15 November 2013

Ironies and Dangers of the Fiasco of Health Care Rollout

The fiasco of the rollout of the Affordable Care Act is fraught with ironies. The Republicans, of course, are gleeful: they blame the president and Democrats for problems which are, admittedly, largely the result of inexcusable kludginess, mainly on the part of government contractors. And any administration must take the blame for that. But that's the first irony: the kludgy awfulness of the implementation (website, etc.) is largely because of the Right Wing-forced contractor market system enforced on our system of government, which practically guarantees outrageous overrun of costs and woeful inefficiency.

But the even greater irony, which is so galling to Progressive Democrats like myself, is that the failures of the health care reform system itself-- its complexity, its lack of fundamental fairness, its inefficiency, its excessive profits to insurers (still there from the old system)-- these things are the result of the fact that in order to achieve any sort of reform of a badly broken system, Democrats, and in particular the Obama administration, chose to adopt the Republicans' proposed solution: namely market based reform, even though for 35 years before that Democrats had by and large been saying that the way to reform health care was a government insurance program, something like Medicare for All, because ... exactly what we see happening... the Republican idea of a market reform system would be very complicated, very expensive, and not very effective at achieving the goal of universal health care at reduced cost. But we went along, only to have them meet success in achieving their stated goal with betrayal and enmity: they turned against their own idea, and wedded Democrats to its failures.

So here we are. The party that has done absolutely nothing, literally nothing, to address America's problems in the last six years now points the finger at Democrats for the failure of their idea, and, here's the worst part. It's working for them. Already the debacle of the shutdown they caused is all but forgotten, and the "generic" lead that made Democrats just a few weeks ago think it might just be possible to retake the House next year has all but evaporated.

These problems are not unfixable, and the Republicans are likely to do themselves plenty more damage early next year when the fiscal can-kick expires, but Democrats need to remain as united as possible, and the administration has to perform whatever Herculean tasks are needed to get this damn thing working, because we do know from history (Massachusetts) and from what is happening on the state level (California, New Hampshire, Vermont, for example), that once people can buy regulated health insurance, which, however bad, is always better than what the insurance industry offers on its own, especially in the individual market, they like it. And from success comes success, politically. So I sure as hell hope they're doing whatever it's gonna take to make this thing work as soon as humanly possible, because the fate of Democratic governance hangs in the balance. That's for sure.

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