You may have heard that repealing and replacing Obamacare recently failed. The analysis of what went wrong comes from many corners. Andy Slavitt, former insurance executive and most recent director of CMS, writes that the ‘failure of Trumpcare can be seen as a rejection of policies that Americans judged would move the country backward.’ Apparently, the theory goes, moderate republicans, especially in states that expanded heavily and rely on Obamacare Medicaid expansion, were skittish of a repeal and replace plan that endangered the healthcare of millions of constituents. The conservative David Frum writes in the Atlantic that most Democrats and Republicans have accepted the concept of universal health care coverage – and that the idea of a repeal of the right to healthcare is sheer anathema. And if the Republicans were wavering, town halls filled with angry constituents were sure to provide an extra dollop of pressure.
The effort to get the messaging right is clearly important to many, but I find most of it functions as a smoke screen seeking to obscure the real battles being fought over your healthcare.
It is certainly true that Obamacare insures millions of Americans. But it is also true that having health insurance and having health care are two very different things. To be clear, the folks attempting to preserve the status quo want to preserve the ability to force all Americans to buy health insurance that costs hundreds of dollars per month. Put another way, the folks attempting to preserve the status quo want to force Americans to give a monthly fee to health insurance companies. Remember, these plans have deductibles so high that most of the cost of care delivered during the year in the form of labs, copays, and imaging studies falls on the hapless patient. The insurer, for the average healthy person, doesn’t pay a dime.