Obamacare's well-insured critics
The Washington Post, November 6, 2013
Obamacare's enemies are right about the disastrous Web site launch and the president's misleading mantra about "keeping your plan." I'm furious at the White House myself for having botched these technical and messaging challenges—issues that anyone could have seen coming three years ago and whose amateur handling has given needless ammunition to the foes of expanded health coverage.
But for those of us who think the health security the Affordable Care Act provides marks a fundamental advance in America's social contract, these White House failures don't come close to the vices of Obamacare's adversaries. Let's just say it: To judge by their behavior, the Affordable Care Act's enemies couldn't care less about helping millions of low-income workers achieve health security, and every time they open their mouths, it shows.
When conservatives rant about the latest mess-ups attending the rollout, they never add the obvious empathetic refrain. It would be simple, really. They'd just need to preface or append to their daily attack a line like this: "Of course we all agree we need to find ways to get poor workers secure health coverage that protects their family from ruin in the event of serious illness."
That's all it would take. But they don't say that. None of them. At least none that I can hear. A single omission might seem an oversight. A few might be a sign of distraction. But when day after day you wait in vain to hear such empathy amid the torrent of anti-Obamacare venom being spewed, you realize something bigger psychologically is at work.
Obamacare foes are more than just angry with the "lying" and the bungling they disdain. They are Very Well-Insured People. We all know about "VIPs." Well, these are VWIPs. Or at least, a certain conservative species of VWIP.
For many on the right, being a VWIP seems to bring with it a certain blindness. They see the Web site comedy of errors and cry (rightly) "incompetence!" They see some people who have to change their health plan and cry (with some fairness) "liar!"
But that's all they see. What they don't see is nearly 50 million uninsured Americans, 20 million or so of whom stand to have relatively desperate lives made immeasurably more secure thanks to this law. These Americans will finally know what it's like to go to bed at night certain that they can't be wiped out financially by illness—and that free or affordable preventive care may help their loved ones uncover disease while there's a chance for a cure.
Obamacare's well-insured critics don't see these Americans at all. And they seem unable to imagine what it would feel like to be one of them.
I want to be careful here. I know this isn't the outlook of every Republican or conservative. John Kasich's Medicaid expansion makes him the most prominent exception (though even Kasich can't see the benefit for many Ohioans of Obamacare's big private insurance expansion). Meanwhile, in yet another case in which your zip code seals your fate in the United States, millions of citizens who could have had Medicaid coverage will remain vulnerable, abandoned by well-insured GOP governors who think their job involves tending to well-insured GOP voters.
Poor uninsured workers didn't make U.S. health care the costliest, most inefficient system on the planet. But these workers are the ones who suffer most under it. And VWIPs on the right don't care.
New rule (as Bill Maher would say): Politicians and pundits who bash Obamacare should have displayed under their talking head or byline the source of their own coverage. Let's caption Ted Cruz in flashing neon that reads, "Enjoys Gold-Plated Health Coverage from Goldman Sachs Spousal Plan." Let's have the subtitles for John Boehner and Eric Cantor read, "Has Never Worried About Going Broke From Illness A Day in His Life Thanks To Federal Government Insurance."
And let Obamacare supporters begin their response to absurd claims that "Obamacare is the enemy" with this simple line: "Spoken like a Very Well-Insured Person." (I've tried this on radio and TV—not only is it accurate, but it feels great to say so, too.)
My wife and I discovered we were uninsurable in the individual market in 2003. It was scary. And we're the lucky ones—bona fide members of the Lower Upper Class with the wherewithal to maneuver to protect our family (and with access to the New York Times Magazine to write about the experience).
Obama said, "If you like your plan, you can keep it."
The Very Well-Insured Obamacare critic effectively says to the uninsured, "If you enjoy being vulnerable to financial ruin or death from serious illness, under our plan you can keep that, too."
Both of these positions are wrong.
But which, at the end of the day, seems more like a hanging offense?
The irony is that Obamacare's protections will be there even for its enemies if, God forbid, they (or someone they love) find themselves sick, unattached to a large employer and looking for coverage in the individual market. I suppose that's the beauty of the rule of law—it serves the smug and the shortsighted, the dopes and the demagogues along with the rest of us. Might be a more just world if it didn't now and then, but them's the breaks.