A non-health wonk relative emailed me recently:
“Can you tell me in very brief terms, why the far right is so much against the Affordable Care Act? To me, it makes good long-term economic sense, is immensely beneficial for the health and welfare of those currently without insurance, and puts us in sync with other advanced societies. I just don’t get the opposition.”
For mainstream folks who aren’t health wonks or political junkies, it can be perplexing to try to understand why House Republicans are so eager to fight the Affordable Care Act that they are willing to shut down the government, possibly cause the government to default on its debts and steer us into a Constitutional crisis.
There are a variety of explanations. Among the more charitable readings:
- They feel the legislation was rammed down their throats and they were disenfranchised
- They honestly feel ObamaCare will be the ruination of the world’s greatest health care system
- They believe ObamaCare will bankrupt the country
- The bill is too complicated
- They want to appeal ObamaCare and replace it with something better
But none of those explanations hold water:
- The law is a moderate one and full of Republican ideas –like the individual mandate and marketplaces –that were included in the bill partly to try to bring moderate Republicans on board. The public option is out, there’s no single payer, and the use of comparative effectiveness research is neutured. And the notion of disenfranchisement rings hollow when we consider how President Bush acted like he had a mandate even though he lost the popular vote. Obama was re-elected and although the House stayed in GOP hands it’s only due to gerrymandering. The average voter voted for ObamaCare
- People who believe ObamaCare will ruing a great system don’t understand the US health care system and how broken it is. Those who actually work in it know it’s full of problems, is more costly than elsewhere in the world, and has less to show for the extra spending in terms of outcomes –never mind equity
- The GOP are the ones that wasted the Clinton surpluses and passed the Medicare Part D drug benefit without worrying about how to pay for it. ObamaCare was scored by the CBO as deficit-positive. Even if that doesn’t turn out to be the case it’s going to be cheaper than Part D
- ObamaCare is complex because it’s moderate. Single payer would be a lot simpler and shorter
- There’s very little substance to the so-called “replace” ideas, which anyway took two years to appear
A more objective read is that some opponents have whipped themselves into a lather over their revulsion to all things Obama and are living in an echo chamber where these views seem rational. It would be better for everyone if they went back to the Birther madness.