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Obamacare’s conservative roots

It was about fifteen years ago, when working for a Republican member of Congress that I was asked to participate in a group that was looking at alternatives aimed at expanding healthcare coverage. This wasn’t a GOP issue, but in those days, many in the Republican Party in Congress (yes, really) were worried about the number of Americans that didn’t have healthcare. The single payer (government footing the bill) approach that had been proposed by President Clinton had been defeated, but many Republicans in Congress were still interested in private sector alternatives. This had a lot of promise and the approach that garnered the most interest was the concept of a government sponsored insurance marketplace. Each state would have its own marketplace and Americans who needed health care could sign up. Expanding Medicaid was also discussed. But key to every part of this proposal was the private sector.

Now, flash forward fifteen years and these long ago conservative ideas bear a surprising resemblance to what has been dubbed Obamacare.  There are details which no one would have anticipated in 1998. Obamacare is more sweeping and it has a mandatory requirement for healthcare insurance for all Americans. Other than that difference, which might have found its way into a GOP proposal if one had ever been made, the concept is just about the same. Obamacare, or more appropriately, the Affordable Healthcare Act, is not based on the government paying for your healthcare, and for that matter, save for minimum guidelines, even being directly involved in the care you receive.  It’s a private sector based program where participants pay premiums and private companies provide the insurance.

So, why is the Affordable Healthcare Act the target of such intense and even obsessive GOP opposition? 

What is so terrible about a system that’s based so strongly in the private sector?  It still defies easy explanation, but it’s become a GOP mantra and there isn’t a single Republican in Congress that supports it.

Rational discourse is almost impossible. The GOP controlled House voted to repeal the Act 41 times, that’s a record by the way, and various Republican controlled legislatures around the country have refused the necessary expansion of Medicaid needed to assure a broader enrollment by those who probably need it the most.

And that need hasn’t gone away. In Virginia 1.1 million people under the age of 65 don’t have health insurance. Nationally that figure is 57 million. That’s larger than the combined population of Texas, Florida, and Virginia. Often the uninsured are children, many more are self-employed Americans and others work for companies or individuals who can’t afford to provide health insurance.  You don’t have to be a social liberal to think that’s something is wrong with this picture. No other developed nation in the world has so many people as a percentage of the population who don’t have access to some kind of health insurance. During the 2009 Congressional debates over Obamacare, several Republican members of Congress, in voicing their opposition, said they opposed the President’s plan and would when the time is right, provide a better alternative. Sadly while their opposition is now legend, they have long since gone silent when it comes to offering any constructive alternatives or improvements.  In the meantime, the Affordable Health Care Act, this decidedly private sector based plan, even if by fits and starts, with a touch of mismanagement and incompetence added for good measure, is moving steadily towards implementation.

 

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