No Lifeline for an Obamacare Replacement

pic_0114New Senate minority leader Chuck Schumer said if congressional Republicans, in conjunction with President-elect Donald Trump’s exhortations, vote to repeal Obamacare, Democrats won’t participate in crafting a so-called “replacement.”

“If they repeal without a replacement, they will own it,” Schumer told The Washington Post. “Democrats will not then step up to the plate and come up with a half-baked solution that we will partially own. It’s all theirs.”

I agree wholeheartedly with Schumer’s approach and urge Democrats to stick to that plan, instead of capitulating to the Republicans and trying to modify or soften whatever plan the GOP hatches once health care coverage is thrown into uncertainty, or worse, chaos, and millions potentially suffer.

To do so would be akin to the Democrats turning over ownership of a marginally inhabitable building to the Republicans, who level it with a wrecking ball and wander aimlessly through the rubble, only to have the Democrats return with hard hats and shovels and mortar to salvage the wreckage, with the promise, “We’ll help you rebuild from these ruins, but we gotta warn ya, dollars to donuts, this salvage job will be condemned.”

As I advised Democrats previously, Do The Opposite, like Seinfeld’s George Costanza. The GOP will expect Democrats to come running to save the day for people who may be losers in the Obamacare tug-of-war. Then they will become complicit in whatever is enacted. Then they can be blamed for screwing up whatever plan Republicans wanted to enact in the first place, which of course will be the reason said GOP plan isn’t working as effectively as touted. Don’t do it. Let the GOP plan ride; measure the results.

I argued in my political memoir detailing my campaign for Maryland state political office, Don’t Knock, He’s Dead: A Longshot Candidate Gets Schooled in the Unseemly Underbelly of American Campaign Politics, that the Affordable Care Act (Obamacare) is largely a piece of legislative manure that leaves the foxes – the health insurance industry – guarding the henhouse, but that it’s certainly an improvement and does a number of good things for people who need health insurance.

“Obamacare is a Rubik’s Cube—lots of turning, spinning, head-scratching, reverses, glitches, bad moves and confusion,” I wrote in Don’t Knock, He’s Dead. “Historic and groundbreaking yet torturously overwrought, the law certainly does some good, but adds yet another layer of preposterous bureaucracy and complexity and supposed ‘consumer choice,’ which really is massive consumer overload and confusion, onto a preexisting byzantine miscreation, and will become another cement-hardened convention impossible to undo.”

My campaign for Maryland state delegate in 2014 was largely based on advocating for accessible, affordable health care for all – universal health care, single-payer health care, Medicare for All – whatever you want to label it. My call was for a nonprofit system that covered everyone, regardless of employment status or personal wealth, one that constituted a right rather than a privilege, and that reduced or eliminated the corporate profit motive. It was for a more humane system that would put Maryland – and ideally, ultimately, the rest of the nation – in line with other democratic, industrialized nations that provide all their citizens essential health care at about half the cost or less per person than the U.S., and achieve better health outcomes on many common measures.

Numerous grassroots and health care organizations continue advocating for such a system, and several state legislatures have made attempts to establish one. But entrenched, opposing, big-money interests are strong – hence, Obamacare was the best we could get.

Wendell Potter, a health insurance public relations executive turned industry critic, nailed the dynamic in his insider tell-all book Deadly Spin, as I quoted in Don’t Knock, He’s Dead. “The health insurance industry is dominated by a cartel of large, for-profit corporations…[T]he top priority…is to ‘enhance shareholder value.’ When that’s your top priority, you are motivated more by the obligation to meet Wall Street’s relentless profit expectations than by the obligation to meet the medical needs of your policyholders.”

I still believe a single-payer system is the only real, equitable, sustainable solution to the ongoing health care mess. Perhaps a failed “replacement plan” full of tired old ideas like Medical Savings Accounts and insurance sold across state lines and free market competition that can be laid squarely at the feet of Republicans could stoke a revival of a single-payer revolution.

Of course, that will bring out the critics and naysayers who will charge that single-payer is an un-American, “socialist” system, an asinine argument. What is Medicare? What is Medicaid? What is Social Security? Socialistic! For that matter, what are our police forces and fire departments and public schools and state universities? Socialistic! We all contribute toward them because these systems and institutions are deemed to be beneficial to society collectively. American rugged individualism is a great concept. But in some aspects, like outstanding health care and the overall health of our citizenry, we are all in this together, and will be stronger as a nation for that.

So, as Schumer said, no lifeline. There could be regression and pain in the short-term, but maybe it could turn the tide for the long-term.

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