EDITOR: The Sept. 19 editorial “Obamacare isn’t free” states the obvious and counters a position no one ever advocated — that Obamacare is free. To support this imaginary position, the MD calls upon Mercatus and Hoover Institute “scholars,” and R. Glenn Hubbard, all occupants of the far right, fact-free bubble they helped create. N.B. Mercatus is one of about 40 “no-think tanks” created and funded by the Koch brothers.
No one ever claimed Obamacare is free. Certainly not any Democrat except, perhaps, the inaptly-named Mountain Democrat. However, what Obamacare will do, and the CBO and real independent economists say it will do, is lower the overall costs of medical care as a percentage of GDP and, while it lowers overall costs, it adds about 30 million people who today have no health care. On a per capita basis, our health care costs will be dramatically lower. Unfortunately, as Bill Clinton recently pointed out, the GOP does not understand simple arithmetic.
Obamacare resembles several European and Asian systems. In France, for example, everyone is obliged to buy health insurance through a union, association, trade group, etc. For those who do not belong to any particular group, there is an “all others” organization. And for those who cannot pay, their premiums are subsidized.
Every three years, unions, associations, groups, private insurers, the government, hospital and doctors’ associations negotiate fees that will be administered by the insurance companies. The fees of doctors are set, but so are the profits and overhead costs of insurance companies. Doctors are not forced to participate. In fact, many specialists opt out and there are private, more expensive insurance plans — no government subsidy-to cover services from those specialists.
The vast majority of French doctors like the system. Every French resident carries his/her own medical and billing records in his wallet, in a password-protected computer chip. There is practically no paperwork to contend with. Doctors simply need someone to man the phone. Doctors are also paid generous bonuses for practicing “preventive medicine,” such as making sure diabetes and heart patients take their drugs, come for regular visits, monitor their blood daily, etc. This requires doctors or nurses to call patients regularly, something we seldom see here.
Doctors are assured of payment within seven working days. Insurance companies love the system because the government is also obligated to reimburse them within seven working days. Insurance companies have a predictable stream of patients, guaranteeing a steady income — no need for legal departments to go after deadbeats, no need to advertise, no need to bribe doctors and hospital administrators with Caribbean vacations, and no multi-million dollar bonuses for CEOs. It must be a good business: almost 100 French insurers participate.
Is the French (or Japanese, or Australian) system perfect? It’s designed by humans so, ipso facto, it’s imperfect. However, taking France (or Japan, or Australia) as an example, what the Hoover, Mercatus and the rest of the no-think tanks ignore is the fact that the French (and Japanese especially) live far longer than we do — the best measure of the effectiveness of a health cares system. They also ignore one important fact: the cost of those health care systems is about half ours. Better results for less money: What’s wrong with this kind of capitalist result?
The answer is hidden in the extreme ideology of the GOP. Why does Tom McClintock (and his mouthpiece, the MD) go after Obamacare as a dog goes after an old bone? Before it became Obamacare, it was called Romneycare and before that, it was called Dolecare (after GOP leader Bob Dole) who got the idea from… The Heritage Foundation, the fountainhead of Tom McClintock’s and the MD’s ideas. Logic, common sense, intellectual honesty and working with Democrats are serious character flaws in the Tea Party universe to which McClintock and the GOP now subscribe.
Of course, we know why the GOP and McClintock want Obamacare to disappear: They cannot support anything, perform any deed for the good of this country if it might benefit a Democratic president. Oscar Wilde said it well: “Patriotism is the virtue of the vicious” and wanting to eliminate Obamacare is, indeed, a vicious act: to let 30 million Americans, mostly kids, die early as long as blind ideology is served.