Alternatives to Obamacare

I had an epiphany yesterday.  Republicans in the House have voted to repeal the ACA 46 times and not once have they offered an alternative.   The reason that they have not offered a reasonable alternative to Obamacare is because Obamacare was their idea.  Yep.  Back in 1974, the Nixon administration proposed an insurance program where all employers would provide insurance for all of their workers or face a fine.  The poor would be added to an expanded Medicare and small businesses and low income folk would receive a government subsidy to help cover their insurance costs.   It failed because Democrats wanted a public system rather than one based on private insurers.  In 1989 the Heritage Foundation proposed a law with an individual mandate requiring everyone to purchase insurance and that feature began showing up in Republican proposals for healthcare reform up until Newt Gingrich made it a centerpiece of his agenda when he was Speaker.  All of this on the federal level.  Then, of course, Romney established a very similar plan in Massachusetts on the state level.  Obamacare is a Republican program.  A Democratic program would have centered on a public option with a single payer.  The ACA is not socialized medicine, it is a program based on the private sector. 

There are other options to the ACA.  I prefer a single payer, public program.  I think that is the only way to address the myriads of problems in our healthcare delivery system.  There was no way the Republicans would have voted for truly socialized healthcare and there were enough Dems who would have sided with them that it was an idea that was dead in the water regardless of whether or not it might have been the best idea.  It never even made it to the table for discussion.

I have heard two other options mentioned by some.

Leave the system alone.  That is fine if you are someone who has good insurance from your employer without a large employee contribution or never experience any illnesses or accidents that cause injuries.  It leaves out the folk who have no insurance or are under-insured.  It causes many people to forgo treatment until it is too late and sends others to the most expensive healthcare option of all, the emergency room.  It leaves those out who have pre-existing conditions which preclude them from purchasing insurance (and there is no way to stop insurance companies from excluding pre-existing conditions without an individual mandate).  And regardless of what folk say, healthcare does not work like any other "free market" industry so in this option there is no way to slow the runaway price increases we've all experienced.  Leaving it alone is not an option that I can see as making any sense at all.

I've recently seen multiple folk advocating another option which I find sickening (excuse the pun).  They are arguing that we do away with insurance completely.  Healthcare would become like any other commodity on the market with individuals bargaining with physicians and hospitals when needed, health care going only to those who can afford it, and the "free" market running its course.  In their minds, those who are healthy would not have to subsidize those who are not and those who are not in this scenario are always caricatured as irresponsible folk whose poor choices are causing their problems.  While there are many who do not need regular doctor visits or medications and think they can go without insurance, one accident or unexpected illness changes everything in a heartbeat.  Those folk argue that a free market would bring down costs, but never imagine the ridiculousness of sitting in the emergency room with a broken bone sticking through their flesh while arguing with the doctor about the costs or leaving to go 55 miles to another hospital that treats heart attacks more inexpensively.  I presume they would argue that anyone arriving at the hospital must pay in advance or not receive treatment.  Without that stricture, who would pay for those who receive treatment and never pay?  Most of all, this kind of idea completely excludes any sense of community and the greater good for the entire community.  I can't help but think of politicians in New York and Colorado who argued against government disaster funds until their communities were struck by Sandy and terrible floods and they saw the light that we really are all in this together.  The only folk for whom this option works are the very, very, very few who never get sick or injured or the extremely wealthy.

Are there other options that I've missed?  Realistic ones that preserve a sense of community?  I agree the ACA is not the best option.  I would even agree that it does not represent any sense of a compromise.  In spite of the fact that it was passed by the Dems,  it is a completely Republican idea that Democrats supported, expecting that Republicans would own the baby they birthed.  They did not.   And they offered no reasonable alternatives... because their proposal was already on the table.

The Authority of Faith or If You're Going to be a Catholic, Be a Catholic

I believe in freedom of religion.  I believe politicians can and should vote their consciences and that their consciences should be informed by their faith.  I also don't believe that public policy should be formed around religious preferences.   That basically means that when a politician puts forward a policy that is consonant with their faith, they better also have some good reasons that are outside of their faith.  A foundation in one's faith is not enough to form public policy.

I respect politicians who truly hold their faith, whatever it may be, and live it with authenticity.  I have no respect for politicians who use faith as a wedge between constituencies and I have little respect for politicians who are less than genuine in their commitments.

That brings me to Rick Santorum and Newt Gingrich, both of who have been playing the "good Roman Catholic" card of late.  Neither is a good Roman Catholic.  Both are ignoring the nature of authority in the Catholic church.  They think and act as if a good Roman Catholic can pick and choose between the teachings of the church and embrace those that fit their own politics or morals while rejecting others.  While in fact, many who call themselves Roman Catholics in the US do just that, it is a difficult place to be when the Catholic Church is built on a hierarchy of authority which cannot be easily ignored.  Juan Cole has an interesting blog piece entitled the Top Ten Roman Catholic Teaching Rick Santorum Rejects While Obsessing about Birth Control where he shows how Santorum does just that.  These two politicians claim to be pro-life and point to their supposed Roman Catholic faith as the foundation for that understanding, all the while ignoring that in Roman Catholic teaching, pro-life is a much broader term that rejects capital punishment, any kind of pre-emptive war, most specific wars including Iraq, and which calls for universal health care, welfare for all needy families...

The first time a politician stands up and says "I am against birth control because I'm a Roman Catholic... and I'm also against capital punishment.  I take Just War Theory seriously and I believe in a safety net that truly provides for the needs and dignity of the poor," I will take that person seriously.  Until then, he or she can't say that they hold a position based on the authority of their church without me laughing at them.  I laugh at Santorum and Gingrich.

Now, there are other kinds of Christians who understand authority very differently.  The Baptist tradition, for example, says that an individual's relationship to God is between them and God.  Authority does not come from a hierarchy but from responsible reflection by the individual and interaction with the Holy.  Without responsible reflection and without relationship to the Holy, there is no authority.  Even when the relationship is authentic, in this tradition, one still cannot generalize the shape or substance of another's relationship with the Holy.  (This is why freedom of religion was an idea that came primarily from the early Baptists).  I know many in this tradition, my tradition, who see things very differently than I do.  Some I respect deeply because their views are based in responsible reflection and in their understanding of their relationships with God.  Others... not so much.

Still other traditions place the authority in the gathered community.  The bottom line is that if one is going to claim religious authority for a particular stand, they had better understand how authority works in that tradition and own the tradition.

why I won't vote for any of the Republicans

OK... anyone who knows me knows that there is a simple answer - BECAUSE THEY'RE REPUBLICANS!  There are clearly some Republican stands that do not work for me.  In my estimation, they are all too quick to throw the poor under the bus and to shred the little safety net we have.  As a party, they have focused on what I think is the wrong issue when they talk about the deficit while what we really need are jobs.  Yes, yes, yes, the Dems are not much better, but they are a little better.  So here are a few of my reasons with each of the four remaining candidates.

Newt...  character counts.  He has none.  We can look at his hypocrisy as he claims to be a "family values" candidate while having done more to sully marriage than anyone I have ever known, read, or read of.  And while involved in despicable behavior, he had the nerve to condemn Bill Clinton for similar acts.  I know he says it was not about the sexual acts but about lying to congress, but when the moderator of the South Carolina debate asked about his behavior with his 2nd wife, he said it was despicable to ask such questions in the midst of a presidential campaign.  Evidently it was fine to ask such questions of a sitting president?!  He claims to have changed.  People do change.  I don't believe him.  His mean-spiritedness through the debates shows that he is the same old Newt.  There are those who talk of him as having "big thoughts" and "great ideas."  When his big thoughts and great ideas include essentially doing away with child labor laws, they sound like terrible ideas and small thoughts to me.

Rick Santorum... I respect a person living their faith and bringing it to play in their politics.  Every single political view that I hold is impacted by my understanding of who Jesus is and what it means to follow him.  That said, Santorum's understanding of what it means to be a Christian is, in significant places, diametrically opposed to mine.  And while I believe one can act ofor public policy changes based on his or her faith, public policy can never find its sole or even primary justification in anyone's faith.  To believe that birth control should be outlawed is so far outside of the mainstream and so far outside of anything that is positive for our country that I can't imagine him being president.  Add to that gender views that take us back at least a century.   I guess I expect more from him since he calls himself a Christian and a Roman Catholic.  When he completely dismisses the rest of the "pro-life" views of his church without a blink, I wonder how much of his political views really are based in faith.

Mitt... First, running a government is not the same as running a business and anyone who thinks it is or should be, doesn't understand government.  Add to that the fact that his role in business was to purchase weak companies, strip them of anything of value, and essentially throw the rest away.  Even if business and government were analogous,  that is not how I want to see government run.  That he is so incredibly rich that he doesn't have to work, makes more in a week off of investments that I do in a decade from work, and seems to see nothing wrong in paying a lower percentage of taxes than the vast majority of the 99% makes me wonder whether he really gets it.  It also seems that he wants this job too bad.  He seems to switch his views depending on what he thinks will get him elected... perhaps not an unusual trait for a politician but still one that I won't vote for if I can help it and it just seems too obvious with him.  I do respect that he gives a much larger percentage of his income to charities than any other politician I know of. 

Ron Paul... he's the one that really scares me.  I don't think the Republican establishment would allow him to win, but I think he is the candidate who would be most able to beat Obama.  Paul's commitment to reduce the role of the military and to end our empire is very attractive to me and to many liberals.  His commitment to enforce the parts of the constitution that protect individuals from the powers of the state likewise is attractive.  His libertarian views regarding drugs also are attractive to many liberals.  His consistency is a wonderful thing in the days of politicians reading polls and changing their views like their ties.  He could strip off many liberal voters who are disenchanted by Obama's militaristic bent or who drank the Koolaid that he is a socialist and expected him to act like one.  He isn't and he hasn't!  At the same time, I think that many Republicans who find those views distasteful would still vote for him just to vote against Obama.   I think he might gain far more than he would lose.  The parts that I don't like about Ron Paul scare me more than the parts I do like entice me... he is commitment to shredding the safety net for the poor, doing away with government involvement in ensuring safe food, water, air, and drugs.  He does not believe government has a role providing an adequate education for all or providing foreign aid that can make a difference in saving the lives of literally millions overseas.  Those views are more than I can take.  Add his racist statements of the past and he is completely off my list too.

When I listen to what each of them envisions for the country, for the world, and look at the stands and characteristics they bring to the table,   none are the kind of leader that I believe we need in this difficult time.  None bring the kind of vision of the future I want to see implemented.

So that leaves me with Obama.   Folk who know me also know that I've never been a huge fan of Obama.  During the Democratic primary I described him to my friends as a centrist and looking at his work in office, that is exactly what he has been... and I'm anything but a centrist politically.  I'm not thrilled... but I like him much, much, much better than any of the above.  I wouldn't vote for a third party candidate even if there was one I loved because I'd be too afraid one of the above might win.

So, given the choices, for me, it's Obama 2012.