Wednesday, November 13, 2013

Beyond Obamacare will be fixed. People will sign up and reap the benefits of universal health coverage starting in January. So what’s next?

No doubt, the Republicans will continue their quest to reverse the limited progress made to date. They will try to deny coverage to many, eliminate the cap on “administrative” costs to insurance carriers, and cut preventative care, which saves lives and money.

Democrats are counting on the projected ubiquity and success of Obamacare after January to lock it in and to shut down the GOP’s incessant and futile efforts to repeal. They’re wrong. Just take a look at other successful programs like Food Stamps. The Republicans are not hesitant to take food from children and veterans in the name of fiscal responsibility. They’re not even hesitant to shut down the government in the name of fiscal responsibility either, knowing that their shutdown cost tens of billions of dollars. And some Democrats are complicit, confusing “blackmail” with “compromise.”

But for now, let’s assume Obamacare survives the wounds being inflicted by the mean-spirited GOP. Like Medicare and Social Security, the Affordable Care Act will be meshed within the fabric of society while still being constantly attacked. So what’s next?

Recognizing that Obamacare is not health care reform, but rather insurance reform, the next logical step would be to join other developed nations that have better health outcomes in implementing some type of single-payer health care system – Medicare for all.  But that will be a challenge for the next generation. In today’s environment, when the mantra of one political party is “I’ve got mine. Too bad for you,” transformational change in health care is going to be a long, hard struggle. Add to that the lobbying power of insurance companies, whose profit is based on the maladies of the American people, and you have a recipe for the status quo at best, and regression at worst.

Even though it may take a generation to make the real improvements to American health care through single-payer, that’s no reason not to start the effort now. But there are other things we can do in the short term to make real progress, too.

One of the best parts of Obamacare is that it mandates free preventative care. This not only improves outcomes, but early detection of diseases also results in less expensive treatment, helping the fiscal balance sheet.

Unfortunately though, even with early detection, people will still suffer from chronic ailments like diabetes, cancer, mental illness, and other diseases that will require long-term, expensive treatment. But that doesn’t have to be. With the help of government, scientific research has eliminated similar diseases like polio, smallpox, and malaria. We should strive for the same thing with today’s diseases. For example, cures for cancer would not only save lives, but would dramatically reduce health care costs.

Unfortunately, funding for medical research is one more area that the troglodytic Republicans in Congress feel they must attack. Politics trumps science as evidenced by George W. Bush’s unilateral shut down of embryonic stem cell research early in his first term. (As an aside, I wonder how many lives would have been saved if the Supreme Court had allowed the Florida vote count to proceed in 2000.)

Today’s House of Representatives has a dangerous anti-science bias. Funding for medical research should be increased, not slashed. Sure, it will cost money in the short term. So did the research that led to the polio vaccine. But thanks to the foresight of previous generations, we are not paying billions of dollars to treat people with polio. This generation needs the same foresight. We need to elect representatives who understand that good scientific research pays off with savings in money as well as in lives.

A version of this diary was originally posted on Blue Jersey

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