The Obamacare Nobody Knows – Part 1

By David Adamson

(This is the first of a series.)

I was a foot soldier in the crusade to pass Obamacare.

David Adamson worked in high technology and health care. He’s the author of Walking the High Tech High Wire and The Wellness Club. He’s written hundreds of blogs on politics and fitness. Learn more about David…

Initially, it wasn’t by choice. I was the executive of a federally qualified community health center (FQHC) with outpatient clinics in rural mountain towns in Colorado. FQHCs, the linchpin of the national healthcare safety net, would play a frontline role in its implementation. Part of my job was to learn what was going to happen, when, and why.

I read books and articles, attended conferences and workshops, joined conference calls, and talked to high and low government officials. Most importantly, I read all 906 pages of House Resolution 3590, the Patient Protection and Affordable Care Act (ACA), which became known as Obamacare. Hidden within the legalese was the thinking of our best clinical and health economics and finance experts translated into policy.

Among the healthcare communities with whom I worked, word got out that I knew a little about the ACA, so I was invited to summarize it to county commissions, hospital boards, and public health departments who didn’t yet. I’d show graphs like this:

 

Then I would explain that our healthcare system had become a financial black hole, sucking in every free dollar, and closing in on 18% of GDP (it’s now 20%). Insurance premiums and deductibles were soaring out of control, as they had pre-Obamacare (and still are — in 2016 it was $25,826 for a family of four). They were squeezing out wage increases and other purchases, like vacations and college. Private sector American companies complained the cost of employee health insurance was making them uncompetitive in global markets. And uncompensated care delivered to the uninsured flooding emergency rooms was hurting hospitals. I’d finally present how the ACA would change this.

My time in the ACA crusade was an eye-opening adventure. Had I been more astute, I would have seen the anti-Obama, ultra-conservative onslaught coming that now plagues our body politic, starting with this troubling scene at a pro-Obamacare rally in Grand Junction, Colo., on Aug. 1, 2009.

Troubling scene: Protest at a pro-Obamacare rally in 2009 in Grand Junction, Colo. Photo by David Adamson.

Or two years later when I was requesting the support of a Republican county commissioner who dressed like a Wild Bill Hickok, right down to boots, duster, shoulder-length hair and handlebar mustache. We were planning a new clinic, to be partly supported by federal funds, in a town that was overrun by uninsured natural gas fracking workers with their attendant health problems, e.g., respiratory ailments, VD, alcoholism, and meth. He took me in his computer to show the National Debt Clock (it’s really cool), and, with sincerity, said that as a patriotic American concerned about our future, he would not support any project using federal funds because that would increase the debt. He added warmly that he supported what we were going to do (and did).

These days when Republicans threaten to repeal Obamacare, it’s obvious that they don’t know what Obamacare actually is. They didn’t when it was passed in 2010, and they don’t now.

Same protest at a pro-Obamacare rally in 2009 in Grand Junction, Colo. Photo by David Adamson.

President Obama could have enjoyed a long tenure in the White House without ever getting tangled with healthcare. As the hapless Republicans are about to discover, healthcare is dangerous for politicians. Corporate healthcare is not heavily populated with leaders whose values are inspired by Mother Teresa. If you threaten their profits, they will try to stop you. Obamacare has been profitable! (Remember insurers sponsored the ads that first branded Hillary Clinton as a cold-blooded, elitist bureaucrat when she tried to help Bill reform healthcare in the early 1990s, and the poisonous label stuck with her right up to her defeat in 2016.)

However, President Obama, a faithful Christian, believed that all people should have access to healthcare. Suffering, disability, and death may be part of the human condition, but access to modern medicine can often eliminate, reduce or postpone them. In his view, it was flat-out immoral that almost 50 million Americans were blocked from it. The Bible commands believers to heal the sick.

Also, one of the most visionary presidents ever, President Obama realized that the healthcare system itself poses a long-term threat to the US economy. He needed to act. It would be dicey; he would be like the kid in the boat with a hungry tiger in “The Life of Pi,” only he would have to finesse multiple tigers — insurance, pharmaceuticals, hospitals, nursing homes, provider associations, equipment suppliers, laboratories.

This already dangerous task was made worse by the ignorance, hostility, and, let’s be honest, racism of Republicans in Congress.

On Feb. 25, 2010, I stayed home from work with a wicked head cold and happened to flip on C-Span, which was live broadcasting the Health Care Summit, hosted by the President, for the leaders of both parties to exchange views about the bill.

Aware he was on national television, Eric Cantor, then Minority Whip, walked into the room with a hang-dog look on his face, carrying a foot-high stack of loose paper that he plopped down on a table with a dramatic sigh.

President Obama patiently watched this, then observed, “The truth of the matter is—is that health care’s very complicated. And we can try to pretend that it’s not, but it is.” At every opportunity, Republicans had been exaggerating the gross volume of the healthcare bill to frighten the public that it was packed with god-awful provisions such as death panels and socialized medicine. (Read the transcript here. President Obama knew his stuff.).

Senate Minority (now Majority) Leader Mitch McConnell, then and now the personification of active aggression towards President Obama, was in the room that day, sulking like always. But to his credit, he was listening because just last week, after releasing the Republican’s 147 page tax cut for the rich posing as a healthcare plan, he conceded that healthcare is “a big complicated subject.” Republicans have no plan of their own to improve healthcare.

Many of us, me included, would have preferred a single payer system like those in the rest of the industrialized world. However, President Obama was a pragmatist. He inherited an economy in the worst recession since the Great Depression. Support was shaky because of turncoat, deficit hawk Blue Dog Democrats. A single payer system was not a politically realistic option.

Facing reality, President Obama smartly neutralized the fears of the healthcare establishment, especially the insurance companies, by ensuring they would not lose money. He combined taxes on the rich, as well as several more obscure ones, and deficit spending to create access quickly. As a result, Obamacare has provided healthcare access to over 20 million Americans. That’s an amazing achievement.

Today no contorted Republican free market math can accomplish the same for less. Under any imaginable scenario, no matter how you fund access for the poor and people with pre-existing conditions, it will never be profitable and will have to be subsidized forever.

Obamacare was never just an insurance program. That’s why it was 906 pages long. It is the framework for a long-term transformation of our healthcare system to make it better and less costly.

It has already irreversibly changed the delivery of health care. You can see it when you go to your primary care doctor or into the hospital, if you know what to look for. In the long run, all of us, including Republicans, will be healthier because of it.

Bye, Bye, Democrats: Yadda-yadda, Not a Joiner

By Alan Vitello

Whelp…I recently switched my party affiliation from Democrat back to Unaffiliated.

That’s not because I no longer believe in most of the basic, and theoretical, tenets of the Democratic Party. It’s because I have become profoundly disappointed with the party and the way it is run.

Alan Vitello is a writer and an award-winning cartoonist who lives in Colorado. Learn more about Alan…

That, and because of a recent experience I just had. Let me explain:

Several weeks ago, I received an email from OFA, also known as Organizing for Action, formerly known as Organizing for America, which formerly was Obama for America. The email advised that—should I choose to apply—they were looking for “OFA Fellows” (read: “community organizers/activists”).

I applied. Passed. Had the phone interview. Passed. Spent four hours on a recent Saturday at an OFA orientation. I left a bit perplexed at the lack of specificity given to what, exactly, I and 40 other selected people would be doing.

Then, I sat through a two-hour webinar on March 8, followed on March 13 by an hour-and-a-half conference call with my “local group.”

It reminded me an awful lot of the disastrous and distasteful semester I spent on the student council during my senior year in high school: “Hey! Let’s pick the colors for homecoming, then we’ll put on a musical in Old Man Murphy’s barn to save the steel mill!”

What the…?

Don’t believe me? Well, read on: An OFA group in Boulder wanted to have a “Teach In.” What the…is a teach in? This is 2017, not 1969! Our local OFA manager LOVED the idea.

An observation about myself surfaced in my thoughts, something I’ve pondered other times in my life: I am not a rah-rah, praise Jesus, Can-I-Have-an-Amen! kind of person. In fact, I kind of hate when I have been in situations where I am expected to behave like a rah-rah, praise Jesus, Can-I-Have-an-Amen! kind of person.

The times I have been in such situations (and you’d think I’d have learned my lesson by now), all (ALL!) ended up with a bad taste in my mouth: teaching religious ed (and being a “proclaimer”) at our (former) Catholic church; being a Cub Scout leader; and my time as a union steward…all of these episodes asked me to open my skull, remove my brain and simply parrot the party line.

Nope. No can do.

It also became clear to me during the March 13 conference call that I was probably the only participant (of a dozen or so) who did not think Barack Obama was the single best president these ol’ United States of America has ever had. I don’t think that, at all.

It also became clear that—under the guise of the usual, liberal, let’s all respect-each-others’ opinions, yadda-yadda-yadda pablum—that the fix was in.

We were supposed to conference to offer our suggestions on what our first OFA-group community outreach capstone project was to be. Each of us was to offer an idea; then we would vote. But it didn’t go that way. Our appointed OFA manager first asked a person she knew from before what HIS idea was. Then she decided his was A GREAT idea. And that was that. Everybody else was just along for the ride.

Harrrummpphhh!

I’m not a guy who will allow his opinion to be subsumed into group think just because I am told to. Nope. It’s the editorialist/journalist and Mary and Joseph Vitello (my sensible parents) in me.

One of the many reasons I loved coaching soccer (and stuck with it fall, winter, spring,  and summer for eight years)—besides great kids and their great families—is that Arvada Edge (the soccer league in Arvada, Colo.) left me alone to run the team as I saw fit. They offered advice when I asked. They offered a few coaching seminars. More than anything, they let me coach. They let me figure it out. I never had to stand up for a praise Jesus (or Pele) even once.

Let’s face it, there’s a lesson for Democrats to learn here.

And a good lesson for me: I am just NOT a joiner. Nor a lover of yadda-yadda-yadda pablum. I still have a brain in my skull, so I’ve still got that goin’ for me.