In the space of less than two and a half years, Republicans in Congress have voted to repeal all or part of the Affordable Care Act a whopping 36 times. Here's a list of these attempts. Each of them includes a link to the votes on each bill, so you can see who voted for this nonsense.
This past week, they voted for a 37th time to repeal Obamacare. And you should care about this issue, because it says two things about the Republican Party. The fact that they insist on wasting time passing 37 bills they know will never become law (can you even imagine Democrats in the Senate passing or Obama signing such a thing?) is something that should concern voters. And the fact that they seem to want to return the health care system to where it was should really make you mad.
Our health care system was broken. And it was broken precisely because it treated health care as a privilege, when it's actually a right. If you become sick enough, you are entitled to see a doctor, regardless of your wealth or lack of same.
There are a few things that should not be subject to the volatility of the "free market," and health insurance is one. It is because we operate under the delusion that health insurance is a "free market" that we spend more than anyone else in the world on health care, and yet sit mired in 37th place in world health statistics. Our health statistics are more in line with Cuba and Albania than Germany, France and Canada, and the reason is the way we treat health insurance.
Those statistics are bad, despite the fact that we probably have the best underlying medical system in the world. Our system trains doctors all over the world, because we have the best. Unfortunately, it was private insurance companies running roughshod over the system that caused the problem, because they were denying huge numbers of people access to doctors. Financing our heath care system with the private health insurance companies making the rules was like buying a new Rolls Royce with a credit card.
When your life or the life of your child is in danger, or you are in so much pain that you can't function, a doctor has an absolute obligation to treat you. If you show up at the ER with one arm falling off, they have to at least patch you up. This is true, even if you live in a box under the freeway. If you show up in the ER during the final stages of cancer, they have an ethical, moral and legal obligation to relieve your pain and treat you. If you have a heart attack, the ambulance will pick you up and take you to the hospital, and the doctor will treat you, at least enough so that you can function.
The problem that caused our system to overload was people without insurance, who simply can't pay their bill. But it wasn't their fault.
First, the hospital would often get their team of lawyers and bill collectors after the uninsured patients, until they forced them into bankruptcy. The patient would lose everything, and the hospital would get a fraction of what they were owed. The hospitals would then raise prices to cover their losses, and that, in turn, caused insurance companies to raise premiums. In other words, those who were insured used to heavily subsidize those without.
Essentially, this created a closed circle. The more things cost, the harder insurance companies would assess risk, and the more people they'd kick out of their insurance pool. After all, they are not in business to pay your medical bills; they're in business to skim as much as possible from premiums, and call it profit. They don't make money by paying more for procedures. They make money by not paying bills they don't have to. Therefore, health insurance companies went out of their way to only cover healthy people, and they did everything possible to keep from paying a medical bill.
This is why health insurance should never be subject to "market forces." Health care is not a voluntary consumer activity. Unlike picking up a pack of gum at the checkout at Safeway, you usually don't get to choose when you need medical care. You don’t always get to shop around for the best price, and you often can't possibly save enough money to get it when you need it.
That's the disconnect. Everyone needs health care at some point, and they will rarely be able to prepare for it. Yet, the Republican Party acts as if there is a "free market" component to it, when there isn't.
The old health insurance system made no sense. Twenty percent of the population were denied health insurance because they were likely to use it. That meant the people most likely to need health care were not allowed to pay into the system. They were actually forbidden from contributing money to the insurance pool, even though their health care would eventually be paid for from that pool. Worse, it created a death spiral. The higher prices and premiums went, the more people lost coverage, and the more people lost coverage, the higher prices and premiums went.
The insurance companies loved the old system, because it maximized their annual profits at the same time it minimized their responsibility for health care. About 18% of the population was uninsured at any given time, whereas 98% of all hospital revenues came from private insurance Medicare and Medicaid. And you wonder why health care inflation was so high, and why your insurance premiums skyrocketed under the old system?
Obamacare isn't perfect. It still leaves about 8-10 million people uninsured. But that's a lot less than the 50 million and climbing who were left uninsured under the old system. And all bills incurred under this system will be paid, meaning hospitals won't have to raise prices as much. But the old system of health care financing was purely immoral. There's no excuse for a rich country to tens of thousand of people to die and half a million to lose everything annually, simply because they have no insurance. No one should pay into the system for decades, and then be denied access to health care because they lost a job, or their company stops offering it, or because an insurance company arbitrarily decides it's "too expensive."
Our government is charged by the Constitution to protect the "general welfare" of the country. And it's hard to argue that a healthy populace isn't good for the general welfare. It is also not good for the general welfare for people to work hard all of their lives and be denied insurance coverage because they once got a bloody nose in eighth grade.
Our system failed us, and it's been reformed to a significant degree. Yet, Republicans demand a return to the old ways. Either that, or they're simply trying to waste time, when the country needs more jobs and revenues.
Either way, they need to go.