These days when Mitt Romney struggles to differentiate himself from President Obama on the similarity between the healthcare reform he worked with Democratic Party legislators to introduce in Massachusetts as governor, and Obama’s Patient Care and Affordable Care Act (ACA), he insists that each state must ultimately be responsible for its own system; in other words the status quo.
What that means in practical terms is that more than 27% of Texans who are uninsured at any given moment can expect no help from a President Mitt Romney; nor 23.5% of Mississippians or the almost 23% of Floridians who have no health insurance. Meanwhile, in the state of Massachusetts which has a system very like the one Obama wishes to introduce nationwide, less than 5% of residents lack insurance.
Maybe we should take comfort in the fact that most of the people who will end up on the short end of a Romney presidency and GOP control of congress live in red states; but somehow I don’t.
The very real benefits of the ACA go far beyond covering most of America’s medically uninsured. Under Romney’s status quo, individuals with pre-existing conditions may be denied insurance or charged exorbitant and unaffordable premiums; out of pocket medical expenses not covered by a skimpy insurance plan (which includes millions of Americans) are not capped so anyone can find themselves with huge medical bills following major surgery, for example, or if they suffer from a chronic condition that requires regular medical care and expensive drugs. Many plans offered now are insurance in name only, so thin is the coverage and so high the deductibles and caps. The ACA will change all of that; and it mandates a decent minimum level of insurance coverage that will likely keep many Americans out of bankruptcy court if they get sick.
And yet despite this signal achievement, Obama has failed to convince most Americans that the ACA is a worthwhile reform. Polls show that a majority like the individual bits but do not embrace the law as a whole. It’s perplexing, although public hostility to the individual mandate is part of the explanation which, if nothing else, appears to indicate that many Americans don’t quite get the whole concept of insurance.
Still, Obama himself bears much of the responsibility. For someone who is both highly intelligent and articulate, Obama has failed dismally to use the bully pulpit effectively to explain the benefits of the ACA and why an individual mandate is necessary.
Don’t get me wrong, the private medical insurance system in America is a disastrous failure and I wish we were reforming it out of existence. It’s a system that excludes 40 or 50 million people altogether causing serious health consequences for many of them, and higher premiums for the rest of us when they seek emergency care; millions of others who do have insurance are landed with enormous out-of-pocket medical expenses because of inadequate coverage. It is also a significant financial drag on those US employers who offer health insurance to their employees, a burden not imposed on firms in most other industrialized countries. The fact is, if you happen to work for a Microsoft or you’re among the 1%, you have or can afford gold-plated health care with no worries; if not, watch out.
In short, and having grown up in the United Kingdom, I would much rather we had real socialized medicine in this country (which is way more efficient than the privately-run mess in America) rather than the fantasy version that right-wing idiots label the ACA. Nevertheless, the ACA is a giant step in the right direction in its effort to impose meaningful and useful reform on the private health insurance industry. It isn’t Switzerland but it’s a good start. Too bad most Americans don’t realize it.