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Michael Miller


By Michael Miller
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Obamacare: For Nation’s Sake, Make It Work

Some of us are understandably baffled. Let’s cut through it. This is what Obamacare says at its core: Insurance companies, you will end some of your most appalling practices and cruelties, the stuff that is banned everywhere else on Earth and should have been banned in America four decades ago. In exchange, millions of customers will be driven to you, some of them subsidized by the government. And it will be very good for you.

That’s the biggest part of it. It isn’t the Second Holocaust that is described to me every single day when I open my email box or tune to the wrong AM radio station. Here are actual phrases included in just today’s emails: “The Dictator-in-Chief,” “Hundreds Of Millions Of People Are Still Going To Lose Their Health Care Plans,” “Obama Assaulting Fabric of Our Nation….”

An enormous political-industrial complex, including an entire national political party, is being funded and coordinated to confuse, discourage and block full implementation of this law. 68 percent of uninsured single mothers and 60 percent of America’s uninsured working poor live in the 26 states where governors have been obstructionist and rejected the federally-funded expansion of Medicaid. We have to invent new words to describe the obstruction and meanness we see across the country today.

There are forces out there who root hard for Lord Voldemort and Count Malfoy to finally get Harry and his friends, and they are dragging this country to a dark, dark place.

Lost somewhere in between those whipping up hysterics and those television talking faces who coo on cue that President Obama “is giving everyone health care,” there fester legitimate flaws in the Affordable Care Act that might have been fixed, improved or adjusted years ago.

In the 2008 presidential primaries, Senator Obama excoriated Senators Clinton and Edwards for supporting individual mandates to acquire insurance. It should not have been linked with some of the very humane, very popular changes in ACA. But the ACA wasn’t crafted to improve Americans’ health care. It’s not even about health insurance. The law was designed by insurance and pharmaceutical companies to maintain their dominant position in the health care mega-structure. The White House traded real reform for a promise that they wouldn’t crush the legislation, as they did during the Clinton administration.

It is, on some level, an understandable trade-off. It is also a fatal flaw.

To ensure that any possible outcome will not reduce their profit margins, insurance and pharmaceutical corporations are using Obamacare as cover. Drug prices have been ratcheting up all year. Those terminated plans that don’t meet the minimum standards about which we’ve heard so much in the last two weeks are plans that insurers introduced after the passage of the ACA, knowing that these plans wouldn’t meet the standards, making a quick profit off the last enrollees.

Meanwhile, we expect people to consider a list of 58 plans available in New York, some of which appear identical at first glance, and decide if it’s better to pay $200 a month more for a plan with no deductible or $200 less for one with a $2,400 deductible. What is the difference between “Deductible’ and “In Network Cost Share”? Why is dialysis $15 on this Platinum plan but 0 on the Silver Plan? There’s no Enter key? Oh, I click on Apply Filters to make it work.

Everyone going through this process asks this:  “Why, why, why didn’t they just give us all the option to buy into Medicare?”

We all have neighbors, friends and family who need this to work, so that we can have a somewhat improved version of the world’s most expensive, least inclusive health insurance system. Americans deserve better, but let’s at least get this to work.

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Michael Miller is a freelance writer, designer and strategic consultant who has worked in state and local government. Email: