politics/102620/individual-mandate-history-affordable-care-act

The reason for this was simple, at the time, traveling the seas paid a high price of individual’s health. We were a young nation that depended on sea travel for our international commerce. Getting sick was costly to business, our economy. Requiring healthcare coverage was an easy fix to a problem that could seriously impact our economy of productivity. So it was required then, as it should be today.

In the late 19th Century, European nations, who were still essentially conservative, began implementing mandatory and universal healthcare for their citizens. In the late 19th Century and early 20th Century the Progressives began looking to expand healthcare for the workers for more “humanitarian” rather than nationalistic reasons.  Theodore Roosevelt advocated for healthcare believing a nation couldn’t be so strong if her people were so sick and poor. In 1906 the American Association of Labor Legislation led the fight for health insurance.  They did not want to abolish capitalism, they wanted to reform it. They proposed health insurance for those families earning less than $1,200.00 a year that provided services of physicians, nurses, and hospitals. The costs would be shared between workers, employers and the State. In 1914 the American Medical Association backed the AALL agenda.  In 1917, the AMA House of Delegates favored compulsory health insurance as proposed by the AALL, but many state medical societies opposed it. Further, the American Federation of Labor denounced the plan fearing that government control of healthcare would weaken the unions by usurping their ability to provide healthcare to their members. There was also opposition from the private insurance companies and finally, due to our entry into World War I, and the anti German “socialistic” views that provided healthcare to their citizens, sympathy for our own national healthcare withered until the 1930’s and Franklin Roosevelt.

After the implementation of Social Security work for national healthcare went forward. After FDR’s death, Harry Truman took up the cause. However, whereas FDR looked at utilizing private insurers competing with each other for business among the citizens who would be subsidized by the government, Truman looked to a single payer plan modeled under Social Security. Everyone paid in and everyone would be covered. Both plans were denounce as “socialism” modeled under what the communists had. Conservatives fought the very notion of universal healthcare for these ideological reasons despite the benefits such plans would provide. When the Republicans took the Congress in 1946 ushering in what Truman would call ‘The do nothing Congress” the efforts for giving the nation a healthcare plan died until the 1960s.

During the push to pass the Medicare and subsequent Medicaid laws, the same conservative voices citing the same arguments of “socialism” taking away “freedom” came down. A future President, Ronald Reagan in his ads opposing Medicare said “If you don’t {stop Medicare} one of these days you and I are going to spend our sunset years telling our children’s children what it once was like in America when men were free.” A line that Senator Ted Cruz actually plagiarized from Ronald Reagan in his opposition to ACA.

What is interesting is that after he became president, Reagan actually worked with the Democrats to save and extend the solvency of both Social Security and Medicare. With Medicare in place and later Medicaid as well as improvements to both programs in implementation, efforts went on regarding the 55 million Americans who remained uninsured because they didn’t earn enough to buy health insurance that more and more became for-profit under Reagan resulting in higher premiums and stricter guidelines regarding who they would insure, but made too much to qualify for Medicaid, and were too young for Medicare. So in the 1990’s, Bill Clinton tried to implement coverage for these people in what became known as “HillaryCare.”

The right used the same talking points of socialism used for nearly a hundred years. This time, the conservative think tank known as the Heritage Foundation came up with a plan that required an individual mandate to buy insurance from the private market. However they weren’t too keen on government regulating the market regarding pre-existing conditions, life-time caps, or rescission of coverage. HillaryCare died in Congress, but the Heritage plan was picked up and modified and implemented in the State of Massachusetts and was later called “RomneyCare.” We then moved to the debate over the writing, creation and implementation of the Affordable Care Act known as ObamaCare. The arguments and tactics mirrored those over the previous century, false claims of socialism, too high of costs, jobs, freedom, and personal attacks on the advocates. But it passed and was held constitutional none-the-less. President Obama succeeded where a century of previous Presidents and administrations failed; he implemented a plan that filled the gap of around 55 million Americans unable to get care. Prior to this, we were the only industrialized nation that didn’t have some form of universal healthcare. Further, our healthcare costs were significantly higher than the rest of the world with worse outcomes for the majority of people. If you had money, health insurance you had care. Unfortunately we aren’t a nation of million and billionaires, so access to our great system of medicine was out of reach to far too many citizens.

Here are some interesting links I used for the above:

http://www.pnhp.org/facts/a-brief-history-universal-health-care-efforts-in-the-us

http://thinkprogress.org/politics/2009/07/29/53311/medicare-flashback/

So what is ObamaCare?

Here is the link to HB3590 “The Patient Protection and Affordable Care Act” also known as “ObamaCare” passed by Congress, signed into law and upheld by the Supreme Court:

http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/html/PLAW-111publ148.htm

If you don’t have the time to read this document, here’s a good summary of the law:

http://www.dpc.senate.gov/healthreformbill/healthbill52.pdf

I cite the links to the law for those of you who may have read or have been sent tweets and post citing certain sections of the law that sound terrible. The problem is, many trolls on the right will cite something in the act and even give the page it is on, thinking you won’t go to the effort to read that page of the law. This has been going on for a few years. There are no death panels, coverage for undocumented aliens, or implantation of micro-chips, anything they cite.

Here is a link from NCBI that tells you what the implications to public health the ACA is:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001814/

Finally, here’s two links I have found to be the most comprehensive and thorough guide to ACA and all the key factor surrounding it to educate you when confronted by those on the right. One comes from American Public Health Association and the other is a guide dispelling the myths from both sides, citing facts, sources and answers you may have regarding ACA:

http://www.apha.org/advocacy/Health+Reform/ACAbasics/

http://obamacarefacts.com/

Key facts regarding ACA:

CBO estimated in July 2012 that 55 million Americans under the age of 65 are uninsured which is 1 in 5. Without ACA, that number would grow.

Healthcare Spending represents 17.9% of our Gross Domestic Product and is expected to be 20% by 2020.

7 in 10 deaths in the United States are related to preventable diseases such as obesity, diabetes, high blood pressure, heart disease and cancer and 75% of our health care dollars are spent treating those conditions. However, only three cents of each health care dollar currently goes to prevention. ACA places emphasis on prevention.

The United States spends far more on medical care than any other industrialized nation but ranks 24th among 30 OECD nations in terms of life expectancy.

Without ACA the CBO estimates that the uninsured rate would rise from 20.4 % in 2012 to 21.1% in 2022 with 60 million lacking coverage.

ACA is expected to reduce budget deficits by $210 billion from 2012 through 2021.

Under ACA you can no longer be denied coverage for pre-existing conditions, you no longer face life-time caps on coverage, you can no longer have you coverage rescinded by the insurance companies, companies must direct 80% of premium dollars to healthcare.

ACA is free market healthcare coverage, not single-payer. Insurance companies must compete with each other for your business. That is capitalism, not socialism.

ACA is fully funded via eliminating wasteful spending of Medicare Trust Fund moneys via fraud and giveaways to private insurance companies. It is also funded by additional tax revenues from tanning salons, medical device providers, insured and penalties from those who don’t take advantage of the individual mandate. This link shows how the funding is provided and why:

http://www.acponline.org/advocacy/where_we_stand/assets/i2-how-is-the-aca-funded.pdf

Here’s another link explaining the funding:

http://obamacarefacts.com/costof-obamacare.php

ACA has been compared to RomneyCare. That is actually a good comparison because the Heritage Foundation program modified by the Massachusetts legislative branch and implement by Mitt Romney is working as this link from Forbes explains:

http://www.forbes.com/sites/robwaters/2013/11/08/its-not-the-website-stupid-new-research-says-romneycare-worked-obamacare-will/

What are the Myths?

These two links analyzes the most discussed myths from both sides of the aisle regarding ACA:

http://www.factcheck.org/2013/09/obamacare-myths/

http://www.usatoday.com/story/news/politics/2013/09/29/fact-check-ted-cruz-obamacare-health-care/2890995/

What are the Pros and Cons?

The major con regarding ACA in my opinion is that it isn’t single-payer as Harry Truman and many today advocate for. It is what works in Europe and will work here. The problem is that isn’t politically possible in Washington today. ACA is a step in the right direction, but it isn’t where we ultimately have to go. However, as the Stone’s say, “You can’t always get what you want, but if you try sometimes, you might just find, you get what you need.”

Here is an honest link of the pros and cons regarding ACA:

http://obamacarefacts.com/obamacare-pros-and-cons.php

Summary:

ACA or ObamaCare is here to stay. As it nears full implementation, it is obtaining higher approval ratings from the American people, which is what the right feared. Much like their concerns over Medicare in the 1960’s, now that we have it, we won’t give it up. Healthcare is a good investment for a nation’s health, productivity and overall economy.

ACAPop

For both liberal and conservative reasons we should be working to make this a more healthy nation. Partisan politics get in the way of logical and pragmatic thinking. However, this has been our nation’s history.

Despite the pros and cons, the myths, the attacks, the problem with the Website, on the whole, this is much better than what we had before and it is already having benefits for people as they become involved with it. To try to end it now is quite simply impossible and those in office who say that’s what they are working for are lying to their gullible base. They say they will end it to get the uninformed people’s support, but they know it can’t be done. Again, this is the history of our politics.

I know there is a lot to read here, but consider this post a warehouse of information you can use with your friends, family, coworkers and more importantly, trolls trying to irritate you into being against a program that helps everyone, including the trolls.

Enjoy!

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