OBAMACARE AND OBAMASCARE EXPLAINED.

The Affordable Care Law or Obamacare has evoked the most bizarre and incomprehensible political response from the Republicans. Opposition to the Law has bordered on the absurd and grotesque. Notwithstanding the fact that John Boehner, Speaker of the House of Representatives had stated after the 2012 Presidential election, in an interview with Diane Sawyer, that the time had come to accept it and move on, he has since moved to repeal it over 40 times. On the most recent occasion he has also threatened to shut down the Government if Obamacare was not at least delayed for a year. So short of a miracle the Government will be shut down.

The rhetoric accompanying the attack on an Act, that was passed by both houses nearly 4 years ago, withstood a constitutional challenge in the Supreme Court and was a centerpiece of the Obama – Romney election has reached maniacal heights.  Ted Cruz, the Tea Party Poster Child, in his 21-hour filibuster in the Senate against it, besides all the irrelevant drivel he spouted, likened his stand against Obamacare to Churchill’s against the Nazis. Those that supported it were likened to Chamberlain. A Republican State Senator claimed that the Act was worse then the Slave Fugitive Act where escaped slaves to the North were returned to the mercies of their Southern owners while several Republican legislators have labeled it the worse Act ever! Some of the crude adverts already produced by the PACS are distasteful beyond belief – a crude leering Uncle Sam doing a speculum examination on a young lady and a rectal examination on a young man.

OBAMASCARE AND WHY

The opposition to Obamacare has very little to do with the Affordable Care Act and plenty to do with Obama and what he believes in. It is obvious whom is calling the shots – not the Establishment Republicans, Boehner declared himself long ago to Diane Sawyer and the Senate Establishment refused to buy the Tea Party circus as articulated by Ted Cruz. John McCain spelled it out that the Affordable Care Act is the law and that elections have consequences. Anyone who is anybody in the establishment have warned the Republicans not to shut the government, the latest being Romney.

As Jay H. Ell has blogged again and again, unelected megalomaniacs and institutions are running the Republican Party. Joe de Mint of the Heritage Foundation is the Tea Party Godfather that is calling the shots. (Blogs: The Republican Party is Dead, June 2013 and Obamagate – Boomerang, March 2013).  This is the height of hypocrisy as the Heritage Foundation originally supported the program and De Mint supported Romney and stated one of the reasons was that Romney introduced the selfsame program as Governor of Massachusetts. The Koch brothers have been rumored to spend between $60 – 400 million fighting Obamacare.

So Obamacare has to be brought down at any cost even at the expense of ruining the Country’s credit rating and/or shutting down the Government. The public does not fully understand the Act so it is as good an issue as any for the Tea Party to use to take over full control of the Republican Party and then the Country. In fact the Republicans as a whole opposed the plan so that they are in a weakened position to oppose the out of control Tea Party crazies.

Obama, also, has become the poster child of all that is wrong with a “country gone soft”. Instead of getting themselves jobs and pulling themselves up by their bootstraps the Democrat supporters stand in line for food stamps, unemployment payments, disability grants and the like. Now they want subsidized health insurance!

 In Kentucky the Affordable Health Care Act was introduced as a Kentucky state project. The Kentuckians have welcomed it and said it is better than Obamacare! A Fox opinion poll, - who else? – showed that 9% more Americans supported the Affordable Health Care Act than they did Obamacare. Obama, himself, has also quipped that if the Act succeeds it will not be referred to as Obamacare.

THE CURRENT USA HEALTH CARE SYSTEM

The Health Care System in the US is dysfunctional. It uses 1 in every 6 dollars spent at an annual cost of three trillion dollars. It is inefficient in that 50 million citizens are not covered by insurance. The reasons for them being uninsured, include, for example, the fact that their employers do not provide insurance or they are excluded because of preexisting conditions. Three out of four citizens who receive health care do so via their employment, the very poor, from Medicaid, the elderly from Medicare and the Veterans from the Veteran’s Administration.

This mixture of multiple payers, private and public result in the highest cost in the world for the administration of health care. Thirty cents in every dollar goes to the administrative costs – or 1 trillion dollars a year. Medical insurance companies are laws unto themselves excluding those with previous illnesses and excluding services prospectively and retrospectively. The companies are not subject to the monopolies act and there is currently very little if any competition between them. Several of the problems that have beset corporations in general such as obscene overpayments of executives beset them too.

Medical expenses are the commonest reason for bankruptcy in the US. These occur mostly with people on insurance as various maximums and exclusions apply. Every study has shown that every service, procedure or medicine in the US costs 3 – 10 times more than in other first world countries. The health care indicators such as longevity and neonatal death are also worse than in any other first world countries. The fear of litigation leads to endemic over servicing of patients by health care providers and nobody is moving to address that problem.

So it is far to say that in the biggest industry in the US no one is getting their bang for their buck.

THE AFFORDABLE HEALTH CARE ACT – OBAMACARE

The Affordable Care Act, (AHCA), is a very complicated and tortuous act and is nearly 2000 pages long. Jay H. Ell will not go into why it is so as that is the way things work in the USA or used to work. It is what it is. It was enacted after nearly a century of Presidents’ attempts to create Universal Health Insurance. These included both Republican and Democratic Presidents starting with Republican Teddy Roosevelt at the turn of the twentieth century ending with Democrat Bill Clinton at the millennium’s end.

It is fair comment to say that the AHCA goes a long way to rectify some of the dysfunction in the system.

Below is a brief summary of some of the key components.

First and foremost it gives an opportunity for the 50 million uninsured to obtain insurance at reasonable, and where applicable, generously subsidized rates. (Remember the very poor are on Medicaid already). There is a penalty for those who do not obtain insurance. Already the rates for insurance that are being quoted are less than those being charged for similar plans. This is because for the first time in history insurance companies are competing for these customers.

Then no insurance company may refuse you on the basis of a pre- existing medical condition. Neither can it drop you in the middle of treatment because you have reached the “maximum”.

Benefits that are already in place include that children between 21 and 26 years of age can be kept on their parents’ insurance plan. This has been particularly helpful to those “children” who are unemployed in the current economic climate and would have to have paid astronomical sums to be insured on an individual basis. Those on Medicare are already receiving assistance in medicine purchase and their costs have been reduced dramatically. Another positive established is that all insurance plans have to include payment of preventive care such as mammograms, pap smears and colonoscopies.

Costs too have decreased by putting certain quality indicators in place in hospitals.

WHY OH WHY IS THERE IN AN ISSUE?

The Tea Party Republican Party fighting this as a life or death issue, on its merits is incomprehensible. Rather they are using this issue to reinforce their takeover of the Republican Party. Their ostensible rationale is that the government is forcing individuals to obtain insurance. Ron Paul, Rand Paul’s daddy, when confronted with the issue as to what Emergency Services should do when someone, who has a life threatening condition, has no insurance. Daddy Paul said that the patient has made a decision and he should not get treatment! Obamacare would fine this patient year after year for not getting insurance but would insist on doctors doing what they have to do.

How this is all going to pan out and the impact it will have on the political scene in the USA will just have to be the subject of another blog. One thing is for certain is that Obama has no locus standi to help mediate in what is really a Republican fight. Another certainty is that he is going to hang tough.