Affordable Care Act, Surrogate for American Politic Differences?

One might think that the Affordable Care Act was akin to revoking the Bill of Rights.  The vehement rhetoric one hears makes one immediately think there is a message not being heard or understood.  How could so many Republicans be so convinced that the Affordable Care Act is so bad, so dangerous, and so wrong, while Democrats feel ACA is an essential reform for America’s healthcare delivery system?

Because the GOP has been so insistent, so long, I have begun to try and understand their fundamental reasoning.  “Train wreck, jobs killer, and anti-American” are certainly not the makings of a fundamental opposition.  I also do not think that the GOP is primarily motivated by sinister and mean spirited urges.  I keep digging, even past those who are clearly pandering to what they think their constituents want.

How about this.   Conservatives hold that most government spending, and social programs in particular, no matter how worthy the cause, are financially unsustainable and worse, uncontainable (they only lead to the need to spend even more on them).  Hmmm.

Conservatives see these spending programs as a crutch rather than a real helping hand.  Spending programs merely extend a social ill rather than eliminating it.  Conservatives subscribe to the notion of “pulling oneself up by the bootstraps”.  If Americans are encouraged to accept a “handout”, Conservatives reason, they will lose their gumption, ingenuity, and drive, conservatives think.

Government spending (read entitlements) programs have two main deficiencies.  (1) These programs (read entitlements) have no “sunset” component.  These program’s nature is they will run to eternity and the only changes envisioned would be further liberalization.  (2) The sum total of government spending (read entitlements) are underfunded (that is they cost more than we are willing to pay).  Medicare and Medicaid, for example, already account for the major portion of the yearly deficit, and there are no signs that this will change.  Conservatives feel it is absolute lunacy to allow these deficits to continue.

Hmmm.

So, how do these fundamental beliefs line up with GOP opposition to the Affordable Care Act?

ACA does increases enrollment Medicaid (and there for Medicaid costs), and does run the risk of raising all other private insurance rates by including previously uninsured in the insurance pools,  There is nothing in the ACA that would suggest that the demand for Medicaid will drop.  Consequently, it could be concluded that GOP opposition to ACA is ideological and simply an expressing a more basic opposition to unlimited government spending.

Hmmm.

On the other side of this coin lies why were government spending programs and ACA in particular adopted in the first place.  ACA is designed to fix to gaping holes in the US healthcare delivery system, the potential to exclude basic medicare care for some residents on the basis of wellness (pre-existing conditions), and insufficient attention to preventive care (which translates into treating really sick people at higher costs).  (Compared to over 2 dozen other modern industrial countries, the US healthcare delivery system costs twice as much and delivers only mediocre outcomes to the average American.  That there needed to be reform to the American model should not be in question.  Why not be arguing over how to fix it?)

But here is where a listening Progressive side could have done better.  There is no need to surrender the principle that all Americans deserve access to affordable basic healthcare.  Rather there needs to be a way to fund coverage and a way to reduce the cost of coverage.  Why should tax payers be asked to increase their tax burden when the US is already spending more than twice as much as the rest of the world?

Other countries, such as Germany, France, Italy, Canada, and Japan mainly fund healthcare through some form of a national sales tax.  While this is consumption based, and could be viewed as regressive, virtually everyone would then have a stake in the healthcare game.  Such a system would eliminate the need for either Medicare or Medicaid, and would eliminate the national need to borrow by balancing the budget.

Maybe a “new consumption tax” might also violate some other core principle.  I just wonder what they are thinking when you have a straight forward chance to eliminate two huge, unending entitlement programs and they cannot embrace a different and fairer healthcare delivery system?

This apparent lack of logic makes me think that to Conservatives, the ACA is a surrogate for the everyday political fight.

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