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Jay Fleitman: Why Republicans hate Obamacare

CAROL LOLLIS<br/>Jay Fleitman

CAROL LOLLIS
Jay Fleitman

The roots of this rancor are twofold.

The process with which Obamacare was passed was a hand grenade going off in the body politic, and the political wounds simply will not heal. Both houses of Congress were controlled by the Democrats and Senate Majority Leader Harry Reid and his House counterpart, Nancy Pelosi, seized the opportunity to force through a major overhaul of one-sixth of the national economy with no avenue for advise and consent for Republicans, and no allowance for discussion or amendment.

There was no support at all by the opposition party and deep unpopularity among the general public. The Democratic leadership could not have been given a clearer message of the public hostility toward this bill in 2010 when Republican Scott Brown was elected to the Senate seat previously held by Ted Kennedy in overwhelmingly Democratic Massachusetts, his campaign dedicated to the proposition that he would be the 41st vote to kill this bill.

Reid and Pelosi pushed forward anyway. Democratic membership in Congress was itself uncertain of the content and ramifications of this 1,200-page bill, which led to Pelosi’s famous statement of “Alice in Wonderland” logic that Congress had to “pass this bill in order to know what’s in it.” With not a single Republican vote in either the House or the Senate, the Democratic leadership bypassed usual procedures in the Senate to cram through to passage this bill of profound national implications.

Any political foresight would have anticipated that this process would lead to a deep polarization of our politics. It is easy to understand how Republicans would refuse to cooperate with subsequent Democratic initiatives after the crass steamrolling of this bill through the House and Senate.

We often hear as an argument against continued Republican resistance to Obamacare that this should now be accepted as the “law of the land.” There is no reason why Republicans as the opposition party should ever accept the legitimacy of this bill or render to it any respect.

Clearly, some goals of this bill are important for Americans. Eliminating penalties for pre-existing conditions, making insurance portable and finding ways to extend affordable health care coverage to those Americans who want it are worthy goals. Equally important is controlling the societal cost of health care without damaging its quality, which is not addressed by this bill.

On the other hand, there are practical arguments against Obamacare. Provisions of this bill are already limiting full-time employment as employers are switching to part-time workers, health care premiums are rising for many Americans and health care costs are being shifted to the younger population of Americans who already suffer from high unemployment and whose career paths are already in peril in the current economy.

There is a core philosophical divide at the heart of the struggle. The Democratic leadership of Obama, Reid and Pelosi sought an opportunity to project the fundamental belief in the central government as the prime agent of change in the solution of national problems. Conservatives, on the other hand, see this bill as a large step in the intrusion of central government into the economic and personal lives of Americans, an action contrary to their view of the nature of American society. Regardless of the Supreme Court ruling that this bill with the individual mandate is constitutional, conservatives believe it is a body blow to the constitutional impetus to limit the reach and scope of a potentially oppressive central government.

And then there is the Massachusetts state health care finance reform bill of 2012, a massive bill passed with scant public discussion that may herald the national future of Obamacare. Massachusetts state financing has suffered under the health care reform bill of 2006 (so-called Romneycare), as its individual mandate led to over-enrollment in state-subsidized health care insurance rather than into private insurance, as was expected. In order to control the budget hemorrhage, this bill of 345 pages whose authors are impossible to identify was passed by a legislature that did not have time to read it.

It builds a massive bureaucracy that will control all money spent on health care in Massachusetts. Medical care will be delivered throughout the state by an experimental structure called an accountable care organization (ACO) that creates a perverse financial incentive as health care providers and hospitals will profit from delivering as little care as possible to Massachusetts citizens.

It is essentially a government takeover of the Massachusetts health care system, but this is Massachusetts.

Government is deemed good and so nobody cares.

How the political turmoil in health care plays out is impossible to predict. The changes that these bills trigger will be impossible to reverse. In Massachusetts, the new financial reforms may change health care delivery profoundly. Whatever these bills ultimately do to health care delivery and the economy in the future will become the “new normal” and Americans may then wonder how we got here.

Jay Fleitman, a Northampton physician, writes on the first Tuesday of the month. He can be reached at opinion@gazettenet.com.

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"Conservatives, on the other hand, see this bill as a large step in the intrusion of central government into the economic and personal lives of Americans, an action contrary to their view of the nature of American society." This is a great article and makes many confusing things clear. But the above statement is at the core. Why, if this is true, does the Republican Party seem to be the great threat to personal liberty and privacy? Consider the Patriot Act. I am confused by the role of libertarianism in the same party lauded by anti-abortion activists. At least since the Reagan administration, it seems to me, a liberal by nature, that the GOP is synonymous with the most dangerous kind of Big Government, dangerous in contrast to the Democratic Party's propensity for annoying intrusion. This is a sincere question.

Republicans that oppose the basic premise that core medical treatment should be affordable for all, regardless of their wealth are saying that a child from a poor family should be denied treatment that would be readily availble to a child from a wealthy family. These same Republicans will go to church and worship that we are all equal in the eyes of the Lord. The hypocrosy is overwelming. I'm not a Christain but I recognise that in a wealthy society there is room to support the truely vunerable - it all about priorities. Republicans, you can't be Christain and refuse healthcare for all.

Sometimes I think Dr. Fleitman writes his articles just to make our blood pressures rise.

Dr. Fleitman, you're my hero. You stand up for what you believe in, and speak the truth. You know full well all the vitriol that will be thrown your way. It's very sad that the so- called party of diversity and inclusiveness won't even stop to consider an opinion counter to theirs.

If that's your idea of a hero, you should really should aim higher. There are conservatives who are doing real damage to our country, not just braying canned platitudes against the current of a liberal local news outlet. If you're into that sort of thing, maybe try idolizing something in a Ted Cruz or a Michelle Bachman. Those are the real mavens of conservatism. Fleitman's just a beneficiary of politically correct journalistic tokenism...an affirmative action recipient among "moonbats," if you will.

As far as I have been able to discover, there is not a single argument against the Affordable Care Act that would not be solved by a single-payer heath-care system. Replace "Obamacare" with "Medicare" in any of those objections and see how many opponents would still (publicly) state it.

"Force through a major overhaul . . . with no room for advise and consent . . ."? It's legislation - it was passed as any other piece of legislation was passed - by majority vote by the parties in Congress! (It has also been upheld by the Roberts (Conservative) Supreme Court.) Just because you don't like it doesn't mean it's not legitimate. Here's a suggestion that typically works in a democracy: get enough people who agree with you to win in the next election and enact legislation you like better. That's what adults do.

Why do Republicans oppose the ACA? As with most issues involving politics--follow the Benjamins.

The Affordable Care Act has been attacked by Republicans with a litany of lies recently detailed in a Gazette op-ed. The author mouths the party line that is only too familiar. The background is complex and deeper than objection to the law’s number of pages or “death squads”. Republican rancor is rooted in racism in an attempt to carry out a political lynching of the country’s first African-American President. The law was “pushed through” after nearly a year of Republican “nyet” to every detail. They left the table. They spare little in an attempt to make the ACA a “train-wreck” Providers who have learned to lucratively game the system abhor change-self-interest is prime. The US is the only first world country without national health care. The medical-industrial complex is the 800 pound gorilla in a system that pays an insurance CEO $125 million a year and denies insurance to those who need it-the sick people. Providers are paid for the volume rather than the quality of care. Massachusetts Health Care is not “a complete government takeover of medicine”. The Affordable Care Act is not perfect but given time the rough edges will be smoothed out. It is the first step toward a single payer National Health System with access for all. Hospitals have been purchasing physician practices, large hospitals purchasing smaller ones and regionalization rapidly advancing. Despite the attacks and lies the ACA is the first step toward a bright future in which all Americans will have access to our world class medical care.

Typical Fleitman tortured argument. Keep it simple, Jay: 1. We've had Obamacare in Mass. for many years known as Romneycare 2. Virtually all previously uninsured are now insured at very reasonable (often subsidized) rates.. 3. No employee has lost their job because of the mandate 4. Romneycare established a bureaucracy but also has market controlled insurance offerings. Obamacare will do the same but also offer even less expensive 'national' policies by BC/BS and others 5. Physicians are mad about reimbursement and liability. Those are problems of private insurance companies and the legal lobby and Congress---neither has anything to do with Romney or Obamacare.

"There is no reason why Republicans as the opposition party should ever accept the legitimacy of this bill or render to it any respect." Yes there is. President Obama was re-elected and Obamacare was one of the reasons why. "The Democratic leadership could not have been given a clearer message of the public hostility toward this bill in 2010 when Republican Scott Brown was elected to the Senate seat previously held by Ted Kennedy in overwhelmingly Democratic Massachusetts, his campaign dedicated to the proposition that he would be the 41st vote to kill this bill." Scott Brown run because Martha Coakley took the blue state for granted and didn't run an good enough campaign. We've also been living with Romneycare for some time already. What's more, Massachusetts voted for Elizabeth Warren and the president. If that doesn't provide a clearer message, well, I don't expect Republicans to reason well. "Provisions of this bill are already limiting full-time employment as employers are switching to part-time workers, health care premiums are rising for many Americans and health care costs are being shifted to the younger population of Americans who already suffer from high unemployment and whose career paths are already in peril in the current economy." Health care costs are always rising. The biggest challenge to young Americans is not health care costs as much as it is student loan debt, for which the GOP seeks to make more capricious. The whole "limited full-time employment narrative is basic Republican hog-wash with no basis in fact, at least not by the author of this opinion. "Democratic membership in Congress was itself uncertain of the content and ramifications of this 1,200-page bill, which led to Pelosi’s famous statement of “Alice in Wonderland” logic that Congress had to 'pass this bill in order to know what’s in it.'" Members of both parties haven't been reading the bills they pass for quite some time now. Let's not pretend that this logic is limited to the Democratic Party. Let's also not pretend that universally health care isn't what Americans want at a more "universal" level that Obamacare provides.

Perhaps what we need is something like a cross between Obama care and "China care". Republicans want NO government in health care (but they seem to accept that government can mandate that health care be delivered to all, thus heavily regulating the delivery side of health care. But, they want the customer side of health care to be 'the market decides'. In China, maybe changing now, you go to ED for example, and you give them the cash up front for your treatment, or no treatment. Maybe we need that. Then, the youngsters, anybody really, who feel they don't really need insurance, as they don't really need health care, can be heald to account for their choice ( a true republican principle!) No cashy, no treaty, no requiring provider to provide obligatory care just because you show up. That will then truly be letting "the market decide" ; both sides of the market , certainly a truly republican ideal.

Can't allow this to go unnoticed. Chinese take great offense to phrases like 'no cashy, no treaty". If somebody had used similar uncle tom phrases during the recent Oprah posts everybody would be up in arms, or an anti semitic comment in response to the editorial about the gazette not having articles about Rosh Hashana. We don't use phrases like 'me no speakie english' anymore. Its the equivelent of the nword to asians.

That phrase is not a slur on Chinese speaking, or any Asian speaking, but rather is pure and simple English speak as the original writer would say it garden variety American to garden variety American; though on reflection I could see how a reader could view it as such. To any reader taking it that way, my apologies. But, the concept I was making still applies; for those who want to have full responsibility for their health care, with NO government intrusion, perhaps we should make it so the health system doesn't have to later , in that persons time of need , be obligated to make up for their gamble that 'they don't need health insurance, because they don't need any health care, because , hey, they're healthy'.

Some corrections: Major retailers have used part-time workers that are given no benefits for more than 30 years. It's not Obamacare that made them use part-timers. And it is those part-timers who are going to get health care coverage, finally. My health care premiums have gone down in the past two years. Only $5 or so a quarter, but $20 a year less is less. I suspect it is because of the provision that providers and insurers are limited in how much they can spend for advertising. Less advertising saves money for consumers. The cost of health care is going to go down in this country. Maybe Republicans don't care.

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