Obamacare and The Red Scare

George R.R. Martin has a quote that I adore: “Nobody is a villain in their own story. We’re all the heroes of our own stories.” It is a relatively simple statement but it’s surprisingly difficult to maintain in one’s head. When I heard about the decision made in Congress, with its Rocky-themed fanfare, cheering, and beer celebrations, I saw red. I felt pure, unadulterated anger directed at the minions of Dr. Evil; henchmen rubbing their collective tiny hands together in smoke-filled back rooms as they conspired to screw over the most vulnerable of our people. As I sat stewing in my own rage, I realized I had never looked at the Republican argument in favor of repealing the ACA. I never felt like I had a need to look into it further. The ACA and its continued growth and rework is so universal to what I want for my country and to what I support in my political ideology that its repeal in turn represents something antithetical to who I am. That however goes against the promise I made to myself at the start of 2017 to keep a more open mind and so therefore I started delving into what drives the ACA repeal.

Many Republicans see the ACA and its push for coverage for all as representative of the government tampering in what should be a private doctor-patient relationship. The balking at tampering though seems to pale against the idea that the numbers don’t add up. While we now have substantially fewer uninsured Americans, insurers on average have lost money in the exchanges and premiums in 2017 increased by around 22% on average. This cost in turn has been passed on by the insurers to people who make more money. Republican lawmakers see this as the beginning of the destabilization of the insurance markets. The higher costs will keep younger, healthier Americans from signing up which is necessary to keep insurers funded. The insurers will need to raise prices further, thus pricing more people out of the market. Lather, rinse, repeat. Eventually the whole thing collapses, leaving many more people uninsured than before the ACA was passed.

What is surprising to many is the support of some of the Baby Boomer generation to repeal the ACA as they represent a group whose insurance is often partially or fully government-subsidized, and who are often the most vulnerable to unexpected shifts in costs. This seems to be an issue steeped in history, both for the Baby Boomers and the Republican party. Back in 1945, Truman wanted to expand the existing social safety net created by FDR’s Social Security Act. Truman’s desire was for there to be healthcare for every American citizen. He called for increased taxes on every wage-earning American to cover the cost of this healthcare and for the remainder to be placed into a pool that would supplement a person’s income if they were left in a position where they were too sick to work. The nation, weary from World War II and still adjusting to the higher taxes of FDR’s New Deal became even more agitated by the idea of another increase in taxes and what they viewed as governmental overreach.

Meanwhile, the American Medical Association had an apoplectic fit over Truman’s bill. They had their own plan formulated already that emphasized private insurance options, which maximized their earning potential and would reinvigorate their flagging ability to shape American politics. They hired a PR firm to help torpedo the legislation who in turn coined the phrase “Socialized Medicine.” Remember, this was the age of the Red Scare. The first Red Scare had faded only 25 years prior and the second Red Scare was only two years away. McCarthyism was taking hold and fear of Communism was being crammed down America’s throat.

The AMA, using the backing of special-interest groups and an aggressive media campaign touting the Communist evils of Truman’s healthcare plan, made the plan deeply unpopular with the American people. Republicans capitalized on Truman’s flagging popularity and took control of both the House and the Senate in 1946 and there died Truman’s hope for universal healthcare. Republicans in turn were now the political heroes who stopped a massively unpopular bill, and were the party that defeated encroaching Communism and sent it packing.

With the Truman plan out of the way, the government instead offered tax breaks to companies to provide insurance plans to their workers, which began the system we had up until the ACA; insurance inextricably bound to employment. But through the years, Democratic presidents have tried to push us closer to universal healthcare. In 1965 Johnson took the bones of Truman’s plan and used them to construct Medicare. Obama eventually building on that further to create the ACA. Yet through the decades, the specter of the Red Scare and the stigma associated with socialized medicine remained. Republicans point to the dwindling resources of Medicare as being indicative of what to expect from the ACA. Ironically so in that we have such a large elderly population specifically because of the protections that Medicare provides.

The reasons are there, lacking much of the nefarious nature to which I once attributed them; driven by history, ideology, and economy. I don’t agree with any of them but I can now at least say that I see them. I feel those beliefs are part and parcel to a philosophy that consistently looks too much to the past and not enough to the future. I am not alone in that thought. Even as Republicans hold strong majorities in government, their philosophy and beliefs are unable to hold back the inexorable march of progress and time. I see them trying to remain unchanging in the face of that progress, but progress always wins.

At the end of the day George R.R. Martin’s quote holds true for me, I see no villains here. I see Don Quixote tilting at windmills. The poor, the vulnerable, the disenfranchised exist as flowers in front of the windmill. They’ll be trampled under Rocinante’s hooves, but Don Quixote sees only flowers and monsters, and flowers are acceptable losses when fighting monsters. He will save the day and win the heart of his Dulcinea. He will be the hero one more time, wrapped comfortably in his own story when Death and its rime-tinged lips kisses him goodnight. My anger is still fierce but I find it now tempered ever so slightly with pity.