Watching the nearly eight-year battle about the Affordable Care Act presents an example for analysis. The Democratic-controlled Congress created the bill that became operational law. For different reasons, voters elected Republicans to Congress at the Midterm election. Republicans made "ObamaCare" a battle cry as they sought to repeal the law that they believed is too onerous.
What Republicans dislike about the Affordable Care Act."
- Mandatory requirement for all persons to buy insurance
- Penalties for those who don't comply
- Creation of a federal healthcare exchange
- Creation of government-controlled healthcare exchanges
- Cost to ensure healthcare for all citizens
- Government-managed versus free market solution
The story begins with the question, "What to do with 30 million uninsured citizens?" That was the estimated number of persons in need of an affordable healthcare solution.
Problem Statement: There are several related aspects of Amerca's healthcare problem: 1) healthcare costs in the U.S. are competitively too high compared with developed nations, 2) a large segment of the population is uninsured, 3) the free-market insurance providers sought not to accept persons with pre-existing conditions or otherwise manage their customers to being the most healthy.
Social responsibility is lost, when profit is the driver. That is why government intervention is necessary to ensure that all citizens have healthcare.
Their free-market theory is that the cost of healthcare is distributed among large populations who have shared needs. Actuaries determine the overall cost on which to base premiums that are profit + medical costs, administration costs, and other "services" costs.
When free enterprise providers are permitted to manage at-will, they will maximize profit in the absence of social responsibility.
Some political representatives and their party seek to regulate the industry to control costs: 1) medical costs that are the doctors, nurses, behavioral professionals and their hospitals, 2) health insurance providers. Some political representatives prefer to let the free-market pressure providers control costs. Some prefer to intervene with guidance, incentives, and penalties.
Another cost element is the cost of medical liability. Healthcare professionals carry insurance to cover their being sued for mistakes. Some politicians want to limit liability to contain costs, while others want free-market dynamics to prevail.
These considerations beg the question for We the People and our elected representatives: What role should the government have in managing healthcare cost and quality?
If we agree that government has a role to play, then what is it?
Is one of our nation's priority outcomes to be to provide affordable healthcare for all citizens and ensure that everyone has healthcare coverage?
President Donald Trump promised healthcare insurance for everyone. That is a start. Now, what does that mean about the extent of coverage and quality of healthcare?
Some Republicans in Congress may not want to address the problem at all, and they must confront their constituents with a clear stand. Others believe that the nation cannot afford to ensure everyone, or everyone equally. They should state their case to their constituents.
In Congress today, we have the Democratic Party with an operative solution, albeit in need of improvement that is the law. We have Republicans wanting to repeal the ACA without a replacement. That is their statement that 1) they don't want to address the need, and 2) they don't believe in caring for the poor and needy. We have others who want to replace the ACA with something that costs less. However, what they are producing so far hurts poor people and provides a windfall to corporations.
Due to a lack of clarity by the Speaker of the House and Senate Majority Leader, it appears that Congressional Republicans are operating without an ear to their constituents and the needs of the nation that is the majority of people.
"Paul Ryan gives GOP the hard sell
Speaker Paul Ryan (R-Wis.) often spoke of the 2016 presidential election as a choice: Are you for Donald Trump, or are you for Hillary Clinton?
As he begins selling the GOP’s healthcare plan to skeptical conservatives, Ryan is talking of another consequential choice for the party: Will Republicans vote to repeal and replace ObamaCare, or renege on their central campaign promise of 2016?
“We know, without a shred of doubt, that this law is collapsing. That means this is the choice we face: Are we going to stay with ObamaCare and ride out the status quo? Are we going to just let this law collapse and whatever happens, happens?” Ryan asked at a news conference Wednesday. “Or are we going to do what we said we would do? Are we going to repeal and replace ObamaCare with something better?
For better or for worse?