Letter 2 America for November 5, 2013

Dear America,

As conservative Republicans scramble for means by which to diminish the lead of the Democratic Party in political polls, they tend to return to the issues that require nothing of them but that they can use to criticize their opposition.  Lyndsey Graham demonstrated the principle last week when he attempted to revitalized the moribund effort to discredit Hillary Clinton--and make no mistake about whom they were targeting--with the Benghazi attack.  Relying on a pulpy 60 Minutes piece purportedly revealing something scandalous when in reality it just repeated what everyone already knew, adding at the end only the sensationalistic, but otherwise insignificant fact that no one has cleaned up the rubble left behind from the attack, Graham tried to revitalize the claim that the Obama administration was preventing witnesses from testifying when the only two witnesses presented by CBS were the author of a book and one who had already been before Darryl Issa's committee.  With that strategy in mind, when the new federal healthcare web site started out with a whimper and not a bang, the Republicans all jumped on what they thought would be a juggernaut, banging away at the dubious point that the failure of technology that could have, and has, happened to all kinds of efforts to use the world-wide-web in an effort to communicate with the public, was a manifestation of the essential deficiency of the law.  But like all the other attempts to hang an albatross around the collective Democrat neck, this one is failing to capture the public's imagination as improvements are being made and more are to come...purportedly enough to render the web site fully operational by the end of November.  The public may have been less than impressed by the Affordable Care Act's (ACA) debut, but interest in enrolling in insurance plans under the law seems to be booming, and in two weeks, the Obama administration will announce the figures on just how many people are availing themselves of the opportunity--in some cases the first they have ever experienced--to provide for their own healthcare with affordable insurance.  Those figures may well put the lie to the notion that Americans abhor the ACA, and the word "Obamacare" may become a badge of honor that Republicans wish they could wear on their lapels instead of those tiny little American flags that they think are somehow large enough to hide their essential political bent toward self-service, even at the expense of the American people, behind.

Still, a troubling issue has emerged from the inception of the ACA's enrollment period in the form of cancellations of extant insurance for a very few, concomitant with offers from the same insurers of new plans that are more expensive and have higher deductibles.  If it turns out to be a wide-spread problem, it will be significant, but before it can be wide-spread, it has to be real.  There was an article on the subject in the New York Times last week that makes that point, albeit perhaps without the intention to do so.  The article cited three anecdotal instances of this phenomenon in which the "victims," so to speak, had their insurance policies cancelled by their insurers and were offered instead plans that were different and far less advantageous.  Of the three, one found a better plan on the ACA website.  Another found a better plan through another insurer.  Only the third did not experience an improvement in her insurance situation, and the article suggested that she really hadn't tried.  And in all three cases, the insurance that they were starting off with entailed high premiums and high deductibles as well, so in two of the three cases the outcome was an improvement over, or at least the equivalent of, what they had lost.  In addition, they were all privately insured rather than through their employers, which puts them in the minority in this country, though some people are also reporting that their employers are discontinuing the coverage they have been providing and referring their employees to the ACA website for replacement coverage.  Of course in those cases, the ACA is just an excuse that such employers use; they could have done the same thing without there being an ACA website for their employees to turn to, so the passage of the ACA actually works for those people rather than being a cause of distress.  That is the real problem with reports like that in The Times.  Anecdotes make the point that the person relating them wants to make, but they don't necessarily reflect general reality, much less the nuances and subtleties that should truly be taken into account when formulating a response to the situation in issue.

So, here we are with the ACA finally becoming a reality, and we don't know whether it is working or not.  The data needed for an inductive assessment won't be available for some time, the information to be released in two weeks or so being just the beginning of what will be needed to determine whether the ACA will work for Americans rather than against them.  But one thing is certain: the efficacy of the ACA in addressing a problem that American political leaders have been trying to address since Teddy Roosevelt will be the subject of debate, but there will be millions of Americans who won't die because they can now go to the doctor instead of sitting on lethal health problems because they can't afford to deal with them.  That also means millions of people producing and consuming, which has the effect of expanding our economy.  It means millions fewer funerals and commensurately less suffering by the infirm and their families.  It means medical prevention of much of that suffering because the ACA requires preventive care in every health insurance policy, and I predict that by the 2014 elections, the vast majority of the American people will have noticed those benefits from the law...and one other thing as well.  Through all of the Republican histrionics and the political maelstrom they created with their carefully orchestrated opposition to the ACA and their concerted, assiduous efforts to enlist the support of the American electorate in their criticism of the law, the one thing that has been absent is a Republican alternative.  Actually, that isn't exactly true; the ACA was the Republican alternative when the Democrats tried to do what should have been done...what every other industrialized nation in the world has done: create a single payer, public healthcare system.  And obfuscation of that fact with plaints about the technical quality of a website won't cover that up come election time no matter how many little American flag pins they wear.

Your friend,

Mike