Has Obamacare failed? In one respect it has. It is not widely accepted by the American public as a beneficial program and therefore can be manipulated for political means. In an earlier blog post, I had taken umbrage with the Republicans’ newest refrain, “Obamacare is a complete failure”, because the statement is not based on data and facts and revolves around (1) justifying the Republicans’ hasty, politically-motivated repeal of Obamacare (PPACA) and (2) misdirecting blame for repeal actions onto Democrats and away from Republicans. In this Them versus Us political theater, it is akin to watching a playground brawl, but unfortunately, in this fight, the losers are the onlookers (the American people).
To get to the root of why Obamacare failed, one must look beyond partisan politics.
Where Obamacare Did NOT Fail
If you look at details of Obamacare (PPACA), you will find many good healthcare reform features. As a program, Obamacare (PPACA) has delivered on increased healthcare affordability, improved quality of care, and increased accessibility. These benefits are rather indisputable. Obamacare (PPACA) is projected to decrease the federal budget over the next 10 years and improve Medicare solvency through Medicare cost reductions! Obamacare (PPACA) has rewritten how Medicare providers are reimbursed. Our government is actually demanding that providers finally deliver quality, cost-effective care!
It is because of Obamacare’s individual reform initiatives that I do NOT consider the law a COMPLETE failure as the Republicans would like us to believe. Going forward past the Republicans’ Obamacare (PPACA) repeal, Americans should demand that any replacement healthcare reform legislation must include the many individual affordability and quality measures that keep costs down, quality up, and Medicare more solvent.
Why Obamacare Failed?
Unfortunately, the best parts of Obamacare (PPACA) were insufficient to save the law. Therefore, I do believe that Obamacare failed–but not for the reasons the present Republican-controlled Congress and President Donald Trump would like us to believe.
Let me explain.
- Obamacare failed from the start. It passed into law only because the Democrats controlled the White House, had a majority in the House of Representatives and a supermajority (60 votes) in the Senate in 2010 when Obamacare (PPACA) was enacted. The Republicans voted as a bloc against it. Over the next six years, Republicans in Congress have been single-minded in their quest to get rid of Obamacare (PPACA) with no stated replacement. Political partisanship and the Republican party’s vow to do everything in its power to repeal the healthcare reform law doomed Obamacare (PPACA). With the help of Republican gerrymandering efforts after the 2010 census, Republicans finally achieved legislative control last November and their long-suffering dream of repeal can finally become reality. Under the present political climate, the American people are doomed to healthcare “reform” that serves political agendas over what is best for the individual American and the nation.
- Obamacare failed because the Democrats thought they could deliver improved healthcare affordability and improved quality of care for the benefit of the individual American WITHIN our private, for-profit healthcare system. Making health care MORE affordable to individual Americans means that those who derive income and profits from health care will have to accept LESS than they are used to getting. The healthcare industry was not going to sit back and let this happen without a fight. Forcing doctors and hospitals to improve quality of care, become more efficient, and to be accountable for the money they receive was also not going to happen without a fight. What is best for the American people and what delivers the highest incomes and profits for the healthcare industry are mutually exclusive ends. Obamacare failed because it took into account the financial interests of the healthcare industry OVER those of the individual American.
- Obamacare failed because it did not properly engage the individual American in healthcare reform efforts. Contributions from patients and patient advocates are critical components of healthcare reform efforts. In Obamacare (PPACA), the individual American was marginalized and treated like a mere recipient of whatever healthcare reform came their way through healthcare industry and government agreements.
- Obamacare failed because the Obama administration did not effectively communicate the benefits and successes of the law to the general population. This allowed misinformation (like Obamacare has death panels and Obamacare is responsible for skyrocketing costs) and Republican propaganda to define the law in many Americans’ minds.
- Obamacare failed because it did not combine the interests of Americans into one group. For example, a “Medicare for All” healthcare reform initiative would have united the health care interests of ALL Americans into one group. If it had succeeded, it would have succeeded for everyone’s benefit. If it failed, then it would have failed for everyone equally. People who already have health insurance through an employer or some government program (like Medicare, Medicaid, or Veterans Health) are less likely to sympathize with those Americans who fall in the non-group health insurance market that Obamacare (PPACA) singled out for help. When Republicans want to get government out of health care and opine that people are responsible for securing their own health care, they do not mean all people. It is easy for Americans receiving employer-sponsored, Medicare, or Veterans health benefits to decry the government handouts being given on the Health Insurance Exchange as they enjoy their taxpayer-subsidized government handouts. For Americans who are against Obamacare (PPACA) because they are not part of the non-group health insurance market, then I would suggest they look at Pastor Martin Niemöller’s “First they came” poem for some thoughtful reflection.
- Obamacare failed because it let the self-serving complaints and actions of insurance companies and healthcare practitioners dictate the path of healthcare reform. When insurance companies threaten to leave parts of the Health Insurance Marketplace, our government should have signaled that this action has business repercussions (like omission from other more lucrative government-subsidized programs like Medicare Advantage). Our government should not respond by throwing taxpayer money at the complainers so that they can be guaranteed a level of income and profit they feel is their due.
- Obamacare failed because it pretends that the healthcare industry operates in a “free market” environment. It never has and never will. Both health insurance companies and healthcare provider businesses operate in “local” monopolies. Healthcare choice is limited, especially during medical emergencies and when affordability issues exist.
Why Obamacare Failed—Summary
As you can see above, Obamacare failed for “large-scale” reasons and not because of the “details” of the law’s function or outcome. Obamacare failed the moment the Republicans took control of the Presidency and both houses of Congress. Obamacare failed because it tried to function within our for-profit healthcare system that divides Americans into separate self-serving groups without common healthcare goals. When it oomes to health care, Americans need to stop dividing into Republican and Democratic camps–the individual political parties are to busy in Them versus Us political theater to put our interests first. Obamacare failed because the Democrats let misinformation define the public’s perception of the law. The Obama administration failed to communicate its benefits effectively. Obamacare failed because the financial losers in the law worked against affordability and quality measures every step of the way and our government let them get away with it. In the end, Obamacare failed because it put the financial interests of those who derive incomes and profits from health care AHEAD of the interests of the American people and our nation.