Healthcare Fun Fact #1

Yucky Obamacare Versus the Affordable Care Act

What initially inspired this whole series was a screen shot of a Facebook exchange where somebody was celebrating the repeal of Obamacare as a great first step in 2017, and then pointed out he wouldn’t be effected personally because his insurance was through the ACA exchange. People laughed and mocked him directly, in online groups across this great compassionate land of ours, and in the comment sections of articles spreading the post far and wide. And dissenters of course screamed “fake news!” But it got me thinking.

Why mock somebody for not understanding something that isn’t so readily understood?

I mean, seriously. The last eight years have been one big campaign of misinformation on one side, and some truly lackluster communication strategies on the other. I don’t think this guy should get sick and potentially die over it, no matter who he voted for. I mean, yeah he could have used Google a bit more, but maybe he has a lot of other stuff happening in his life. Game of Thrones takes up a lot of time. I don’t know.

So here is some basic stuff, that maybe you’re afraid to ask yourself.

Obamacare and the Affordable Care Act are actually one and the same. In the 2008 race everyone was hot to fix healthcare and a candidate’s name would get randomly attached to whatever they were proposing in their platform. It was within this context “Candidatecare” was born, and everyone had one.

“Obamacare” got translated into a kind of socialized medicine free healthcare for all type of proposition. And a lot of people hated that idea. Like, look at the picture at the top of the page. Remember the death panels? It. Got. Ugly. And irrational.

But in reality, as everyone went to the polls in November of that year, what Citizen Obama was pitching was a private/public solution, with the goal of universal coverage, income based subsides, shared responsibility and some regulation that wouldn’t deny you some coverage if you had been sick before, and coverage and services wouldn’t be more expensive just because you were born with some lady parts. Here’s a long, boring article comparing McCain’s plan to Obama’s without political bias. If you wonder where people started to not appreciate what was being proposed, the length and dryness of this article is a good first step. I feel bad even linking it for you.

But the headline is, Obamacare was never about socialized medicine or total government takeover of health insurance.

Here’s the funnest of fun facts which some know, some don’t. This plan was based on the Massachusetts state healthcare plan that had been relatively successful and embraced by the folks of the commonwealth. It wasn’t perfect but it was nice. Thanks Mitt Romney (sincerely, not sarcastically).

Obama won, and in addition to a tiny financial mess he busied himself with, healthcare became his signature issue, one that he would be lobbying for through the very very end. In theory, what eventually became the Affordable Care Act should have been an easier proposition than other options he could have put forward. It had a track record at a state level. It was implemented by a Republican. It made progress without ignoring the part of the country that was railing against socialism. But no.

I’m venturing a hypothesis that the healthcare debate and congressional voting was the real first social media wedge that caused friends to just give up on one another and be done already. The first “why can’t we just go back to posting pictures of kittens and food?!?!?!” plea. My own friends list suffered some casualties.

It wasn’t easy. But it passed.

Here’s my professional opinion (for real). The name “Obamacare” took on a life of its own during this time, and was used to rally opposition against it. When it passed and started gaining more public support President Obama embraced it. He was proud of this milestone. He wore it like a badge of honor. He was very very wrong to do so.

The problem is, the name is easily misunderstood for an insurance plan. And too easily separated from the Affordable Care Act, which is not an insurance plan either. When you have a topic that doesn’t demand attention, you can’t afford to confuse people with the basics.

This type of misunderstanding became late night fodder, and oh wasn’t that so so funny to laugh at people who didn’t get it? At the time I’m going to admit um yes. It was hilarious. In hindsight I really wish we had taken this more seriously, and also hadn’t been so arrogant. (Even though people having insurance is the right thing to do). Because look where we are now.

So, what is the Affordable Care Act, exactly?

The ACA is legislation, not insurance, introduced to make our healthcare system work better for patients by addressing three specific goals: cost, quality and access. Within each of these aims there are financial, technological, clinical and marketplace initiatives including Medicaid expansion that work to meet those goals.

Because of the ACA the uninsured rate is the lowest it has been in history — which means more people have access to preventative and wellness care for the first time, less people are denied coverage or face a lifetime cap in coverage, younger people who are struggling to find employment (remember the Great Recession!) could stay on their parent’s plan, and lots of other nice and civilized things.

And now we’re fighting to keep it. Or kill it. Depends on which side you’re on. Is it the best thing ever? No. Could we do better? Absolutely. Though in the coming days I hope to show you how many challenges are before us so you can see all the pieces.

Let’s start here.

Did you know 75% Americans support either keeping the Affordable Care Act, or leaving it in place until another plan is ready to go? That’s not an insignificant number of people agreeing on one thing, especially for a subject matter that has been so divisive for nearly a decade. I mean I hate to say something so obviously, but how hard is it to build from this point of agreement? How hard would it be for representatives in government to listen? I suppose we’re find out, and cross our collective fingers.