When President Obama signed the Affordable Care Act in 2010, supporters celebrated the first major victory in a century of fruitless struggle to create a universal health care system in the United States of America.
For liberals, the ACA was a triumph over what had seemed an impossible political barrier. To conservatives, “Obamacare” represented a dangerous overreach. For some patients, the law preserved life and financial security. To insurance companies, the law posed a significant threat to vast profits.
In a divided nation these varied reactions created uncertainty and, eventually, political and market instability.
Because of widespread political division, many states never even attempted to participate in the health insurance exchanges at the heart of the Affordable Care Act. Minnesota did, but the rollout was bumpy. All of this created a sense of uncertainty that prevented most Americans from embracing the new law, even though it benefits millions. Can you imagine going back to a system that denied care to people with pre-existing conditions?
A spike in consumer health care costs this year shattered confidence in Obamacare across the country. Health insurers backed away from popular, affordable plans, leaving people to shop for more expensive alternatives.
That’s how Donald Trump was elected president with a Republican Congress. That’s at least part of why Minnesota Republicans won legislative majorities in the House and Senate, including surprising gains here in Northern Minnesota.
But repealing Obamacare will only transfer the current cost problems around the system, regressing to the very woes that caused the law to be written in the first place. The repeal process could hurl millions off of affordable health coverage. And we can see it happening already, even though the ACA is still on the books.
For instance, negotiations between Blue Cross-Blue Shield and the Fairview hospital system could affect thousands of people in our region. BCBS is the state’s largest health insurer, while Fairview operates the Range Regional Medical Center here in Hibbing, among many others. Without a settlement, Fairview would become an “out-of-network” provider for Blue Cross customers, adding significant expense for care at those facilities. Some might be able to switch clinics (although they would lose their family doctors), but in Hibbing it’s pretty hard to switch emergency rooms.
It wasn’t just Fairview. Across Northern Minnesota, Blue Cross Blue Shield announced this month it would no longer cover care at small clinics and speciality medical service centers in the region.
People who were never affected by Obamacare now feel the affects of a private industry trying to assert control over the profitability of health care.
Our private, for-profit insurance system is simply incapable of serving everyone. It works great for the healthy unlikely to make claims, or those who negotiate for expensive plans though their employers. But for-profit insurance constantly fails the chronically sick, people in non-traditional employement, and the working poor. Industrialized countries all over the world find efficient, effective ways to deliver care to these populations. Why can’t we?
The answer is that it’s not easy to blow up private insurance when it covers almost 60 percent of the population. Especially, when politicians and the insurance industry have successfully pitted Americans against each other.
As long as the healthy and profitable are the majority (and let’s hope they are!), the private sector will not address the continuing crisis facing the sick, very young, elderly, poor and — the worst wretches of all — the self-employed.
Health care coverage must be detached from our place of employment. We must approach health care as a right for all people, to be paid for by all patients based on means, and all employers based on size. We all pay our own way and a little bit more for those who can’t pay as much or at all.
If you can’t fathom the idea of a publicly-delivered system, then consider how the United States can better facilitate a private one. The benefits aren’t only health care coverage, but new financial freedoms for businesses and entrepreneurs.
We’re already paying more for health care — in taxes, insurance, fees and costs — than any other industrialized nation in the world — by a lot. That was true before Obamacare.
Repeal of our current law will disappoint voters, because so much money goes into a system that seems hellbent on excluding people.
The most depressing thing to me personally is all this has been written before, not that long ago. Here we are doing it all over again. Only, this time, our leaders seem to have no real plan whatsoever. We’ll “find out.”
The question isn’t whether we should retain or repeal Obamacare. The question should be how we do better.
Aaron J. Brown is an author and college instructor from northern Minnesota’s Iron Range. He writes the blog MinnesotaBrown.com and hosts the Great Northern Radio Show on Northern Community Radio. This piece first appeared in the Sunday, Nov. 27, 2016 edition of the Hibbing Daily Tribune.