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Health care: nothing but the truth

November 4th, 2010

Halloween’s over, but don’t expect Republican scare tactics on health care to end any time soon. The alleged “government takeover” of health care is one of the main reasons Americans are turning their backs on President Obama and the Democrats. And a number of competent Democratic candidates and incumbents were destroyed on Election Day by Americans’ confusion over health care reform, which is really a shame. Because plenty of people who tell me they’re against “Obamacare” change their minds after I tell them the facts. I’m not saying I’m some kind of master debater. It’s simply that when Americans know the truth about health care, they tend to support it. 

But before I dive into the specifics of Obama’s health care reform policy, it’s interesting to note that the most common complaint I hear about health care isn’t about the policy itself but about the need for reform in general. The question many often put forth to me is, “Why do we need universal health insurance when anyone, insured or not, can receive emergency room health care?”

And the answer to that is simple: because emergency room care can cost a ton. And if you don’t have insurance, it can be all but impossible to pay off an emergency room medical bill. When that happens, as it often does, hospitals have to increase their costs all around to make up the difference which, in turn, increases the cost of health insurance for all of us. That’s one of the main reasons why health care costs are increasing faster than inflation and the growth in Americans’ income. And that’s exactly what Americans need to understand: universal health insurance isn’t the goal of health care reform. Rather, it’s a means by which to achieve the real goal of reform, which is controlling costs. 

Universal health insurance helps to control costs by making sure everyone is contributing to a system from which they will likely benefit sooner or later. But in order to implement universal health insurance, Obama didn’t institute a “government takeover” of the health care industry. Rather, he simply made three main tweaks to make the private health insurance sector work better. 

First, Obama’s health insurance reform includes a mandate that health insurers not deny coverage to Americans with pre-existing health conditions. These are the people who are most likely to need insurance, so insurers often consider them a financial burden. At the same time, in order to prevent only sick Americans from buying health insurance, which would bankrupt the insurance industry, Obama’s reform policy also includes an individual mandate. This mandate requires all Americans – with few exceptions – to purchase health insurance or pay a tax penalty. And finally, since not all Americans can afford health insurance, Obama’s policy creates a system of government subsidies for lower and middle-class Americans to help them buy insurance. While most Americans probably agree that these subsidies are necessary, what’s controversial is where the money for the subsidies should come from.

Now I’ll be the first to admit that this policy is far from perfect. Although it will help reduce the deficit and insure millions more Americans, it still probably won’t do enough to control costs. It also includes a huge amount of regulations, and although a lot of them are pretty helpful, like allowing children to remain on their parents’ insurance plan up to age 26, I’m sure there are some that aren’t so great. 

But it’s a good start. And Republicans who are calling for the repeal of Obama’s health care law are irresponsible and ignorant of the problems Americans face.

However, the intense Republican opposition to health care reform is indicative of a deeper issue. Back in 1993, in response to President Clinton’s health care reform proposal, Republican senators put forth an alternative proposal that mirrored much of what is contained in Obama’s policy, including an individual mandate. This ideological transformation over the past 17 years reflects how Republicans have become increasingly conservative while Democrats – like the majority of Americans – are more moderate than ever.