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President Obama
(Reuters
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Yes, it was a
flawed compromise. But to achieve universal, humane healthcare for all, we
first need effective implementation of the ACA.
The Affordable
Care Act began life as a compromise—a complicated and frustrating political
calculation—and it is never easy to defend a compromise. But failure to do so
at this critical stage in the rollout of the ACA will create a crisis not just
for healthcare in America but for the notion that government can and should
repair the breaches that threaten civil and humane society.
When President
Obama and Democratic leaders in Congress decided to expend political capital to
address the absolute failure of the free market to provide affordable, readily
available healthcare to tens of millions of working Americans, they took off
the table the right response to the crisis—a single-payer, “Medicare for All” system.
They believed
the best reform was politically unachievable, so they cobbled together a hybrid
of public regulation and private insurance that has come back to haunt them.
Now, as the peddlers of junk insurance game the system to defend their profiteering,
and as Republicans gleefully spin incoherent “told you so” fantasies, some
Democrats are going weak in the knees. Thirty-nine of them in the House simply
threw in with the Republicans on November 15 to back an attack on the basic
premises of “Obamacare.”
There is no
question that the drafting and design of the Affordable Care Act was flawed
(the administration should not have sacrificed the public option, for example).
Nor is there any question that the rollout of the government ACA website was
disastrous.
These problems,
of course, must be addressed. But the “fixes” now on offer from Congressional
Republicans are, at best, a mangling of the initial plan and, at worst, acts of
sabotage that will fatally undermine the promise of quality coverage for the
uninsured and underinsured.
These are the
stakes. And they are too high for progressives simply to follow cues from a
shaken administration and a divided Democratic caucus. Progressives must step
in not only as ardent advocates for better implementation of the ACA—a
relatively easy task—but also for structural repairs to the law that will make
it a better bridge to the truly universal, truly humane and truly functional
healthcare system that America needs.
Step one is
triage: the government must get websites and outreach initiatives up to speed.
Step two is vigorous defense against the dark arts of Republicans who have
wedded their party’s limited future to the project of destroying not just
Obamacare but Obama. A divided and dysfunctional Democratic response will only
strengthen the hand of the Republicans in 2014.
So unity is
called for—but it must be a thinking unity. Progressives must prod the
administration and Democratic leaders to fight harder and smarter. It’s time to
go on offense against Republican governors who have refused to expand Medicaid,
shamefully shutting 5 million Americans out of coverage (see Richard Kim).
It’s time to
start talking up the expansion of public health programs that are part of the
broader ACA agenda, and that will mend a torn safety net in communities across
the country. And it’s time to embrace and encourage speedy application of new
regulations that will rein in abusive and recalcitrant insurance companies.
Healthcare is a
right, and reforming America’s broken system is a social and economic
necessity. The Affordable Care Act is a modest reform, with flaws rooted in the
compromises that shaped it. But it is not a compromise to fight for the ACA’s
effective implementation. Indeed, winning that fight will make future reforms
all the more possible.
Source: http://www.thenation.com
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