WE.CONNECT.DOTS: Obamacare for dummies

By Dick Miller

WE.CONNECT.DOTS:  Once upon a time the leaders of the industrialized nations on earth concluded that quality health care was a right, not a privilege.

Scratch that.

Every industrialized nation except for the United States.

Bosses in the United States believed health care was another product of a free market.  Another form of recognition that profits far outweighed the few people who might be saddled with lousy health, children included.

An additional benefit of failing to provide adequate health care to all is economic effects can be manipulated as a powerful tool in foreign policy.  Take prescription drugs.  The U.S. allows drug manufacturers to recover research and development costs through higher prices here.  This is true even when Big Pharma has ceremoniously listed its headquarters in another country to escape paying taxes here.

Canadians continue to benefit from this seedy arrangement, despite skepticism that such a cozy arrangement cannot last forever.

A skeptical batch of Canadians were unduly nervous when President Obama began pushing his Affordable Care Act through Congress.  They were certain Obama Care would include competitive drug pricing, ending their free ride.

At an impromptu meeting in Chicago, I assured these concerned Canadians this was not going to happen.  A sufficient number of Congress (mostly Republicans) members helped Pres. George Bush II prohibit Medicare from negotiating prices for drugs circa 2003.

As long as something less than a majority of Congress would not act in consort to end this rip-off, the practice continues, fueled by adequate campaign contributions.

With some hindsight, the failure of ‘Obamacare’ is easy to see.  In my career as a labor-management counselor, specializing in health care cost control, I could contribute.  Newly elected NW PA Congress member Kathy Dahlkamper attempted to arrange my testimony.

I wanted to apprise Congress of two issues.

First, we needed to return to a “certificate of need” process for construction of new health care facilities.  Although often ineffective, earlier versions of CON did prevent some duplication of bricks-and-mortar.

One local example of this wasteful practice was that 20 years ago, Mercer County had four magnetic resonance imaging units, the same number as open for business in Toronto Province with ten times the population.

Second, giant health companies seem to have the industry by the throat.  They held that grip by enforcing a “most favored nation” clause in each contract with a health provider.  This prohibits the provider from making its services or products available at a lower price than this contract.

Except there were no hearings on Obama’s version of universal health care.

Under the delusion that Obamacare should be a universal conception, even though Republicans were adamantly opposed, the President allowed Obamacare to be defined in a series of committee meetings, many closed to the public.

In many instances, Republicans used these committee meetings to negotiate their terms into the insurance.  When it came time to vote, not a single Republican in the house or senate voted for the bill.

Too late to make corrections.  Sen. Ted Kennedy died in August of 2009 and Obama lost his paper-thin voting super-majority in that Chamber.

Bottom Line: Obama Care is the ugliest issue of his Presidency.

At last two public school teachers told me “I will be damned if I am going to pay for anyone else’s healthcare.”  A Republican businessman, liberal or moderate in most other issues, believed he had worked to earn health care “better than others.”

Now, union members were backing off as soon as they learned they would be paying for others’ health care through an assessment known as the “Cadillac Tax.”

Over the years, it became obvious that most people believed universal health care was being paid by anyone but them.  After initial funding by Congress, each assessment had to kick in at a critical level and time to keep the fund solvent.

Hoping to find “win-win” solutions, the Cadillac tax was rolled back from 2017 to 2020. Fines against people who did not purchase adequate coverage were abated or reduced.

The difference since this presidential election is momentum.

Until November 8 the program was in the hands of Obama, who wants it to continue.  Now, control is passing to those who never wanted it.

Of major concern, however, are the number of Congressional seats sacrificed in 2018 when 20 million people lose coverage.