Reflections on the Affordable Care Act

The problems with Obamacare are well documented.  And they are real.  People have a right to be upset with the roll-out of the ACA.  But the fundamental premise that all Americans should have access to healthcare is being addressed, and it reflects a value for life and justice and generosity.

This article in the New York Times details some of the promises and ongoing problems of the ACA.

In some cases, those most vociferous on the problems are those that have done everything they can to derail it.  They are like a neighborhood bully who, having just rammed a stick through the spokes of a little boys bike says, "see I told you you would crash."

And then there are those who say, "we aren't opposed to access, we are just opposed to this approach."  But were were these people for the 20 or 30 years that this problem developed?  Obamacare addresses problems that were well documented and not being addressed.  Those problems could have been addressed in some other way in the years prior to Obama being elected.  If churches and non-profits should be at the forefront of this effort, why weren't they? Or why wasn't their effort adequate?  Why wasn't their enough of them?  Or did they do the best they could and the inadequacy of the effort prior to Obamacare just illustrates the limits of this approach?  (I'm not judging the efforts of those who were involved in non-profit healthcare prior to the ACA, I'm talking about the systemics of it.)

Finally there are criticisms of cost.  Several things are happening here.  First, American's are being asked to pay the real cost of their healthcare. (Or something closer to that number.)  In some cases, people were getting more than they were paying for.  Second, people are getting an insurance contract that is fundementally better than it was for many in the past.  The situation is similar to regulations on automobiles.  In some parts of the world, you can get a new car for substantially less than you can here in the States, but the workmanship, safety and efficiency all suffer.  You take your life in your hands driving these cars.   In the same way, people who use to have low-cost insurance plans, more than likely did not realize the extent of the exclusions and limitations on those plans.  In some cases they were paying for an insurance contract that was not worth the paper it was written on.  Having said this, this is one area I could see agreeing with conservatives.  Maybe American's should be free to buy bad insurance contracts.  I could see offering a super low-cost insurance contract that came with the equivalent of a Surgeon General's warning.  "Warning!  This contract does not comply with the requirements of the ACA and contains significant limitations, including..."

Having said all this, the problems at present are real.  Good intentions are not enough.  President Obama and his deputies need to deliver on the promises they made because those promises reflect a concern for life, and justice, and generosity.