What really needs an ACA cure is our political process

Pat McCoy

November 27, 2013

The political frenzy over the Affordable Care Act is an object lesson in what is wrong with American politics. Rhetoric equating the reform law with socialism, and even slavery, has abounded and belies its moderate scope and concessions to the market-based insurance system that had left almost 1 in 5 Americans uninsured.

Its complexity, and many of its implementation challenges, reflect the myriad compromises and deals among powerful special interests — and the elected officials they bankroll — that were necessary to limp the final bill to passage by a mere three votes in the House of Representatives.

It’s laughable that an effort to bring our health care system more in line with that of other developed democracies would be so loudly and relentlessly characterized as an existential threat to our way of life and basic freedoms. It’s like a sick joke that many attackers supported the individual mandate themselves for years as a necessary component of extending coverage and that the political party that has made opposition to the law its raison d’etre ran a candidate for president who had championed the mandate himself when it was politically expedient to do so.

The fact that the law is universally called Obamacare — becoming more about the president and politics than what is good for the uninsured and our future — speaks volumes about the tendency of our commercialized, profiteering political culture to turn debate into a sound-byte cesspool.

The Affordable Care Act does need improvement, and its proponents are not defending ineptitude in promoting and rolling out the new law. People can and should challenge its premise and weaknesses, as is our right. But their position should not be that we don’t need an adequate health care safety net or that folks can just go to the emergency room. Those who want to dismantle the ACA’s reforms need to propose a serious alternative, and they have not.

Can we live without health care reform? Sure, if we want to do nothing about 45,000 deaths a year for want of insurance coverage, runaway costs ultimately unsustainable, a delivery system riddled with inequality and injustice and overall outcomes that often compare more with impoverished nations than developed nations. Can we live with a government that cannot rise to the challenge of health care reform? That’s less clear. This is the same government mired in inaction for years, and in some instances decades, on jobs, education, immigration, energy policy and climate change, growing income and wealth inequality, and deficit reduction. As polls show, the American people are deeply cynical about their cynical and unproductive government, and an appalling number don’t bother to vote.

It’s political reform we need most urgently. It won’t solve other problems, but it would give us a fighting chance to solve them. Many excellent proposals exist to reform campaign financing and lobbying, protect voting rights and increase voter participation, take partisanship out of redistricting, change Senate rules so a majority eventually can rule, and more.

Without improving the process of choosing a government and conducting its business, the progress we desperately need on health care and other major issues to keep our nation safe and strong will remain more mirage than reality. The time to take action for political reform is now. Let’s demand it.

Pat McCoy is executive director of Action NC.