In 2013, America’s Supreme Court ruled on the health care reform law. They made a decision that had significant policy impact and is now shaping the presidential campaign.
Many observers waited to see if the court would overturn the Affordable Care Act. Those observers predicted that even if the court rolled back “ObamaCare,” it wouldn’t change the fact that the nation’s system of health care is broken.
At the time, it didn’t matter what SCOTUS decided. People would still get sick, healthcare costs would continue to rise, and far too many people would go without insurance. The federal budget is not sustainable and will wither if health care costs aren’t somehow brought under control.
Before getting Congress to pass the ACA six years ago, progressives used up a good deal of political capital. The result was not pretty, but it does provide a starting point to the path which will eventually create a sustainable “wellness system”.
Even Republicans recognized the then-current system was not sustainable as they spoke of a need to “replace.” During the intervening years, conservatives have continuously failed to be clear about what changes they want to be made.
What is clear is that both sides — conservatives and progressives — need to move beyond their respective status quo and find a way to forge a new deal. As Congress grows more partisan, a working agreement is seeming increasingly improbable before November.
Americans would be the winners if politicians on both sides of the issue would start working towards a resolution that everybody could live with; even if each side doesn’t get 100% of it’s “wish list” fulfilled.
Universal coverage has been the touchstone for progressives. Conservatives’ health policies have not been as heartfelt as total coverage is for progressives. Most observers feel that Republicans believe that people don’t have enough “skin in the game” and are wasting other people’s money.
Accepting the differences is essential as any other approach will oppose compromise. When, and if, a healthy agreement is reached, the first step should be to agree to implement universal coverage for catastrophic health care costs that would wipe out a family. Situations such as being in a car wreck or suffering cancer would require higher deductibles, but it would protect against people gaming the system economically.
Medicare is a large enough risk pool that helps to keep the per-person cost low. If the Medicare program was expanded, individuals could buy private insurance to cover the large deductible. “Gap insurance” could be provided by employers as well.
Both sides will respond to this idea with “yeah, buts” and “if only.” Still it is the approach that gives everyone the core of what they are seeking.
A health care reform should begin by acknowledging the big idea each side brings to the table. It is the vital first step for everyone.
Six-years later, people are still getting sick, and the system is still broken. Thinking should begin now about how actually to start fixing the problem as soon as the new occupant of 1600 Pennsylvania Avenue is selected.
Each side holds its ground with evangelical fervor and believes the other side lacks common sense, accountability, and patriotism.
It’s a wedge in which all of us are being squeezed.