Monday, January 09, 2017

Elementary Facebook Commentary on Obamacare

So, a friend comments on the post of someone who's made what I think is probably a fact-free assertion about The Patient Protection and Affordable Care Act, which is how that post lands in my Facebook feed - because my friend commented on it. Basically, then, when I comment that I need to see original sources on that assertion and will give it no more weight than dinner party gossip until such citations are supplied, my comment pushes the post I was reacting to into the feeds of other friends ... friends of friend of friends, or something like that.

I go away for the day and return to find that one of the friends who saw the post I saw because that first friend saw it, has vented ungenerously and at length in response to my response to that post. Not venting at me, you understand, because he knows me, and would almost certainly never say the things he said to friends of friends of friends of friends on Facebook. There are literally dozens of comments, many of them escalating back and forth between who don't know each other and don't want to.

That about gets you up to speed on how I came to write the following on the Facebook page of a friend of a friend:

We're all nominal adults here so I won't apologize for having a sometimes abrasive friend, but maybe I teed him up with my offhand remark about dinner party gossip. If so, I'm sorry about that. I'm sad to think this particular thread may be too far gone in the tall grass to find the way forward. 

Nevertheless, since so much of what's being said lies somewhere between hearsay and personal anecdote, I'll drop my own anecdote here, FWIW. 

I've lived in two, very different, states during the years The Patient Protection and Affordable Care Act has been law. Both these states - California and Washington - went all-in on The Affordable Care Act from day one, and both have made a successful transition from what was to what is. 

What was - for my household - was insurance premiums going up between 26 percent and 39 percent every year, year after year. What was, for us, was rising deductibles and diminished benefits. What was, was my spouse paying a higher premium than me because she's a woman. What was, was hospitals and labs charging whatever they wanted, with no obligation to disclose their rates in advance, nor any obligation to make clear the details of those charges after the fact. What was, was the threat that we might see our coverage dropped because of long term health issues. What was, therefore, was the prospect of medical bankruptcy if, say, the economy tanked at the same time one of us suffered a high-cost medical crisis. And, if you're still with me, what was, was the shared hit every taxpayer took if her neighbor declared medical bankruptcy. 

What is, protects every one if us from medical bankruptcy; ensures that none of us can be disallowed coverage, period; requires that healthcare providers disclose and justify their charges or suffer marketplace consequences; guarantees that women and men are charged equitably; demands reasonable value for fees from insurers and healthcare providers, and makes them give us money back if they under-deliver.

Premiums continue to rise under what is, but far more slowly than under what was. At our house, that looks more like 10-12 percent in these years. And we're getting more for our money with what is, because the law was written to include basic preventive care.

So, two things:
  1. If your state declined to fully implement the Affordable Care Act, take it up with your near neighbors. The law was written to ensure that every state has every opportunity to take every advantage on behalf of every citizen. If your state has failed to do that, then your state has failed. Only you can fix that.
  2. The Affordable Care Act shoulda, coulda, woulda been better for everyone if everyone worked on it, instead of so many working against it. It still can be better...all the way to great, if we make it so. All that requires is looking each other in the eye and saying, "I'm for you...and if you're for me, then we're in this together, so how about we get this solved so we can move onto something less obvious - less elementary - than, "Hey, my neighbor and I would both like to be as healthy as possible for as long as possible so we can do as much good as possible for our families and communities, and so on..." I mean, that just seems like basic stuff to me, to the point that I find it shocking that people are screaming obscenities at each other over such a kindergarten concept as love your neighbor as yourself. 
Just between us adults, I suspect there may be much more interesting problems to solve than whether everyone should and can have access to decent healthcare. I say let's get that solved and move ahead with the interesting stuff.

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