This morning I watched the president’s speech in Boston yesterday. It felt like a campaign rally. At first, it seemed off-key, although the combination with Sebelius’ dogged endurance of the deserved brickbats by Republican members was, I’d say, a relatively good day for the White House, which is not saying much these days.
But as I listened to the speech, it seemed to me that the president made some points that really do need to be re-made. Nothing makes me madder than a technical problem I cannot understand, let alone solve. Last night, as we were thrashing out various technical issues for the Dish, I got real testy and frustrated. So I can perfectly understand not just the frustration but the rage at healthcare.gov. I can also see why the cancellation notices for individual insurance policies because they don’t cover enough and perpetuate the free-rider problem would be maddening. Obama’s relentless repetition that if you like your plan, you can keep it, period, was bullshit, and he must have known it at the back of his mind. Trust is a very dangerous thing for a president to risk. And he deserves some shellacking for it.
At the same time, look. I’m running a small business now – and we are talking to our insurance broker about what the ACA means for us. We’re not panicking, and we may well pay less. As we go through the process, I’m going to keep you informed as to what happens. As for me, with the mother of all pre-existing conditions, I cannot express how relieved I am that having HIV will no longer carry the risk of bankrupting me, if I have to seek insurance one day on the individual market. I wonder if I would have risked going independent with the Dish without the security that, even if it all fell apart, I wouldn’t be left to the ravages of the individual market for insurance for those with chronic conditions. At a small level, it gave me some sense of security to take an entrepreneurial risk. It may be a huge boon for business for people to switch jobs or try new ventures knowing that the health insurance caveat against risk-taking is now gone.
But I’m extremely lucky and privileged. How can you put a price on the relief of struggling middle-class families whose current insurance policies can be abruptly canceled, or amended with little recourse, or those who simply cannot afford insurance at all and face not just the pain of sickness but bankruptcy as well?
The ACA also offers a real chance to bend the cost curve in healthcare. At its worst, it’s a start – and something that can be worked on as time goes by. Every law can be amended. But what the ACA does at its core is bring everyone into the same boat – and a bigger pool is always better for insurance purposes. That’s both a moral and a fiscal gain. I can see how it could be amended. At some point, we might be able to get rid of the employer subsidies and expand the individual market considerably. Or we could move to a single payer. But it will force all of us to grapple with this question more directly and more practically. If you don’t see it as a panacea but as a baseline for the future, it looks better.
What I’m saying, I guess, is that we should not miss the forest for a few rotten trees. If they get the website working, if more people get to sign up, if premiums remain below what was expected … then we will have a very different debate than we are having right now. And look: this is the law. It’s not a project we can simply ignore. But it is a project we should see in perspective – which our current partisan brouhaha is obscuring.
(Photo: President Obama spoke at Faneuil Hall to bolster support for his national health care law in Boston on October 30, 2013. Cathey Park, of Cambridge, displayed a cast on her broken wrist with ‘I (heart) Obamacare’ written on it. When U.S. President Barack Obama finished his speech, he shook hands with the crowd and signed her cast, next to the heart. By Yoon S. Byun/The Boston Globe via Getty Images.)