On Politics: Healthcare in America

Obamacare was recently saved by the surprise opinion of arch conservative Chief Justice John Roberts. Regardless of his hidden reasons for saving Obamacare, he really did Americans a favor — not that any one would know it by listening to Republican rhetoric.

I do not disagree with the Republicans that Obamacare could be greatly improved. Personally, I would like to see Medicare made universal for all Americans. That’s my solution to the problem of healthcare for all Americans.

The Republican solution is…. That’s really the question voters should be asking of every Republican. It is not enough to say repeal and replace; there needs to be clear understanding of what the replacement will be. Experience in American politics dictates that repeal will result in no replacement because there is no consensus, even within the Republican party, on what to do. Unlike Democrats who can say “perhaps Obamacare is flawed but we at least addressed a problem and came up with a plan,” the Republicans can only say that Obamacare is flawed.

I have asked my congressperson, who is now Republican as a result of redistricting, to outline for me in detail precisely what she proposes to replace Obamacare with. “How can I evaluate,” I asked, “the merits and demerits of Obamacare versus the Republican plan without knowing the details of the Republican plan other than that once Obamacare is repealed, leaving me with nothing, Republicans might come up with a solution of their own?”

The problem with asking a question like that of a politician is that they do not know how to respond, so they don’t respond. Politicians want to talk in soundbites, in platitudes, not in substance, and voters too readily are willing to let politicians do that. Sadly, so are partisan newspapers. I keep waiting for Fox News to ask that question. They can tell me what they think is wrong with Obamacare, which largely boils down to an unwillingness to see fellow Americans receive medical care because these pundits have goldplated policies, but not one is willing to do the newsperson’s job and ask “replace with what?”

American’s are too willing to accept the Mitch McConnell approach: it doesn’t matter as long as it isn’t Obama(care). It is better to have no insurance than to have Obamacare. McConnell and fellow Republicans make it difficult to be proud to be an American because they make it clear that, to them, “real” Americans are anti-Obama and those who are pro-Obama, or at least not anti-Obama, are not “real” Americans.

There has been discussion in recent months about the benefits of Obamacare, but there are at least two benefits that are not often mentioned but which I think are key: first, the self-employed will finally be able to have medical coverage at a reasonable cost; second, that no American will be stuck in a job they hate just so they can have medical benefits for themselves and their families — medical insurance will be portable. This latter benefit will encourage and permit Americans to become entrepreneurs and fuel the next workplace revolution.

The Republican failure to offer an alternative plan to Obamacare has resulted in a “debate” that is really not a debate and that is full of misleading rhetoric. Consider the exchanges that Obamacare requires. The exchanges are central locations that individuals can visit to see what competing insurance plans are offered by private insurers and at what price. This will promote competitiveness in the private marketplace on both price and coverage. What the exchanges do is simply make information available in an easy-to-find-and-use location. The services are still private industry services, not public services, although a public option will be offered.

Doesn’t this sound like a Republican idea? It does to me. The complaint is that private insurers will have to compete with the government. Well, hasn’t the Republican argument always been that private enterprise can do any job cheaper and better than the government? So why the sudden shift? Perhaps the Republican argument is toothless and this will expose too many voters to the toothlessness of the Republican vision.

Or perhaps the problem is that if Obamacare actually works and makes people freer it will also mean that employers can no longer rely on mediocre benefits to keep employees and will have to pay higher wages; or that it will increase competition among employers for employees, which Republican business contributors will not like; or perhaps it will result in more people voting Democrat because the Democrats did something to solve a major societal problem and the Republicans were simply obstructionist.

The Republicans can combat this by coming forward with their alternative plan to provide healthcare coverage for Americans, especially for the 60+ million Americans who are currently uninsured. I, for one, am open to an alternative plan. If it is a better plan than Obamacare, then I certainly would urge my congressperson to support repeal and replace; but I assure you that I will never support repeal without a replacement in hand.

The time has come when Republicans need to have a true dialog with the American voter and disclose what their alternative vision is in detail. I understand that this is something that is contrary to the way Republicans have campaigned for decades — I think the last Republican to attempt such a dialog was Barry Goldwater and I suspect his overwhelming defeat by Lyndon Johnson led Republicans to take the vague road — but the time has come when that dialog should be resurrected.