Op-ed column: Health care law still flawed; we need a backup plan
Last week was a rare moment of total validation for Democrats. After years of both political parties pretending they’re chock full of pre-eminent constitutional scholars, the country’s high court finally had its say. And Democrats won: the Affordable Care Act is constitutional.
That doesn’t mean Obamacare is perfect — or permanent. After all, if Mitt Romney is elected president, he won’t find it terribly hard to repeal the whole thing, given a solid majority in both houses of Congress.
And for New Yorkers, that’ll mean trouble. There will then only be one state in the union with universal health care coverage: Massachusetts. And it’s all thanks to the forward thinking and courage of their former governor, Mitt Romney, who set their system up — the great achievement of his term.
Wait, what? Yes, it’s because of Mitt Romney that our neighbors in Massachusetts get to enjoy a high-quality health care system, which is why President Obama modeled his own Affordable Care Act after Romney’s plan.
Both laws do essentially the same thing: They reform the health insurance market, give coverage to those who can’t afford it, and penalize the people who have means but insist on freeloading off our emergency rooms.
It’s no surprise that by June 2010, about four years after Romneycare’s passage, 98 percent of Massachusetts residents were insured. Even better, seniors and children were just a rounding error away from 100 percent coverage. It turns out that government can work efficiently to solve our problems, but only if we have leaders willing to work in a bipartisan, transparent fashion.
Though he’s now running from his own program, it’s worth remembering that Romney deserves a lot of credit: specifically, for stepping up where the federal government didn’t. That’s why it’s sad that Romney wants to deny all Americans the same health care coverage he gave his own state. But in the case this happens, we should make sure we don’t get caught off guard.
I don’t want to go back to the days where I could be denied coverage for pre-existing conditions, and I’m glad I’ll be able to stay on my parents’ insurance until I’m 26. I’m also glad employers are going to be required to provide health care plans, and that the private health insurance market is going to have to spend at least 80 percent of its budget on actually providing health care — or give their customers rebate checks. Call me a left-winger, but then you’d be calling Americans as a whole the same thing — the country overwhelmingly supports all of these provisions.
Not end of reform
I hope the media start mentioning the above and more, now that the constitutional debate is over. But these benefits can’t be the end of health care reform in America.
The system is still flawed and the legislation is too. Even if President Obama is re-elected and the ACA stays in place, there is one core problem that remains: The law doesn’t provide a public alternative to the for-profit insurance market, even though (anecdotal evidence aside) public health insurance has proven to be more popular and efficient where it’s available — be it in the rest of the modern world, or among America’s senior citizens who use Medicare.
I agree with the Republicans: There should be legal recourse for people who don’t want to buy into for-profit health insurance. However, that recourse should be a publicly run insurance plan. Policy wonks call it a “public option,” but a more accessible nickname might be “Medicare for All.”
Vermont is actually implementing this system over the next five years: They’re putting in a state insurance program called “Green Mountain Care” that legally has to keep costs below the average state level. Any additional taxes necessary to pay for it will be offset by the savings people get from the program. And before you assume something like this might work about as efficiently as the DMV, note that the rest of the industrialized world has some form of public health insurance — and that the United States nevertheless remains No. 1 in health care costs, while leaving 47 million uninsured pre-Obamacare.
The private market is best much of the time, but not for critical services where the product is more important than the profit. As far as health care goes, public options don’t spend as much money on advertising and administration. They also guarantee a basic level of care for the neediest, which can be supplemented by the private market for those who want extra coverage. By their very nature, public plans aren’t motivated by short-term profits, but long-term quality of health for citizens. And give everybody access to a “Medicare for All” system and you’ll see costs go way down, since such a system wouldn’t be covering only the poor and the retired — the pool would have people with steady incomes in it too.
Back up plan
Since Gov. Cuomo has championed Albany’s newfound competence, it’s time we put that competence to the test. Let’s have a back up plan in place. And if the ACA survives the next presidential term, we should go further. Let’s join Vermont, and the rest of the modern world, and set up a public plan for New Yorkers — one that would force the for-profit insurers to drive down costs themselves, or close shop.
Mitt Romney believed in 2005 it was important to take leadership to keep Massachusetts’ residents insured. Gov. Cuomo and the rest of us ought to be just as forward thinking as Mitt Romney once was.
Steve Keller lives in Averill Park and is a regular contributor to the Sunday Opinion section.