Health Reform Is A BFD

That's what Joe Biden whispered to President Obama two years ago just before the signing of the Affordable Care Act.

Starting Monday, the U.S. Supreme Court will begin to hear arguments regarding the constitutionality of the ACA, a.k.a. Obamacare. It's an election year, and the High Court has never been more of a political animal, so the eventual outcome is anybody's guess. (I do know that Justice Clarence Thomas' wife Ginni is CEO of Liberty Central, a right-wing PAC working to overturn the ACA. That shitheel Thomas therefore ought to recuse himself, or better yet, fucking quit. Won't happen.)

Thought I'd share a few excerpted thoughts on the subject of health care from a pair of worthies: Fareed Zakaria, "Health Insurance Is For Everyone", published in Time, 3/26/12; and Paul Krugman, "Hurray For Health Reform", published in the NY Times, 3/18/12.



The centerpiece of the case against Obamacare is the requirement that everyone buy health insurance -- the so-called individual mandate. Nearly 20 years ago, Switzerland concluded that to make health care work, everyone had to buy insurance. Their system is very similar to Obamacare. Today, the Swiss enjoy high quality of care, everyone has access, and costs have moderated. Overall satisfaction is high. -- Fareed Zakaria

How would the ACA (ObamaRomneycare) change American health care? For most people the answer is, not at all. In particular, those receiving good benefits from employers would keep them. The ACA is aimed, instead, at those either going without coverage or relying on the miserably malfunctioning individual non-group insurance market. -- Paul Krugman

Individual health insurance just doesn't work. If insurers are free to deny coverage at will, they offer cheap policies to the young and healthy (and try to yank coverage if you get sick) but refuse to cover anyone likely to need expensive care. -- P.K.

Taiwan created a new health care system in the 1990's. It has a single insurer, basically a version of Medicare. The result: universal access and high-quality care at stunningly low costs -- only 7% of Taiwan's GDP. In the U.S., we spend 17% of GDP on health care. -- F.Z.

Put simply, we have the most expensive, least efficient system of any rich country on the planet. -- F.Z.

In Massachusetts, Romneycare is already working! The number of uninsured has dropped sharply, quality of care hasn't suffered, and costs are very close to initial projections. -- P.K.

Free markets just don't work well in health care. Such a market would work just as it does for BMW's: anyone who can afford one can buy one. But the vast majority of Americans wouldn't be able to pay for a bypass or a hip replacement. -- F.Z.

The ACA isn't easy to love, since it's very much a compromise. But for all its imperfections, this reform would do an enormous amount of good. It's truly urgent, because fewer and fewer jobs come with health benefits. Employment-based coverage has been declining steadily since 2003. So this reform had better survive -- because if it doesn't, many Americans who need health care won't. -- P.K.

The Obama plan is not perfect. It maintains the connection between employment and health care, which is massively inefficient and a huge burden on American business. It does little in the way of controlling costs. But it expands access to 30 million Americans. That's good economics and also the right thing to do. -- F.Z.

Twenty other countries provide health care for their citizens in some way or other. All of them have found the need to use an insurance or government-sponsored model. All of them provide universal care at much, much lower costs than we do and with better results. -- F.Z.

Our task is not to abolish our system for a utopia that never actually existed, but rather to accept our messy reality and try to improve it to allow everyone access to decent care at an affordable price -- something every other rich country in the world already does. -- F.Z.


(Check out the blog archives of 2/25/10 for "Health Care Reform: Buster Explains It All", written 9/9/09)