Sorry for the length, but I didn't have time to write a short blog.

Friday, November 15, 2013

Health Care Hype Part 2: The Politics

We know that this program was no small issue.  Big programs never do run well to start.  The Bush Medicare Part D program did not go well either.  It was unpopular according to the polls.  Its rollout was rocky despite having two and half years to prepare.  It was opposed by Democrats, although not to the point of shutting down the government. It is now a very popular program.  According to Reuters even Social Security was no picnic. "Social Security, that now beloved centerpiece of the nation's social safety net, offers a case in point. Created in 1935, the program took 40 years just to include all working Americans." It was "blamed ...for a slowing economy and a swelling federal bureaucracy. Fierce congressional opposition led to the formation of a blue-ribbon panel to overhaul the measure. Medicare fared no better.  The elderly didn't like it, and it had to be sold door to door. No one knew if it would even work.  Giving birth to a big program is not easy.

Does it mean we shouldn't try?

In 2008, President Obama, who had as a part of his campaign promised to try and get Health Care reform, began to push for exactly what he promised.

Perhaps more than any other issue, the Affordable Care Act has created the division. When it was passed in 2009 by Democrats, no Republicans in either the House or the Senate voted for its passage. One Republican did not vote in the Senate as he was absent.    It should be noted that even though Republicans had been involved in the crafting of the Senate bill, they voted against what they had helped to build.  The passage gave rise to the Tea Party.  The ACA was passed without bipartisan support, but not without input. The Bush Medicare Part D was passed in much the same way except 16 Democrats did vote for the law.

Riding a wave of resentment by many red and purple states and in an off year election, the Senate lost its super majority and Republicans took control of the House. The loss was actually not just due to the ACA, but it contributed.  It was at this point that the Republicans became known as the "Party of No."  The battle over the health care culminated with a shutdown of the government and a threat to not raise the debt ceiling.  The majority of Republican Senators remained for the most part seeming more centrist Republicans.  There are a few that cater to the far right.  The House took over 40 votes to repeal the law.  These were votes that they knew could not be any more than a political statement. Their concerns about the cost, it turned out, was somewhat justified, but they spent so much time in opposing everything, the problems became more and more convoluted.

Here is the problem with both parties playing politics with the law.  It is a law not a policy or a bill which frequently appears in talking points.  It is a law.  Never in the history of the US has any Congress done so little.  It is the price of playing politics without governing.  What needs to happen is what should have happened is once the ACA was passed into law, the Republicans should have immediately began to work on making it work for them.  Opposition without a plan is not governing.   If one team stands at the goal line and refuses to play, they forfeit.  They don't get to complain about how the other team is playing.  It is time, dear congress, to share the sandbox and play together.

But it doesn't stop there.  With the dismal rollout of the website, we immediately had hearings.  That is a good thing.  Oversight is one of the things congress is supposed to do.  The question is that will the hearings actually offer up solutions or will they continue to be, as I have watched them, political grandstanding.  I remind you, that the shutdown cost by every economist's point of view at minimum 24 billion dollars. The outrage that started out was about a website that cost $70-$93 million dollars to build, not $500 million as has been reported on the right or the under $50 million as reported on the left. So the question became who is responsible for this disaster? Personally, if I contract someone to do work, I think they should do it.  If they fail, they don't get paid.  Unfortunately, government contracts don't work that way.  Perhaps, they should.  The fact remains the site was not ready.

Then came the loss of insurance by what will most likely turn out to be around seven million people.  The Republicans actually have a bill in the House which would prevent the loss of the insurance.  There is hope...or maybe not.

You see what it boils down to is how the bill is worded. Right now, as it stands, the actual bill doesn't just protect those folks who have cancelled plans because of the roll out.  It protects those who have junk plans, it allows insurance companies to continue selling plans that do not meet the basic needs, it allows insurance companies to deny because of pre-existing conditions, and it allows insurance companies to charge more for women.  In other words, it basically is another attempt to gut the ACA and not just protect those who might be damaged by it.  Still, all bills are negotiable, but will they negotiate.  Perhaps, they will negotiate the bill in the Senate which seems to prevent the loss of those insurance plans.  The only problem is that some of those plans were to go into the exchange which would help support the cost of the law. In other words, it could subtract money from a law that was essentially supposed to be paid for. The fact also remains that Obama is not running again and will veto any bill that undermines the law. It still requires a 2/3 majority to override a veto and that is not likely to happen.

News programs have their own politics to play as well.  I am not talking about Fox or MSNBC either.  We all know their agendas.  I am talking about mainstream media which continues only to report on the failure and not the success.  Why?  I have my suspicions that it goes back to that fear of appearing unbalanced.  The Republicans took such a hit during the shutdown in mainstream, now mainstream media outlets are feeling the pressure to report only the problems of the Democrat created program.  When the reports turn out to be inaccurate or based on partial leaked information, little is done to correct the error. It is also easier to report on the failure on either side because it guarantees better ratings and more sensational reporting.  Even the news now worries about the bottom line.

So far the playing of politics has outweighed governing and reporting.  Sad but true. So what does the law do? Surprisingly, little is covered in reporting and the White House has not  been successful at getting this information wide spread.  The opposition party has also done a lot to prevent the public from getting an acurate picture.  So in my last post, I want to try and list what the law is supposed to cover.