Letter 2 America for January 24, 2014

Dear America,

After World War II, Winston Churchill was addressing Parliament when he said, "Democracy is the worst form of government, except for all those others that have been tried from time to time."  That sentiment seems appropriate with regard to the Affordable Care Act (the ACA); it is the worst health care system, except for what has gone before it in this country.  The facts seem to elude the conservative masses, but the statistics are an ineluctable demonstration of that principle.  We had, before the ACA, the most expensive health care system in the world by a third, and that continues to be the case as the incomes of medical specialists climb at a pace that dwarfs inflation.  And while conservatives tout that system as the best quality health care in the world, the statistics on infant mortality, morbidity and death from serious disease, rates of obesity and virtually every other measure belie that notion, and actually render belief in it inconceivable.  Yet, conservatives, both those in government who spread their dogma on the subject as if it were holy gospel and those whose politics make those government agents believable despite the deracination of their reasoning from reality, refuse to give up the fight to bring the ACA down--and not incidentally its progenitor, President Obama--while proposing nothing in its place.  I heard someone arguing that the fact that only 11% of those now enrolled for health insurance under the ACA--actually that statistic is only one finding among several on this point ranging up into percentages in the high twenties, as the proponent of the 11% figure admitted when confronted--were lacking insurance before the law was enacted.  But even if that is true, it means that somewhere around 250,000 people (and if the higher percentages are correct that figure is more like 700,000) can get the health care they need to keep body and soul together rather than dieing of diseases that can be cured if the victim can just afford it.  If you are one of those people, you are quite glad for the ACA, so it is no trivial accomplishment even if the conservatives' preferred figures are true...presuming that they mean something in the first place.  But I would set all that aside if I were debating the subject and ask this question, which I have asked countless times before, quite possibly to the annoyance of anyone who reads these letters: "What do you have in mind to address the problem of people dieing for lack of money in the richest country in the world?"

I will admit that I too oppose Obamacare.  I never liked it, and frankly, it always sounded more Republican than Democratic...more conservative than progressive...to me.  When Mitt Romney sponsored the idea in Massachusetts, that's exactly what I thought and my mind has not changed.  But then came 2010 and the fight over universal health care first proposed as a "single payer system" like those employed in all of the rest of the industrialized nations.  Those systems resulted in better outcomes...virtually all of them...than we were getting here in the United States.  But an unholy alliance of Republicans and conservative, Blue Dog Democrats scuttled that idea, and the result was the ACA, which those same conservatives now call Obamacare, though only in derision.  We have what I oppose, but what else is there in the offing.  To put it simply, Obamacare is the half loaf, or maybe even the quarter loaf, that is better than nothing, though nowhere near the full loaf that those in favor of a single payer system envision for our American future.  Add to all this the fact that, not only did Mitt Romney get the first version of insurance reform passed in Massachusetts, embracing the term Romneycare, but the origins of the idea was in the opposition to a single payer system that was evolving as the preferred plan when Hillary Clinton was heading a commission during the first Clinton administration to determine how the nation could best proceed on the issue of universal health care.  Insurance reform...Obamacare, or the ACA if you prefer...was the conservative scheme for business to make money out of everyone getting the medical attention he needs, and frankly, it still is.  That's why I oppose it, but why do conservatives oppose it.  It is a somewhat nefarious conflation of government serving the people with government promoting business, the latter being the holy grail of Republicanism.  But despite my aversion to such policy, I must admit that I see it as better than nothing.  So, why is it that the Republicans, whose dogma is the guiding principle of the scheme, oppose it so vociferously.  Why do they vituperate President Obama for this feat of heavy political lifting that presidents have been attempting to accomplish for a hundred years...even Republicans like Richard Nixon.

The answer is simple: politics.  Republicans have been out of power for a long time, and now they are out of favor with all but their hardest baked supporters.  My guess is that the next election will be a rout in favor of the Democrats because despite their efforts to color it otherwise, the Republicans are still an obstructive force in Washington, and that becomes more apparent every day.  Now they have attached the ACA's defunding to some extent to the extension of unemployment benefits, and that's a couple of million votes right there.  They still haven't passed a farm bill, which has effects not just on food stamp recipients, but on farmers...agribusiness...as well.  And the internecine force of the Tea Party has not abated, and won't until the voters dispatch them to whence they came, the first opportunity for doing so coming up in November.  The Republicans showed an appreciation of that fact when they passed the current budget plan over their objections, but as soon as they had done the pragmatic thing in that regard, they reverted to the inflammatory disputation of everything Democratic that got them into this mess.  When will they ever learn.

Your friend,

Mike