On Sunday, I wrote a letter to the President, commiserating on his difficult week due to Ryancare and the recalcitrant Republicans. (I haven’t heard back yet. I should probably check my Twitter feed.) Because he was taken aback by how complicated health care policy turned out to be, I helpfully pointed out that there are only three general paths open to us:
- Government-funded health care for all.
- Repeal the Affordable Care Act (aka Obamacare for the 35-40% who did not realize they are the same) and return to the market approach pre-ACA.
- Keep the ACA in place.
So, I was interested this morning to read David Leonhardt’s column (below) in the not-so-failing-New York Times. He describes essentially the same three options and makes the case that the House and the Administration are unwittingly setting us on path #1.
The nearly universal rejection of the GOP bill made clear there is little interest in returning to the bad old days for those who don’t have employer-provided insurance: either pay through the nose (or whatever ailing body part applies) or just keep your fingers crossed and pray. So, scratch #2.
If my appeal to the President to support #1 somehow fails, in spite of his public promises of better health care for everyone, that will leave #3 by default. But, Leonhardt’s contention is that Tom Price has already begun taking steps to reverse and eliminate provisions of Obamacare. The thing is, though, the provisions that are most vulnerable are the more conservative aspects of the law– remember, the ACA’s gene pool has lots of GOP DNA– those governing the private insurance markets or exchanges. Those most protected from attack are the more liberal, namely those under Medicaid and its expansion.
I cited a 2016 Gallup survey indicating a majority of Americans favor some form of federally-funded universal health care. There are others. And when survey questions are purged of political rhetoric from either side, I believe the results are even more positive. I imagine a fictional phone survey illustrating this might sound something like this:
Question: Do you think we should get rid of the job-killing Obamacare?
Answer: Hell, yes!
Question: Do you think all Americans should have good quality health coverage they can afford?
Answer: Hell, yes!
So if voters like government-provided health care and Republicans are going to undermine private markets, what should Democrats do? When they are next in charge, they should expand government health care. -David Leonhardt
Sounds good. It’s just that, as John and Paul said, it’s a long and winding road.