Last week's column (Feb. 20) addressed the political strategy of denial with respect to increasing income inequality and stagnation of the middle class. The first step is to deny that the problem exists. This is followed by insisting that nothing can be done about it, followed by insisting nothing should be done about it. When the problem becomes severe enough to demand action, the final stage is a combination of building straw men and blaming the victims, while condemning those who have tried to address the problem.
Let's look at the issue of affordable health care for all Americans.
First step: Deny that there is a problem or, more correctly in this case, ignore it. For some time, most Americans with middle class and, especially, upper middle class, jobs have had employer-based health insurance. Elected politicians long have enjoyed "Cadillac" health insurance plans. Thanks to LBJ, Americans over age 65 have Medicare. (Can you imagine such a program being passed by the dysfunctional Congress of today?)
And, importantly, the big time media stars have good health insurance. The whole conversation on health care would have been much different if these "analysts" themselves would not have access.
In short, it is - or was, take your pick - mainly temporary workers, working poor, and generally citizens without political clout who fell through the cracks. So for political purposes, the problem of the uninsured was "non-existent," safely ignored.
But as the problem really does exist, the next politically expedient step is to insist that nothing can be done about it. After the ill-fated attempt by the Clinton Administration, pejoratively known at the time as "Hillorycare," went down in flames, politicians steered clear of the issue. The Republicans came up with some ideas based on broadening the insurance pool, including the young and healthy, but soon dropped the whole affair.
But the problem persisted, and became worse during the Great Recession as middle-aged, middle class people lost employer-based health insurance. Like the working poor, they couldn't afford health insurance. In case of "pre-existing conditions," they could not get it at all.
Many politicians still insisted that nothing should be done about it. At least not politically, as there is no political mileage in addressing problems suffered by the politically unconnected. "It would cost too much." And, heaven forbid, involve the government? "Should not do that," came the refrain.
And finally, the last step, with millions of people without access to arguably the finest medical facilities in the world. Millions going untreated or, at last resort, resorting to high cost emergency rooms for treatment - a very inefficient use of the system, especially when earlier access to routine health care would have prevented severe illness.
Enter the Affordable Care Act (ACA) and critics using the final step in this strategy. Blame the victim, "the unemployed should try harder to get a job." Build straw men, "it's a government takeover of health care." And especially, heap abuse on those who are addressing the problem. Never mind that there is little or no political gain in addressing this tough and complex problem.
And never mind that the ACA is built around the free market principles once articulated by the critics themselves a couple of decades ago, and the plan established by Mr. Republican himself when he was governor of Massachusetts.
The hypocrisy of the critics doesn't end there. Conservatives like to remind us that "there is no such thing as a free lunch," and there are costs attached to making health care available to every American. Of course there are. But these same critics totally ignore the fact that in one form or another, society picks up the costs of the uninsured, whether it be in the form of higher insurance premiums for the rest of us, or public assistance in some form.
As hospitals are required to treat those who don't have the dough to pay the bills, these costs are absorbed by somebody else in one form or another.
So, what about those who can't afford insurance on their own? It is surely more efficient to subsidize health insurance for low income people than for them go untreated, or to resort to high cost inefficient use of emergency rooms, costs ultimately borne by the rest of us.
What about those government mandates that critics cry about - the alleged "loss of freedom?"
There's an easy answer to that, all but totally ignored by the media, and not well explained by the Obama Administration for that matter.
If a vehicle owner chooses not to insure his vehicle against collision, and he wrecks his car, he doesn't expect General Motors, the government, or society in general to buy him a new one. But if an apparently young, healthy person chooses not to have health insurance, but gets ill, or racked up in an accident, and runs out of resources, society does pick up the tab.
In other words, it's a matter of responsibility to be insured. And if an individual can't afford it, it is more efficient to subsidize the premium than to let the person go untreated or pick up the tab after the fact.
Of course, the ACA needs to be reviewed and improved where there are glitches. But in their attempt to make political points and trash the Obama Administration, critics have alternated between trying to kill the bill, or to retain its most popular points, such as insisting that insurance companies cannot deny coverage for those with pre-existing conditions.
But these same, mostly conservative, critics, who claim to understand the private sector, fail to explain how insurance companies can legitimately be required to take on the currently ill with pre-existing conditions, while not expanding the pool to include the young and healthy.
It should not need reminding that, absent premature accidental death, "young and healthy" is a temporary state for all of us.
- John Waelti's column appears in the Times every Friday. He can be reached at jjwaelti1@tds.net.
Let's look at the issue of affordable health care for all Americans.
First step: Deny that there is a problem or, more correctly in this case, ignore it. For some time, most Americans with middle class and, especially, upper middle class, jobs have had employer-based health insurance. Elected politicians long have enjoyed "Cadillac" health insurance plans. Thanks to LBJ, Americans over age 65 have Medicare. (Can you imagine such a program being passed by the dysfunctional Congress of today?)
And, importantly, the big time media stars have good health insurance. The whole conversation on health care would have been much different if these "analysts" themselves would not have access.
In short, it is - or was, take your pick - mainly temporary workers, working poor, and generally citizens without political clout who fell through the cracks. So for political purposes, the problem of the uninsured was "non-existent," safely ignored.
But as the problem really does exist, the next politically expedient step is to insist that nothing can be done about it. After the ill-fated attempt by the Clinton Administration, pejoratively known at the time as "Hillorycare," went down in flames, politicians steered clear of the issue. The Republicans came up with some ideas based on broadening the insurance pool, including the young and healthy, but soon dropped the whole affair.
But the problem persisted, and became worse during the Great Recession as middle-aged, middle class people lost employer-based health insurance. Like the working poor, they couldn't afford health insurance. In case of "pre-existing conditions," they could not get it at all.
Many politicians still insisted that nothing should be done about it. At least not politically, as there is no political mileage in addressing problems suffered by the politically unconnected. "It would cost too much." And, heaven forbid, involve the government? "Should not do that," came the refrain.
And finally, the last step, with millions of people without access to arguably the finest medical facilities in the world. Millions going untreated or, at last resort, resorting to high cost emergency rooms for treatment - a very inefficient use of the system, especially when earlier access to routine health care would have prevented severe illness.
Enter the Affordable Care Act (ACA) and critics using the final step in this strategy. Blame the victim, "the unemployed should try harder to get a job." Build straw men, "it's a government takeover of health care." And especially, heap abuse on those who are addressing the problem. Never mind that there is little or no political gain in addressing this tough and complex problem.
And never mind that the ACA is built around the free market principles once articulated by the critics themselves a couple of decades ago, and the plan established by Mr. Republican himself when he was governor of Massachusetts.
The hypocrisy of the critics doesn't end there. Conservatives like to remind us that "there is no such thing as a free lunch," and there are costs attached to making health care available to every American. Of course there are. But these same critics totally ignore the fact that in one form or another, society picks up the costs of the uninsured, whether it be in the form of higher insurance premiums for the rest of us, or public assistance in some form.
As hospitals are required to treat those who don't have the dough to pay the bills, these costs are absorbed by somebody else in one form or another.
So, what about those who can't afford insurance on their own? It is surely more efficient to subsidize health insurance for low income people than for them go untreated, or to resort to high cost inefficient use of emergency rooms, costs ultimately borne by the rest of us.
What about those government mandates that critics cry about - the alleged "loss of freedom?"
There's an easy answer to that, all but totally ignored by the media, and not well explained by the Obama Administration for that matter.
If a vehicle owner chooses not to insure his vehicle against collision, and he wrecks his car, he doesn't expect General Motors, the government, or society in general to buy him a new one. But if an apparently young, healthy person chooses not to have health insurance, but gets ill, or racked up in an accident, and runs out of resources, society does pick up the tab.
In other words, it's a matter of responsibility to be insured. And if an individual can't afford it, it is more efficient to subsidize the premium than to let the person go untreated or pick up the tab after the fact.
Of course, the ACA needs to be reviewed and improved where there are glitches. But in their attempt to make political points and trash the Obama Administration, critics have alternated between trying to kill the bill, or to retain its most popular points, such as insisting that insurance companies cannot deny coverage for those with pre-existing conditions.
But these same, mostly conservative, critics, who claim to understand the private sector, fail to explain how insurance companies can legitimately be required to take on the currently ill with pre-existing conditions, while not expanding the pool to include the young and healthy.
It should not need reminding that, absent premature accidental death, "young and healthy" is a temporary state for all of us.
- John Waelti's column appears in the Times every Friday. He can be reached at jjwaelti1@tds.net.
