From a Reuters poll:
The survey results suggest that Republicans are convincing voters to reject Obama's reform even when they like much of what is in it, such as allowing children to stay on their parents' insurance until age 26.
Strong majorities favor most of what is in the law.
The American People want a health care system where people with pre-existing conditions are allowed to buy insurance for themselves and their families and not cut completely out of the market — a full 82 percent of people surveyed, in fact!
The American People want a health care system where people cannot be dropped from their policies when they become sick.
The American People want a health care system that is affordable for all Americans who need it.
Washington Post/CBS Poll, October, 2009,
before the well was poisoned by political rhetoric.
The American People want a health care system where they don't have lifetime caps placed on their coverage.
The American People want a health care system where routine physicals and checkups are covered without co-pays.
- The American People—72 percent of us—want a health care system that requires companies with more than 50 employees to provide insurance for them.
The American People want a health care system where they don't have to be afraid to lose their job, or leave a bad job, because it would mean they would no longer have health insurance coverage.
As a psychiatrist, I try to hear out my patients before I jump in. It’s a method I’ve used while waiting to hear the Supreme Court’s decision on the Affordable Care Act (ACA). Fortunately, reason prevailed and the Supreme Court confirmed the ACA was constitutional.
The ACA works. Take it from me, a doctor in Massachusetts. The nation is now on the cusp of a system basically identical to the one we have had in the Commonwealth for years. I'm proud of it, and as a dad of an "Obamacare" baby, I'm grateful for it.
But unbelievably, we still have to fight for it.
I’ve focused my career on treating people in “emerging adulthood,” ages 18 to 35, and the ACA has been invaluable to them. During this stage of life, individuals make attempts to set professional and personal goals. This is also the phase when many chronic psychiatric conditions manifest, re-challenging the sense of self and derailing first forays into adult endeavors. Keeping a job that comes with insurance can be one task too many as the cloud descends. Catastrophic care for an uninsured young person comes with a heavy personal toll and a high price for the rest of us who pay for it through our taxes.
For the last two years, thanks to the ACA, all young Americans can stay on their parents’ coverage until age 26. My patients have often used their parent’s insurance to begin with me; if by age 26 they don’t have a job with coverage, the MassConnector exchange helps them purchase a private plan. Moreover, insurance companies cannot exclude my patients due to psychiatric “pre-existing conditions.”
My profession prevents me from speaking specifically about any of my patients, but I can share a story of my own. Our daughter is a healthy and happy “Obamacare” baby. In the 32nd week, my wife presented to the hospital with excruciating pain. After repeated workup she was diagnosed with a pregnancy-related liver condition. Immediate delivery would restore my wife’s health but result in potentially life-long complications of prematurity for our child. Watchful care over five weeks would provide the best shot for both of them. In the end, my wife required more than one hospitalization before being induced at term.
We've been asked to provide some "tweetable" rebuttals to the Republican talking points about The Patient Protection and Affordable Care Act. Here they are:
For those concerned about calling the penalty for failure to become self-insured a "tax," it's important to keep in mind whom we're tarketing with this message: moderates who sometimes think like conservatives and sometimes think like liberals. (Hello all you moderates reading this! We love you!)
For moderates who have already decided this is a "tax," that's okay, we're just putting the "tax" aspect into perspective (and into our own frame!): Public Protection Is Paid For By The Public.
We accept every other "tax" to pay for public services that protect us from potential catastrophe so we don't have to hire our own private contractors to stand guard on our property. It is now the same with healthcare, only better! You actually can hire a private contractor to protect your person if you choose .. even if you don't have the means! And then you don't even have to contribute to the public pool!
But if you prefer to let the public pick up the responsibility for saving you from your "burning house" (your body) when you fall ill, well, the public will have the funds to provide you the necessary services to put out your body fire now. How cool is that? And responsible. Win/Win/Win
Following the auspicious decision of the United States Supreme Court to uphold the Patient Protection Act on the basis that a tax on individuals who don't purchase healthcare is Constitutional, Republican candidate for president, Mitt Romney had this to say:
"... ObamaCare raises taxes on the American people ... If you don't want the course that President Obama has put us on, if you want, instead, a course that the founders envisioned, then join me in [replacing President Obama]. ..."
Previously we reported that Scott Brown of Massachusetts is telling his constituents this, about taxes:
"... the wet blanket of high taxation and overregulation smothers everything that has made America the greatest country in the history of mankind."
John Adams, Founding Father and 2nd President; Thoughts on Government, 1776:
“Government is instituted for the common good; for the protection, safety, prosperity, and happiness of the people; and not for the profit, honor, or private interest of any one man, family, or class of men; therefore, the people alone have an incontestable, unalienable, and indefeasible right to institute government; and to reform, alter, or totally change the same, when their protection, safety, prosperity, and happiness require it.”
James Madison, Founding Father and 4th President; Federalist Papers, No. 57, February 19, 1788:
“The aim of every political constitution is, or ought to be, first to obtain for rulers men who possess most wisdom to discern, and most virtue to pursue, the common good of the society; and in the next place, to take the most effectual precautions for keeping them virtuous whilst they continue to hold their public trust.”
Alexander Hamilton, Founding Father and 1st Secretary of the Treasury, Citing David Hume, February 5, 1775:
“‘Political writers,’ says a celebrated author, ‘have established it as a maxim, that, in contriving any system of government, and fixing the several checks and controls of the constitution, every man ought to be supposed a knave, and to have no other end, in all his actions, but private interest. By this interest we must govern him, and by means of it make him co-operate to public good, notwithstanding his insatiable avarice and ambition. Without this we shall in vain boast of the advantages of any constitution, and shall find, in the end, that we have no security for our liberties, and possessions except the good-will of our rulers—that is, we should have no security at all.’”
Benjamin Franklin, Founding Father, American diplomat, statesman, and scientist; letter to Robert Morris, December 25, 1783:
"All the property that is necessary to a Man, for the Conservation of the Individual and the Propagation of the Species, is his natural Right, which none can justly deprive him of: But all Property superfluous to such purposes is the Property of the Publick, who, by their Laws, have created it, and who may therefore by other laws dispose of it, whenever the Welfare of the Publick shall demand such Disposition. He that does not like civil Society on these Terms, let him retire and live among Savages. He can have no right to the benefits of Society, who will not pay his Club towards the Support of it."
In 2007, a few months before I left the health insurance industry, I was tasked to write a "white paper" designed to help convince media folks and politicians that the problem of the uninsured wasn't much of a problem after all. If demographic data was sliced just so, I was expected to write, it was easy to conclude that many of the uninsured—some 46 million at the time—were that way by choice.
I was told to point out, for example, that a significant percentage of people without coverage were in families with annual incomes of $75,000 or more. The implication: That those folks were simply shirking their responsibilities. A crucial fact that I was not to disclose, of course, was that many Americans, including wealthy ones, couldn't buy coverage at any price because of pre-existing conditions. These are the "untouchables" as far as insurance companies are concerned. (That's my term, not the industry's. The underwriters prefer the term "uninsurable.")
I also was expected to stress that most young adults—who comprise the largest segment of the uninsured—had chosen to "go naked" because they felt invincible. They simply didn't want to pay good money for insurance because that cash could better be spent keeping the fridge stocked with Bud Light. To perpetuate that myth, we even came up with a catchy name for those twenty-somethings—the "young invincibles."
Our message to America: Don't feel sorry for those irresponsible bums, and by all means don't let Congress pass any new laws that would require insurers to cover them.
[Editor's Note: An internal investigation by the Bush Administration's Department of Health and Human Services in 2004 uncovered that the administrator of Medicare, Thomas Scully, threatened to fire the program's chief actuary, Richard S. Foster, if he revealed to Congress before they voted on it, that the cost of Medicare Part D would far exceed what the Bush Administration had been telling the public. It was deemed not to be illegal for Mr. Scully to withhold this critical piece of information from Congress, and Mr. Foster apparently had no legal authority to circumvent his boss to inform Congress directly. We do, however, find it immoral and an affront to Democracy to intentionally hide important fiscal data from us—the taxpayers—when we will be on the hook for those costs.]
Insurers and their buddies want private profits at our expense, not real reform.
If you think the idea of privatizing Medicare has gone away, that the health insurance industry has thrown in the towel on one of its biggest goals, there was fresh evidence last week that you would be wrong.
As I wrote more than a year ago — when Rep. Paul Ryan (R.-Wis.) unveiled his plan to replace the Medicare system with one that would essentially be run by private insurers — Democrats would be foolish to think that Ryan couldn’t get the public to support the concept. I noted then that insurers would be investing heavily in efforts to convince people that Ryan’s plan represented the only way to save the Medicare program from insolvency.
Should your ability to obtain and/or maintain your health insurance coverage be tied to whether or not you have a job? What happens if you’re sick, in the middle of treatment (maybe for a long-term medical issue such as diabetes or high blood pressure), and you’re handed the pink slip? Can you afford the inflated price of COBRA, which is based on the plan your employer chose for you and not what you might choose for yourself if you had the option? Will you have to go uninsured—and possibly even unmedicated—until you find another job?
Millions of Americans have faced these problems every single day for decades … until the passage of President Obama’s and the Democrats’ health care reform legislation; The Patient Protection and Affordable Care act. With this new law in place, employees are no longer restricted by the uncertainty of long-term employment for how they’ll manage their health care if their job goes belly up.
And do you know what that makes the Patient Protection Act, in addition to being about health care reform?
A bill about jobs!
How is The Patient Protection Act about jobs? Great question! And answered in part by Richard Kirsch in his recent column, “ObamaCare Isn't Just About Health Care – It's a Winning Jobs Issue”:
Massachusetts is the only state in the country where you don’t have to worry about losing your health insurance if you lose your job, and it will remain that way if Mitt Romney, the man who signed that Massachusetts bill into law, gets elected president. But if President Obama beats him, every state in the Union will join Massachusetts in 2014. …
Many of the independent voters who will determine the presidential election are confused by the Affordable Care Act, as its passage has [seemed to offer] no relief for a major worry in their lives: if they lose their job, they’ll lose their health insurance. Or maybe they’ve already been forced to take a job without health insurance, or are self-employed or out of work. …
We'll be hearing a lot from politicians this summer and fall about the urgency of dealing with Medicare spending, which will begin to rise sharply in the coming years as increasing numbers of the country's 75 million baby boomers turn 65.
If we're fortunate, some courageous candidates will call for renewed debate on a provision of the health care reform bill that had once enjoyed bipartisan support. The one that spineless Democrats decided had to be yanked when a certain former vice presidential nominee claimed, falsely, that it would create government-run "death panels."
Medicare expenditures now total more than half a trillion dollars annually, representing 15 percent of federal spending. The only programs to which the government devotes more dollars are Social Security and national defense, both of which consume 20 percent of yearly federal outlays.
People love the benefits of the Patient Protection Act.
It must be difficult to sustain a myth that is dying. It must be discouraging to see the cracks appearing, to try to patch them up, to strive to suppress the truth. It must be disheartening to be in conflict with your fellow myth-protectors, even as the conflict becomes public.
Yet that is just what is happening to the Republicans as they strive to sustain their myths about health care finance and the Patient Protection Act, which was signed in 2010. Republicans swept into Congress in the 2010 elections largely based on a campaign of repeal and replace the PPA. But what they didn’t acknowledge in campaigning, and what is coming home to roost now, is that replace is about medical care and health care finance, but repeal is solely about politics.
There are many layers to the Republican myths about health care and the Patient Protection Act, particularly that the PPA is unpopular and economically unsustainable. Both of these myths are based on purely political strategems rather than realities, ignoring the popular provisions, many of which have already gone into effect. Just a few are:
- Allowing dependents to remain on their parents' insurance plan until their 26th birthday
- Reduction, and later elimination of the “doughnut hole” in Medicare Part D
- Prohibition of excluding coverage for pre-existing conditions, or dropping policyholders who become sick
- Requiring insurance companies to use 80 percent or more of your premiums on actual heatlchare or return the difference.
And now, in 2012, the country waits for the Supreme Court challenge, which could result in nullification of parts of PPA.
And here the cracks begin to appear for the Republicans. News reports are appearing this week which indicate strife with the republican leadership in the House over how to proceed next. One faction recognizes that there are popular parts of the Patient Protection Act which are at risk, and that Republicans are vulnerable to criticism if these are not replaced. Meanwhile, the most conservative Republicans continue their monolithic opposition to any aspect of the PPA. The controversy has become public this week, including the flip-flops of Speaker John Boehner who initially said “We have better ideas on health care—lots of them. We have solutions, of course, for patients with pre-existing conditions and other challenges,” yet has failed to articulate any. Then later in the week, after criticism from the most conservative House members was exposed, in his weekly column Boehner stated “The President’s Health Care Law … Must Be Fully Repealed,” without mentioning its most popular provisions.