Obamacare: a symptom, not the disease | Citizen | Indy Week
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In trying to provide equitable health care, the U.S. is hamstrung by the founding fathers.

Obamacare: a symptom, not the disease 

My wife and I recently celebrated our 30th wedding anniversary in Charlottesville, Va., near where our presidents lived from 1801 to 1825. Thomas Jefferson, James Madison and James Monroe were neighbors, fellow revolutionaries and founding fathers. Madison and Monroe were Jefferson's protégés.

Visiting their homes, we revisited the promise of the Age of Enlightenment. In 1776, Jefferson's draft became the Declaration of Independence, which said the pursuit of happiness was everyone's unalienable right. In 1787, Madison authored much of the U.S. Constitution, a framework for government to promote happiness, not oppress it.

While we were there, preparations were underway for the 150th anniversary of the Gettysburg Address, delivered by Abraham Lincoln on Nov. 19, 1863. Lincoln spoke of those who died defending the founders' vision of a nation "dedicated to the proposition that all men are created equal."

The 50th anniversary of the assassination of John Kennedy is also approaching. We were reminded of Kennedy's statement that that our country pursues great ends "not because they are easy, but because they are hard."

Against this lofty and terrible backdrop, I was shocked to learn, when I switched to 21st century news, that a fresh catastrophe surrounds Barack Obama and the Affordable Care Act. "Presidency in Crisis!" ABC's This Week proclaimed on Sunday. "Trust has been shattered!" cried host Martha Raddatz.

Get a grip.

The presidency was in crisis in the War of 1812 when the British burned the White House to the ground. Madison barely escaped.

Trust was shattered when Lincoln was killed and when Kennedy, his brother Robert and civil rights leader Martin Luther King were killed as they stood for equality. That dream of the founders has sparked many crises. This isn't one of them.

The Affordable Care Act—Obamacare—is a convoluted contraption of a law. But as bad as it is, the law will endure because to replace it with something better, or with nothing, would be hard.

And despite what John Kennedy said, at this point in America we don't do hard.

In considering Obamacare, two other observations from Charlottesville seem in order. First, and notwithstanding Jefferson's and Madison's high-flown rhetoric, these presidents were rich kids who could afford to enter politics young because their families staked them to plantations. They owned slaves, and they freed very few. Some of the slaves Jefferson freed were undoubtedly his own children.

We shouldn't be surprised, therefore, that the government these men devised is replete with "checks and balances" designed to deter democracy—rule by the majority—while protecting the rich and their special interests. Slave owners were the ultimate special interest.

Second, there wasn't much health care in the founders' day. Diseases were rampant, cures few. Of Jefferson's first six children, four died young—and his wife died at 34.

But while the founders couldn't have imagined our modern health care industry, the first U.S. Congress did create a public hospital. Enlightenment thinkers Jefferson, Madison and Monroe believed that if people were allowed to pursue science and reason free from religious or government interference, they'd unleash social progress in myriad ways. Jefferson, who famously said he could not live without books, founded the University of Virginia in Charlottesville and designed it around a library, with no chapel.

The founders foresaw that the nation would grow and opportunity was unlimited, for white men, anyway. Government should help, but leave the wealthy alone. That's why Jefferson bought the Louisiana Territory—to generate new wealth from settlers' crops, buildings and, later, from oil and minerals made into iron and machines.

Fast forward to 2013. The founders' system is working. The nation is fabulously wealthy. But our wealth is controlled by a few, as is government. Millions remain in poverty.

Nowhere are these divisions more evident than in the health-care industry. Our riches allow us to spend lavishly—some $2.7 trillion a year—and it's well within our means to provide high-quality care to all. But we don't.

The first fact to grasp about health care in America is that we spend upward of $8,500 a year for every man, woman and child, according to government data, far more than any other industrialized nation and for results that are no better. If you're paying for health-care insurance and you earn too much to qualify for a subsidy under Obamacare, it's going to cost you a bundle.

Obamacare isn't the cause, though. It's a symptom brought on by special interests. The U.S. has fewer doctors and hospital beds than other industrialized nations, which, by the way, do cover everyone. Because our health-care industry keeps its supply of services low, it can charge high prices, rationing care based on your ability to pay—or your insurance company's.

All Obamacare does is insist that insurers accept your money even if you have a pre- existing condition. Meanwhile, these same insurers—because of individual mandate-—will enjoy an influx of younger, healthier and highly profitable new customers, many with government subsidies.

In North Carolina, we have the ultimate in special-interest strangleholds: Blue Cross Blue Shield is a near-monopoly insurer; big hospital companies are gobbling up medical practices; and state government has tied its own hands when it comes to setting rates.

Thus, we'll pay dearly for Obama's decision to jettison the public option to get a bill through Congress. No way the insurance companies were going to let Obamacare pass if it created competition for them, and they had the power to stop it. So Obama caved.

Now, we're stuck with Obamacare until we can figure out how to do what every other industrialized nation has done and put the public interest ahead of the special interests. Reverse the founders' order, in other words.

Unfortunately, it may take a real crisis for that to happen.

  • In trying to provide equitable health care, the U.S. is hamstrung by the founding fathers.

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