Lost in the Glare

Sitting in the Walmart parking lot yesterday on the way home from work, some snatch of an NPR story on the Affordable Health Care law brought into clear focus what the Law aims to accomplish, and how. I was struck later by the appalling fact that this clarity was not readily obvious to me long long before yesterday in the Walmart parking lot. But of course the Republican din of distraction has been at full volume since before the Law was even passed, and has included such features as protests with men brandishing arms, signs suggesting Mr. Obama was a bushman, the idea of "death panels," messages of panic and horror and fear from all manner of accomplished salespersons such as Mssrs Limbaugh, Beck, and Hannity, and an entire faux news network complete with all manner of pretty blonde news readers and associated with all the major American sports events. In ordinary American life, the din far outdistances the small bits of real information. This is primarily why we now have half of our Congress controlled by charlatans and muddled idiots--a terrific wound to our government's ability to function.

In all of this on-going and distracting din I've never heard, once, the statement of a simple truth--the truth I heard yesterday by accident in the middle of an NPR story which was not even directly about this fact. Here's the deal. One of the most central features of the health care reform bill is the elimination of existing conditions as a factor in obtaining health coverage. The meaning of this fairly complex idea is that the insurance companies are now expected to simply insure everyone. Thus, policies which distinguish between, for example, male and female insurees, are no longer allowed. The fundamental idea is this: all people are either healthy or ill. The illnesses may vary for any number of reasons among the pool of ill, but that detail can't be allowed to drive the crafting of policies which favor the well and drive away the ill.

Even on reasonably clear PBS news coverage of the problem of policy cancellations, this basic premise is omitted. Last week there was a flurry of stories about individuals who had lost their existing policies. One middle-aged woman on PBS complained that since she was no longer able to get pregnant, why should she pay for insurance covering pregnancy issues.

This is exactly the crux of the new law, and must be addressed head on. On the PBS show, it wasn't. You can imagine that it's never addressed on Fox. But yesterday on the NPR piece, the federal employee trying to explain the new law addressed it, and clearly. New health insurance coverage is aimed at covering everyone. Not everyone will need any particular coverage, e.g., prostate cancer isn't relevant at all to women, pregnancy coverage isn't relevant to men, and so forth. But--to make the law work there must be a general policy which covers everyone. This is the fundamental difference between the ACA Law and the current situation. Insurance companies can no longer carve out policy coverage which cherry picks the pool of potential insurees. And on the other hand, the pool has been expanded to include everyone, which should make for much lower rates.

This is the fundamental change. Yet the House has already passed another "reform" which, by allowing existing cherry-picked policies to remain in force forever, basically rolls back the reform. But this fundamental remains mostly obscured, to the public, by the din. And the folks banging the pot lids include every Republican in Congress. And yesterday, this group was joined by several dozen Democratic House members. This suggests that even many Democrats do not understand the fundamental change the law accomplishes (or that many Democrats care more about their personal advancement as Important People than their charge as representatives of their constituents).

This din started in 2009, with the orchestrated efforts to shout down all rational conversation about the new law at various meet-the-public events held by Democrats who supported the law. This was the advent of the so-called "Tea Party." With the really terrible execution of the "roll-out" in October, the Obama Administration has opened a vein. The entirely unnecessary blood-letting will draw all the sharks who care not at all about any such thing as affordable health care. Indeed, this is what we're watching now. "Oh my, you're bleeding, let me help you with that." CHOMP.

The reform to our very broken health care system has not yet been accomplished. The sharks await the next election cycle, and the next. All the while their hope is that most of us never really face head on the fact that in life there are but two groups of people, the healthy and the ill, and that these demarcations are never permanent, but only seem so. The healthy never need health care coverage. For the ill it is often literally a life and death matter. You can't get radiation or chemotherapy at the ER. You can't get dialysis. The ER doesn't give out essential medication, and it doesn't perform crucial operations if you can't pay for them. A fellow I know, in his 80s, just got a pace-maker. The bill was for $100,000.

Medicare paid.

[photo of sharks from National Geographic]

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Update: A great article on the current state of the start of the Affordable Care Act:

http://www.latimes.com/business/hiltzik/la-fi-mh-obamacares-failure-20131118,0,6037469.story#axzz2kxsJ8MMV

It is remarkable and disgusting to discover, each and every day I click over to sample Fox News, how the unrelenting din of attacks on the Affordable Care Act remains the primary subject of this so-called "news" channel. Has the United States ever had to deal with such a powerful media effort at brainwashing its citizens? In the next Democratic Administration, should we be so lucky as to manage in 2016 to deflect the Republican attack on democracy once again, the first order of business should be some well thoughtout effort to mitigate this cancer on our democracy--the gigantic propaganda machine that operates 24/7 to confuse and confound all reasonable thought on the serious subjects which the United States must deal with--before such subjects become so powerful that they deal with us as they will. Events beyond political control do happen. While the Romneys can then talk of things "sorting themselves out naturally," the human cost of this way of operating is not only unacceptable for any civilized people, but will have its own terrible political cost as well.