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Monday, July 23, 2012

Obamacare: Why We Should Be Glad it Passed Constitutional Muster, and why the Media Constantly Gets it Wrong

Before reading further, take this quiz here.  Do not worry, I am not interested in keeping score, but it is clear and apparent that not many folks know exactly what is in Obamacare.  I blame the media, which in its lazy fashion, has taken to the tact of polling people about what they think is in the law, rather than what is actually in the law itself. 

This past Thursday marked a milestone in the Supreme Court.  Nobody expected that Justice John Roberts would join the liberal four justices in finding The Affordable Care  Act to be constitutional.  Without going too much into the details of the decision, it is clear that the alternative would have been disaster.  The dissenting opinion called for the complete destruction of the measure and effectively limit the powers of the federal government to the point that future attempts at health care reform would be rendered extremely difficult, if not impossible.  Because the healthcare situation, with its rising costs and diminishing coverage is untenable, the Supreme Court's decision is certainly cause for celebration.

Admittedly, there are significant flaws to Obamacare.  Regardless of subsidies, extensions of medicaid and other provisions, some people will fall through the cracks.  Because Obamacare is completely based on private insurance with no public option, this could be a boon for insurance companies, increasing both their profits and their control of the market.  While some progress was made on the prescription drug front, the price controls remain minimal.  Obamacare can as such be best viewed as a step toward a final solution, rather than a solution in and of itself.

Even so, Obamacare marks the single greatest achievement of the Obama administration so far, and represents the greatest extension of health care benefits in more than a generation.  Yet Obamacare remains unpopular, with a slight majority of Americans disapproving of it.   Most of Obamacare's provisions, with the exception of the much maligned individual mandate are popular, if one asks about those measures independently.  The provisions of this mammoth act are manifold, which might be one reason for its much maligned length.  Among other things, Obamacare:
  • Bans discrimination against patients for pre-existing conditions or illness.  No longer will a child with diabetes be charged outlandish rates for health insurance, and no longer will someone with cancer in their past be denied coverage because there is a risk of recurrence.  
  • Guarantees that anyone under 25 may remain on their parents' health insurance.  No longer is coverage cut the minute a person leaves college, but extends to allow him or her to establish themselves in a job with such benefits.
  • Aims to make health care affordable to just about anyone through exchanges.  Those who are not insured through their employers (or those who opt out of their employers' coverage) may receive group coverage anyway at similar rates.
  • Mandates that everyone in the country who can afford it purchase health insurance, and issues fines for those who refuse to purchase insurance.  Though much maligned, this provision is absolutely necessary, since insurance companies would no longer remain solvent otherwise.  

    Think about it.  The insurance companies are required to ignore pre-existing conditions in offering insurance and figuring rates.  This is a boon for those patients who need treatment, of course, but everyone else could simply ride the system, buying insurance only when they become ill and need care.  The insurance companies would thus be servicing only the sick, who inherently generate more costs than revenue.  A deep pool of healthy patients has always been necessary to keep insurance companies afloat, all the more so since insurance companies will no longer be able to choose their market.
  • Provides tax incentives to businesses that offer health insurance, while penalizing those businesses with 50 or more employees who refuse to provide coverage.  
  • Provides income-based subsidies to help make insurance affordable to as many people as possible.
  • Increases the minimum qualification for medicare, offering a safety net to catch many of those who are not otherwise able to get healthcare even after subsidies.
  • Puts a "tax" on those people who are financially able, yet refuse to buy insurance because they are healthy now, and can buy in when they are sick anyway.  Some people seem to dislike this tax.   Ironically, these are the same clowns that go around griping about welfare queens.  If you can afford health insurance and refuse to get coverage, you are making the rest of us pay your way.   You are the very leach you are complaining about. 
I have not listed everything in the bill of course, but the bill is readily available online, and healthcare.gov is a good resource to find out how one is affected by specific aspects of the bill. In short though, the act promises to make healthcare available to more Americans than ever before and to ensure affordable rates. With this Supreme Court ruling, not only is this modest improvement to our healthcare system preserved, but so too are the tools to fix it even better in the future.

Wednesday, July 4, 2012

Happy birthday, USA....kind of.

It is interesting that many folks regard July 4, 1776 as "the birthday of the United States." When the Declaration of Independence was signed, little changed for the 13 colonies. They had been fighting the British for about a year and the war was to last until 1783 when the Treaty of Paris was signed by the Kingdom of Great Britain and the United States of America, which ended hostilities and recognized the sovereignty of the US. Therefore one could say that September 3, 1783 is the “birthday of the US,” however it was not until the following year that the Treaty was ratified by the US and Great Britain. The Congress of the Confederation ratified it in January of 1784 and Great Britain did the same in April, with the ratified documents being exchanged on May 12, 1784. Then, one may ask, the “birthday of the US” is sometime in 1784? I would answer no.

It would be another three years, on September 17, 1787, until the Constitution was adopted by the Constitutional Convention and George Washington elected the first President of the United States. In the years between 1781 (when the Articles of Confederation were adopted) and 1787 the United States was a confederation of largely independent states who handled their own foreign and military policies, produced their own currencies, etc. The Articles of Confederation made state’s rights the priority and established a weak central government which turned out to be unsustainable, a lesson that was to be relearned in the Civil War when the Confederate States of America were severely hampered by the priority of state’s rights.[1]

Though the Constitution was adopted in 1787, it was not ratified by all 13 states until May 29, 1790 and in March of the following year the Bill of Rights was ratified. So in all honesty, the United States of America, as we know of it today, did not reach infancy until 1790, a full 14 years after the signing of the Declaration of Independence in 1776. If we are going to celebrate the “birthday of the US” we should really be celebrating it on May 29, not July 4 which celebrates the signing of the Declaration of Independence which was the first explicate statement of the intentions of the rebellion of the colonies.

[1] A good example of this was the different gauges of rail roads in the southern states. Because each state had its own gauge goods had to be moved from one trail to another when being transported across state lines. In times of war this is a huge hindrance when troops and supplies need to be moved quickly and efficiently.