Had they called it “Obamasurance”, which it is, instead of Obamacare, which it never has been, it may never have become law in the first place.
And voters today would be fully aware of the type of end run the Republicans are trying to employ to save that which is most profitable to them and nothing else.
With Democrats the name they put on legislation is never accidental. “Affordable”? “Care”? Right. Under FDR they named “Social Security” and it really wasn’t. Under LBJ they gave us “Medicare”, and that wasn’t either. “Civil Rights” is one of the most profaned terms in American History. By the 1960s, after the first full Social Security generation had retired, a working person could sit down and figure out how much better he could have done with his 3% forced contribution simply by designing his own retirement plan. My dad did. (Today it’s 6.2% or 12.4% if you’re self-employed.)
The big winners in this forcible tithing have been 1) the federal government, adding thousands of new 6 x 6 office cubicles to the voting populations of areas around Washington DC, and 2) the insurance companies, who have finally been able to call themselves “Big Insurance”. So, two, not one new barricades have been added that stands between the patient and his/her doctor and care.
Now, I’m social security age, and also qualify for VA services, but I have to have insurance just so I can access a primary care physician who can refer me to my cardiac specialist. So I have to go visit that doctor every two years. My last visit, three months ago, was instructive, because all we did was chat about his aggravation with our mutual insurance company. He told me “the Company” has taken on a team of physicians at the front office who could, and increasingly have, second- guessed many decisions and diagnoses his practice had recommended. Since I wasn’t a regular patient the doctor felt he could confide in me, (“cathart” might be a better word) and he fears our insurance company is trying to run his practice by proxy which may well become their business model for the future. He’s right to worry for that does seem to the be caretlist business model of the future.
I doubt his 3-physician practice will continue its association with my insurance company for very long. The problem, in many states, is that insurance choices are getting smaller, and in some states they have been reduced to only one. But the prospect that ACA patients may in fact conduct all their consultations with physicians from a great distance, those physicians in hire to their insurer are looming.
Q: Was this always part of the Obama-surance plan, or is it an after-thought of the insurance companies’ design?
Insurance companies being promoted to Big Insurance is a big deal. After decades of wallowing around in the minor leagues of American big business, and still a step or two short of being able to sit among the transnational giants of global capitalism, on the national stage they can exhibit the same characteristics of those in the High Castles at Davos. High among those is the ability to forge relationships with government that allow them to avoid the rigors of business competition and practice a form of business activity protected by the government. “Fascism” is defined as a business practice that spells “capitalism” M-O-N-O-P-O-L-Y.
And they were well on their way.
But then, Donald Trump came along.
Trump wasn’t supposed to win so Republicans weren’t supposed to have to march up and cast votes proving they actually meant all those promises about the ACA they’d made since 2010.
Personally I don’t think Mitch McConnell can pull it off, in part because he cannot persuade his big donor-funded fellow senators to concede on key elements of a repeal that could demote Big Insurance back into the world of competitive ordinariness. Competition across state lines is but one aspect, but I doubt President Trump will sign any compromise House-Senate bill that doesn’t contain it.
John McCain strode to the podium and made probably his best speech since his 2008 nomination. But he just couldn’t help it, so at the end he chastised his side of the aisle by saying it would be only fair if the GOP allowed Charles Schumer to write in Democrat amendments of the new bill. Sigh. Oh well.
In the face of the fact that the original Obama ACA is 100% bastard; conceived and incubated in darkness, and raised on 100% Democrat paternity and perfidy, it’s only proper that this bastard be destroyed by 100% Republican retribution and justice. So, no thanks, John.
But Trump holds two cards in this regard, not one.
He knows that if this repeal effort fails, he will lose very little politically. Obama-surance will simply suffer a slower, more ugly death, leaving it to Republican and Democrat voters to apportion their share of the blame. I’m perfectly certain, and comfortable, with the fact that neither Mitch McConnell nor Paul Ryan can ever bring a voter-desired repeal bill home. The reason is simple; in the strictest military sense, neither can lead. That’s not been part of their job description for many years.
As a result as many as a quarter of the Republican Congress could be replaced in 2018, and hopefully by Republicans yet unnamed (since the Democrats still have less to offer voters) if they run on an enthusiastic “Make America Great Again” message, and prove, as Trump proved in 2016, that all that donor money the GOP establishment seem willing to risk their jobs for may not matter anymore. A real change in the political culture portends.
The “message” will be everything and big money can’t compete with it when the people attach themselves to it.
As the Koch brothers are lamenting, so might Big Insurance, that their very business model is no longer effective, and maybe even passe. After all, America’s original design was to overturn a worldwide business model Satan had installed over 5000 years earlier. So, we’ve done this before, with only a simple message.
In 2014 Dave Brat proved this by walking his district door-to-door, using an inexpensive second-hand rVotes system while Eric Cantor’s funneled millions of dollars of television advertising using approved GOP establishment programs. Cantor couldn’t touch Brat’s ” message”. Mitt Romney and his campaign turned down rVotes in 2012, in favor of a cocktail of GOP-approved get-out-the-vote plans approved by the RNC, headed by Reince Priebus. The power of big money in the GOP goes back at least to Karl Rove and GW Bush, who turned into a very profitable, it not always successful, way of pursuing election success.
In 2016 Donald Trump once again the power of the message against Hillary’s hundreds of millions.
If the era of the big donor is dying, America can be saved. Sitting members of Congress who get that, will be saved. Those who don’t will sink or swim.
Lisa Murkowski, how long can you tread water?
Publications: Famous Common People I Have Known and Other Essays
Donald Trump, the Common Man and the American Theology of Liberty
(Both books in Kindle format only, Publishers and agents welcome, as both need to revised)