Friday, October 4, 2013

My Obamacare Experience... And Why The Shutdown Was Never About Obamacare

Being self-employed, I have had to buy my own health insurance for several years now.  I have been subject to the faster-than-inflation escalations in my premiums, and got a nice 40th birthday gift from Blue Cross in the form of a $50 per month premium hike.

Additionally, thanks to a nerve impingement in my right shoulder that needed a couple of months of physical therapy to work out in 2004, anything having to do with that shoulder is a pre-existing condition. So when I injured that shoulder playing sports in 2012 - eight years after a completely unrelated condition - Blue Cross would not pay for the office visits or the MRI to even find out what was wrong, let alone cover the arthroscopic surgery to fix the torn labrum.  As a result, I have had to live with some degree of pain for the last 18 months.

While the world waited breathlessly as the Republicans demanded ideological concessions just to keep the government open, I was actually most interested in whether the new insurance exchange launching at the same moment would lower my out-of-pocket health care costs, no longer leaving me at the mercy of Blue Cross actuaries.

As it turns out, Blue Cross themselves saved me some effort by e-mailing me a link to check out which plans they were offering in the ACA marketplace.

I currently pay $348 per month for health insurance, with a $1500 deductible.  For a plan with the same level of coverage, I will now pay $297 per month, with a $1000 deductible.  This will save me $1100 in 2014. That's $1100 that I will spend on something other than health care, money that will stimulate the economy and create jobs and tax revenue. That money did not come from other taxpayers. The savings came as a result of setting up an exchange that would allow everyone to access group buying power.

No, Mitt, you don't need to be a private equity magnate to be a job creator. In fact, the greatest engine of job creation is entrepreneurship. In fairness to Romney, he got that part right. We want people starting businesses, because their subsequent growth is what creates jobs. And now people will be freer to start new businesses, no longer tied to the security of their current employer's group health care plan.

Maybe that's what the Governor of Masachusetts was thinking when he reformed health care to achieve universal coverage in that liberal, highly educated state. Go figure.

As a bonus, my pre-existing condition will now be gone, so next fall I can have the surgery to repair the cartilage in my shoulder so it doesn't eventually end up arthritic.

Of course, the reason insurers can no longer discriminate against me for my pre-existing condition is because of the individual mandate. If healthy people were not driven into the risk pool, then everyone would simply wait until they were sick to get coverage, and the entire insurance system would collapse.

Irony of ironies, the mandate was a Heritage Foundation idea from the '90s, forcing "personal responsibility" on people so they wouldn't be such a drag on the system by showing up in emergency rooms. The individual mandate was a conservative answer to Hillary Clinton's quest for a single-payer system.

In any case, the Teahadists will scream about losing our freedoms, but as best as I can tell, the only freedoms I'm losing here are the freedom to be in pain and the freedom to overpay for health insurance.

Sorry, Senator Cruz, but contrary to what you wailed no fewer than 100 times during the course of your 21-hour fake filibuster/ideological hissy fit... Obamacare is working.  

Cruz and Marco Rubio, among other wingnuts, had forewarned during the course of the buildup to the latest unnecessary crisis that Obamacare would be near-impossible to get rid of once it rolled out, and that's why it had to be killed in its cradle.

Pardon my French, but what incomprehensible bullshit that is. If everyone truly disliked ACA as much as Cruz would have you believe when he repeated endlessly that Washington wasn't listening to the American people, then eliminating or at least eviscerating it would be easy and a great wedge issue to run on in the 2014 midterms and beyond. It would be a supreme exemplar of liberal overreach.

There are two things that conservatives truly feared...

1) Millons of people, including their own right-wing followers, would have the same experience with ACA that I just had and learn that Republicans have been lying to them about it for years. Once ACA rolled out, there would be no way to hide the truth anymore. And once the cat is out of the bag, the result is a huge defeat on the issue, and a potential backlash from their own base. Not only did Cruz and his acolytes promise that they could stop Obamacare (they could not)... but it's not even the deficit-expanding, freedom-killing menace it was advertised to be!  With each passing day, Cruz and the Tea Party have more and more 'splaining to do.

2) During the entire 2012 election cycle, we heard "Repeal and Replace" from Republicans without even a hint of a proposal on what to "replace" it with. Ideologically, the Ayn Rand wing of the party is fundamentally OK with the status quo: tens of millions uninsured and the rest of us paying too much.  Even if you skip past the moral issue of the richest nation on earth leaving so many people uninsured, it's brain-dead economic policy that slows growth by creating a feedback loop of rising health care costs even for those with coverage. The uninsured showing up in emergency rooms cost the rest of us money, and people like me who pay too much for health care are not spending that money on other things. Still, it's easier to argue against extending coverage than it is to argue for taking coverage away from people. At the same moment they shut the government down, the GOP also lost the ability to continue screaming "Repeal and Replace" without having a health care idea of their own. Once known as the "Party of Ideas", solving any kind of problem has not been the Republican way for a quarter century now - especially when a Democrat is in the Oval Office. 

We can now observe some clear patterns at work, so we can get at the heart of what the shutdown is truly about. Obamacare is just today's excuse to do what they wanted to do anyway. This shutdown isn't about Obamacare, and it's barely even about Conservative ideology.

And sorry, liberals, but while there are certainly millions of Confederates south of the Mason-Dixon Line who don't love the idea of a black man living in a house that they believe was named the White House for more than one reason... this isn't about race, either.

The Republicans are Ohio State; thus the Democrats, like Michigan, must be existentially bad and battled relentlessly in a zero-sum game.

This is not remotely about principle. It's purely tribal.

Let's take a walk through history...

In 1993, Bill Clinton raised the top marginal tax rate to 39.6%. Apparently un-moved by the fact that the Reagan tax cuts did not, in fact, trickle down and pay for themselves, every Republican in Congress voted against the hike. Republicans frantically told the American people that these tax hikes would slow down the economy and be a job-killer.

Of course, we all know what happened next: the largest peacetime economic expansion in history, unemployment fell to record lows, and the deficit disappeared and became a surplus. The tax hike was not even a tiny economic speed bump, but did improve the budget situation. Forced to choose between lower taxes on the wealthy or a balanced budget, we got a definitive look at which the GOP would choose.

Once trickle-down economics had been shown for a second time to be no more than a Randian fantasy, Republicans needed a new battleground on which to fight Clinton and the Democrats. They had no serious policy qualms with him. The economy was booming, the deficit was dwindling to nothing, and Clinton himself was a pro-business centrist whose governing bent was not dramatically different from his Republican predecessor.

Rodney King could well have been talking about the GOP rather than the LAPD when he cried, "Can't we all just get along?!"

Clinton had to be taken down.  Because freedom!

If you think the current shutdown is senseless, the shutdown of 1995 seems particularly absurd.  The defict that year was only a quarter of what it is today, and would continue falling.  Unemployment was at a low 5.6% and falling.

When public opinion logically turned against the GOP, costing them 8 House seats in the 1996 midterms, they opened up a new front in the tribal blood feud. Ken Starr, who had been appointed Special Prosecutor to see if he could make some political hay of the death of Vince Foster (a 1994 analog to Benghazi), had his mandate expanded to simply investigate Clinton's entire life in an effort to find anything at all that might keep him from governing.

All they found was a stained dress.

But remember this pattern: lose a fight on tax policy, have their position again be proven wrong, then escalate the tribal war into the realm of the pointless and ludicrous - throw a tantrum.

Clinton gave way to Bush, who blew the surplus and cut taxes (mostly on the wealthy) in the hope that the third attempt to validate trickle-down would be a charm. By the time we had finished putting two wars on a credit card, the budget surplus Clinton left us had turned to record deficits. Vice-President Dick Cheney, second in command of a party that purports to be the fiscally-responsible outfit, now hilariously said "deficits don't matter".  

Predictably, the Republican position on this reversed on January 21, 2009. Overnight, deficits now did matter, and the Tea Party was born.

Not having learned the lessons of the Clinton years, Obama idealistically - and foolishly - began his presidency believing that if he reached across the aisle, someone there would take his hand. Swept into office as a "movement" candidate, Obama harbored dreams of being a post-partisan leader, but the Republicans would have none of it. 

In January of 2009, House whip Eric Cantor and Senate leader Mitch McConnell led quasi-secret meetings where the decision was made to blanket-oppose all Obama attempts to govern. Chuck Grassley famously said he would not vote even for a good health care bill. McConnell, even more famously, said that the Republicans' top objective was to make Obama a one-term president.

Such blanket obstructionism was unprecedented. But wIth the bitter taste of the Bush legacy still in their mouths, damned if they were going to allow Obama to be Reagan to Bush's Carter.  Creation of a sect of "Obama Republicans" to mirror the "Reagan Democrats" would politically realign the country and force a wholesale reinventon of the GOP lest they cede total control of the government to the Democrats for a decade or more.

A successful Obama presidency would be an existential threat to the GOP, and they responded accordingly.  The GOP proceeded to employ Fox News in a massive campaign of misleading, hypocritical and oftentimes outright false propaganda to stir up as much tribal hate and fear as possible.

Remember the Birther campaign, anyone? Death panels? The whole GOP Greatest Hits album.  

Pouring gasoline on the intellectually bankrupt but tribally vital Tea Party movement in order to re-take the House in 2010, Republican obstructionism progressed into wholly toxic territory. Ted Cruz, Mike Lee and 40 or so Tea Party House members have paralyzed the legislative branch - indeed, they have passed less legislation than the famed "do-nothing" 80th Congress during the Truman years. They did not go to Washington to govern the country better than their predecessors had. With Obama in the White House, they went there to make sure the country could not be governed at all. This is how Congress can defy 90% of the country's desire to see expanded background checks on gun sales.

Obama made yet another mistake in negotiating over the 2011 debt ceiling raise, an episode that remains stunning on multiple levels.

First, Obama allowed the Republicans to engage in hostage-taking as he actually negotiated with John Boehner - a mistake he has smartly not repeated. Such tactics cannot become accepted political process if America is to be governable. How would the Republicans view the same tactic if Obama refused to sign any Federal budget unless Congress passed comprehensive gun control?  My guess is they would call such hostage-taking treasonous and impeachable.

So Obama and Boehner worked out a "grand bargain" featuring $10 in spending cuts for every $1 in revenue... and incredibly, the Republicans rejected it.

For some of the hardened Teahadists, any compromise whatsoever, even one weighted overhwelmingly to the right, was unacceptable. If the other side is evil, how can you compromise with them? And anyone who expressed a willingess to do so would face a primary challenge from the right. Jim DeMint has pushed Congress further to the right while in charge of Heritage Action then he ever did in the U.S. Senate.   

Can you imagine any Republican today working with Obama the way Ted Kennedy worked with George W. Bush on the well-intentioned but ill-conceived No Child Left Behind?  A Republican can't even go to the White House for movie night without fear of being primaried.

Thus, in the Republican deliberations on the "grand bargain", Paul Ryan espoused the real reason for rejecting the deal: Obama would be seen as a bipartisan deal-maker and problem-solver, willing to put country first. It would all but seal his re-election. 

The GOP would not even accept what they had asked for if it would help Obama!

The debt they claimed to care so deeply about was still a secondary consideration to re-taking the White House, even if having a Democrat in the White House did not prevent them from getting the debt deal they claimed to want. This was simply the latest instance of the GOP not caring nearly as much about deficit and debt as their bumper stickers would have you believe.

So here we are today. The Bush tax cuts for the top bracket have expired, and that hike has once again not slowed down economic growth as the Republicans had claimed it would. Further, the deficit has continued to fall, just as it did under Clinton. We're now 4-for-4 on trickle-down proving not to work in practice. It is, unquestionably, as George H.W. Bush called it in 1980: "voodoo economics". It's settled science, like climate change, evolution, and other things conservatives don't believe in.

Remember our pattern: lose the fight on tax policy, have their position shown to be wrong, then embark upon a pointless tantrum to obstruct government with no clear, realistic objective or endgame beyond the shutdown itself. This is not, and has never been, about Obamacare. We've seen Republican descension into zero-sum tribal madness before, so we know what this is about. This was eminently predictable. 

This latest showdown is about the modern Republican Party's steadfast refusal to even participate in the government at all if there is a Democratic president.

No comments: