When the Affordable Care Act was signed into law six years ago, it was a historic achievement, but it was based on a bargain that has not been kept.
President Obama did not have the support in Congress for a government-run health care system. Even some of his own Democrats opposed that proposal. So he got what he could – a deal with the health insurance and pharmaceutical giants.
The quid pro quo was more customers for health insurers in exchange for the insurance companies’ cooperation. He also anticipated that drug companies would adopt responsible pricing policies.
Clearly, the bargain has been broken. Some big insurance companies have not supported the state exchanges. Some drug prices are anything but responsible.
And that is a major reason for rising enrollment costs.
Of course it wasn’t just the health insurance giants and Big Pharma that sabotaged Obamacare. Republicans – members of Congress, governors and legislatures – overwhelmingly rejected it.
Yet, despite the rabid opposition in red states and in Congress, the law has provided health insurance coverage to some 20 million people, many with preexisting issues, who were not previously covered.
But there’s work to be done. Minda Wilson, author of “Urgent Care, Ten Cures for America’s Ailing Health Care System,” sums up the situation this way:
With the Affordable Care Act in its current state, the working poor are better off but hospitals lose; doctors lose and the Middle Class really loses. And, you guessed it, Big Pharma and big insurance are the big winners.
And the President conceded when the law was passed:
This legislation will not fix everything that ails our health care system, but it moves us decisively in the right direction.
To me, the ultimate goal should be expansion of Medicare to include all Americans, And the private insurers could be given an opportunity to compete against – or participate in – the new system (as they do with Medicare Advantage).
But I can only imagine the fierce opposition any such plan would provoke among Republicans.
Ever the realist, Hillary Clinton details on her web site proposals to “fix” Obamacare. But even for modest reforms, she will need support in Congress.
For the sake of all Americans – healthy and sick – we can only hope the voters give her that support by sending Democrats to the House and Senate.