The Republicans' healthcare debacle
Former US President Barack Obama is gone, but his historic achievement Obamacare lives on.
The Republican Party is in complete control today—it has a majority in both the US Senate and House and has a Republican president, yet it fell flat on its face in its effort to repeal Obama's ambitious attempt to make healthcare accessible to most US citizens.
The US House had already passed a law to repeal and replace Obama's healthcare law, which Republicans have been promising to dump for seven long years. Republicans rode on public rage to win elections, but when push came to shove, they could not cross the finish line.
The US healthcare is devilishly complicated, so it's impossible to give a succinct summary of how it works. Pre-Obama, US healthcare was a scandal. The United States is the only industrialised nation which doesn't offer healthcare to all its citizens. If somehow you lost insurance, and had a longstanding disease like blood pressure or diabetes, you had what health insurers called a "pre-existing condition." Your new health insurance would cost an arm and a leg, or companies would refuse to insure you at all. Medical bankruptcy—going bankrupt because of medical bills—is one of the most common reasons for people going bankrupt. Healthcare costs continued to grow.
Obamacare was a serious attempt to address this crisis.
A simple way to look at Obamacare is to think of it as a three-legged stool. The first condition was that everybody would be guaranteed access to insurance. However, this would raise costs for insurers. So Obamacare made it compulsory for everybody to buy insurance, the so-called individual mandate. This would create an enormous pool of people to share costs.
But what about people of limited means? Insurance would just be too expensive. So Obamacare offered generous subsidies.
The system has been far from perfect, but thanks to Obamacare, tens of millions of Americans have gained health insurance.
Republicans fought the law tooth and nail from day one. They predicted its collapse. But to paraphrase Mark Twain: "Reports of its demise have been greatly exaggerated."
Last year, with the victory of US President Donald Trump, Republicans were giddy with joy. There was talk about repealing Obamacare by January.
Yet a funny thing happened.
It turned out that while Obama's healthcare law had always struggled in polls, once people learned it might be yanked off, Americans began to realise its value. Constituents stormed lawmakers' constituency meetings across the country, putting the fear of God in lawmakers.
How was a law that people were ambivalent about before so popular now? Psychologists call it "loss aversion." Democrats faced it when they tried to introduce Obamacare. Fear of losing a benefit trumps possible gains for many Americans. Democrats paid a terrible price in elections for introducing a law that they were confident would help people, because voters worried about how it might hurt them. Republicans were only too happy to fan those fears.
After seven years, in a delicious irony, when Republicans tried to dump Obamacare, it was their turn to face the wrath of the loss-averse public. And Republicans did not cover themselves in glory with the plans they came up with. The non-partisan scorekeeper, the Congressional Budget Office, gave devastating estimates of Republican proposals, warning that tens of millions would lose health insurance if their proposals became law.
And then there was Trump. What a stark contrast with Obama, who had made a sustained, passionate, reasoned case for his healthcare law throughout the long painstaking process of the law's passage. Trump, it became abundantly clear, had no idea what the healthcare plan was. It's not an accident that he is the tweeter-in-chief—124 characters appear to be just about the length he can hold a thought. His contradictory and sometimes absurd remarks on the healthcare battle remind me of media expert Ben Bagdikian's tongue-in-cheek dismissal of a national newspaper: "It gives new depth to the word 'shallow'."
By the time the Republican attempt to slay Obamacare collapsed in the US Senate, it had become a bizarre mixture of soap opera and a theatre of the absurd. Arizona Senator John McCain, recovering from a recent diagnosis of cancer, flew down for a vote where he delivered the coup de grace. Despite a majority in Senate, Republican members failed.
It left behind a trail that reeked of hypocrisy. Republicans failed to pass the very law that they had passed before when Obama was president, when they could posture to their hearts' content, secure in the knowledge that Obama would veto the law. This time around, as there were real consequences, they failed to walk the walk.
So in the end, the fiery seven-year-long Republican attempt to slay Obamacare became, to quote from Shakespeare's Macbeth, "but a walking shadow, a poor player/That struts and frets his hour upon the stage/And then is heard no more. It is a tale/Told by an idiot, full of sound and fury/Signifying nothing."
And thank goodness for that. Tens of millions of Americans will continue to have healthcare.
Ashfaque Swapan is a contributing editor for Siliconeer, a monthly periodical for South Asians in the United States.
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