Marty Wiseman: Defunding Obamacare: the mother of all debates

September 24, 2013 10:13:51 AM



As we approach what will probably be the definitive debate on the future of the Affordable Care Act, a word or two of explanation is in order. This column will contain a number of questions, but very few concrete answers to those questions.  


The subject today involves arguably the most significant piece of social legislation in our lifetime - The Affordable Care Act, or Obamacare as it has become known.  


With the passage of a budget, or alternately a government shutdown, and the raising of the ceiling on the national debt, or by contrast the default on the nation's debt obligations hanging in the balance, the debate and vote on funding, or effectively repealing, Obamacare stands as the fulcrum upon which these Armageddon-like actions hinge. 


All have heard the crescendo of critics decrying each rate increase announced by an insurance company. While critics attribute these increases completely to Obamacare, some questions need to be asked. To what should we attribute the more rapid rate increases and constant reduction of benefits in the years prior to the 2009 passage of Obamacare? These rate increases began their rapid ascent immediately after the failure of "Hillary Care" during the Clinton administration. Had the insurance and other health care providers kept their increases in check during that time, would there have been such a pressing need for the Congressional action that culminated in Obamacare? 


I received a copy of a letter two weeks ago from a woman who, while moving and temporarily between jobs, became ill with extremely high blood pressure. Upon going to work, and after incurring significant expense in bringing her blood pressure under control in the early days of her new job, she was informed that there was a 365-day exclusionary period in the coverage of this pre-existing condition. What is the answer for this hard working employee and others like her? 


A family friend who was required to undergo a radical mastectomy suffers from the residual effects of severe lymphedema. Fortunately, this employed person has health coverage and has had insurance for some 30 years. Unfortunately, the company raised her monthly premium from around $500 a month to $1,300 per month. What is the answer for this employee who has worked for three decades? 


Then there are the uncertain numbers of the uninsured and marginally insured. Those numbers range from 500,000 to 600,000 in Mississippi to 50 million nationally. What are the prospects for those among these individuals who must deal with brain tumors, leukemia, chronic heart disease, and severe or debilitating injury? When the fates of these individuals are raised in the form of a question, the answers become vague and run the gamut ranging from "let them go to the emergency room" to "we can pray for them." 


Several months ago, the vow from one political camp and indeed from Republican Presidential Candidate Mitt Romney was one to "repeal and replace." It was a clear call to scrap what Congress had passed in the form of Obamacare and to put something more effective at addressing the significant shortcomings in American health care in its place. Now many Americans, both Democrat and Republican, would probably take this deal once all of the key elements of the new plan were known. Is there indeed a plan to replace Obamacare and what are the key components of that plan? 


We then arrive at the most sensitive subject of all in our efforts to address the health care needs of our brothers and sisters. In the midst of all of the rancorous conversations between liberals and conservatives has been the discussion of the appropriate role of religion in the nation as a whole and in a variety of policy debates ranging from reproductive rights to health care. Washington Mall rallies have been held to proclaim America as a Christian nation. 


With the words of Jesus Christ to his followers that "If you have done unto the least of these you have done it unto me" or his directive to the young lawyer who prompted the story of the Good Samaritan to "Go and do likewise" as backdrop, are we now finding that the claim that we are a Christian nation is too big of a burden to carry anymore?  


Astoundingly, the arrival of atheist philosopher, the late Ayn Rand, on the scene seems to have afforded to anti-government program types a welcomed proponent of individual destiny as opposed to a civic community. Indeed her advocates such as Paul Ryan and others have taken to distributing her books "Atlas Shrugged" and "The Fountainhead" much as the Giddeons distribute Bibles. What are we to make of it all? 


Efforts of opponents of Obamacare, like those of Senators Ted Cruz of Texas and Mike Lee of Utah, have been relentless during the August recess. House Speaker John Boehner has promised a "whale of a fight." If the Oct. 1 signup period witnesses a large number of takers for this first comprehensive attempt at a national health care program, this may indeed be the last chance to head it off. All that is left is one more question - Where will we be when the smoke clears?