Try to remember the elation most of us felt in 2010, when President Barack Obama managed to usher through Congress the first national health insurance system in our history, now known as the Affordable Care Act (ACA). Though a lot of House Democrats deserve a lot of credit, as well, the fact of the matter is, not a single Republican voted for it. And it wasn’t because they thought it sucked, either; their only concern was putting one over on President Obama. They only cared about beating him.
At the same time, the GOP seemed to have a thing for the old system. It wasn’t because the old system was any good at all; the Republican Party has no interest in governing; they only care about one thing; appealing to their dysfunctional, deplorable “base.” (Has there ever been a better word to describe the current GOP faithful than “base”?)
As a result of losing on the health insurance front, Republicans have spent the past decade-plus years trying to kill it. When they were in the majority of both the House and Senate, they voted to repeal the entire law many dozens of times. And since we blew the 2016 election and allowed the incompetent Donald Trump to take the presidency, he has tweaked the law enough to make it less effective for nearly everyone.
Dealing with healthcare will have to be a priority over the next year, especially in the wake of Trump’s massive failure with dealing with the coronavirus pandemic. The biggest problem with ur system used to be its immense cost, which locked too many millions out of healthcare altogether. Now, with the Republicans’ tweaking of the system over the past decade and their constant bleating about wanting to “own the libs,” the ACA has become very damaged and is not what it used to be. This year’s open enrollment promises to be the worst since the law took effect in 2014, and millions of American families will find it more difficult to find good insurance that is also affordable. That means we will have a lot to do to fix it. Of course, that will start with ridding the government of Trump and as many Republicans as possible. They will do everything they can think of to stop any progress on healthcare.
However, while we have to worry about the obstruction we’ll face from the far right, we also have to worry about obstruction from the far left, as well, meaning white unicorn progressives. We already have a model for a national health insurance system that works to cover virtually everyone, and that means restring the Affordable Care Act and adding a public insurance option, in order to mitigate risk for the private insurers who will be needed.
In other words, we need to restore the Affordable Care Act and re-add the “Patient Protection” part back into the law, as it was originally conceived in 2009. That will mean winning a massive majority on November 3. We can’t afford to pass these bills by a vote or two; we have to win wide margins in both the House and the Senate.
Just as importantly, we can’t get distracted. We cannot afford to waste our time on versions health insurance that are difficult for most people to understand and that will be enormously difficult to pass by a wide margin. Families are flailing right now; we cannot afford to tilt at unicorns and windmills. We need an insurance system that is efficient and effective, like the Affordable Care Act, with a single public insurance option.
We cannot be sidetracked by working on “single-payer” health insurance. It’s not necessary and just getting people to understand it will waste a lot of time, which we won’t have. A case can be made that we can work toward a single-payer system later on, to make the system even better at some point down the line. However, people need help RIGHT NOW. It’s also not necessary right away, no matter how eloquent its advocates sound. We need a universal health insurance system, which is not the same thing as “single-payer.” In fact, there are hundreds of countries with universal systems and almost none are single-payer.
We have to fix the national healthcare financing system once again, and as soon as Trump is gone, we have to restore it to what it was before he was “elected.” There is no time to demand 500 new features; we should just work toward what we had before the Republicans screwed it up, with one major tweak; we should have a public option, to encourage competition and to keep the risk levels down for the private insurance companies will be providing the actual insurance. That will make us the “more perfect union” demanded by the Constitution; something Republicans have apparently never heard of.