Opinion

The Progressive Argument For Obamacare Repeal

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President Trump campaigned on repealing and replacing Obamacare. Congress, when campaigning for reelection every two years, promised the same. Yet Congress can’t seem to get the job done. First, they needed the House, then the Senate, finally the White House. All delivered to GOP control by the voters. With the reasonable expectation of repeal and replace.

Yet nothing from Congress but a dial tone. The House passed an Obamacare-lite bill, tweaking some of the more onerous parts, but certainly not a repeal. Now repeal and replace wallows in the “greatest deliberative body in the world”, the US Senate. One Republican Senator, Richard Burr, told the Wall Street Journal, “It’s unlikely that we will get a healthcare deal” this year. Deliberation but no action.

Just great. The party of stupid is living up to its name. My first response is to ask, “Why vote Republican?” My second thought is to suggest a new tactic. Why not make the progressive argument for repealing Obamacare? And no I don’t mean replacing it with Bernie Sanders’ Medicare for all.

Using the language of the left, Obamacare is a travesty, worse than Donald Trump, Steve Bannon or Ted Nugent. This language consists of four key words in the progressive lexicon. Tolerance, diversity, inclusion, and sustainability.

American universities have entire offices and departments devoted to these important concepts. For example, my alma mater Cornell has an Office of Diversity and Inclusion. As well as a Department of Sustainability. How does this apply to Obamacare?

Obamacare is “intolerant” of those who, often by individual choice and effort, are healthy. And choose to spend their money, not on insurance they don’t want or need, but instead on goods and service they desire. Call them “pro-choice”, to borrow another favorite term of the left. Obamacare takes away an individual’s right to choose. Unacceptable in the progressive world.

Obamacare limits “diversity”. Something called the ten essential benefits, coverage that all insurance plans must provide. All plans are the same, monolithic. Much like the all male or all white corporate board rooms that liberals complain about. Why not diversity in insurance? The young newly married couple may want maternity coverage in their plan while the single 55-year-old guy does not? The hypertensive diabetic may want his myriad medications covered while the healthy 25-year-old snowboarder wants only catastrophic coverage in case she crashes into a tree. How about a rallying cry of “all insurance plans matter”?

“Inclusion” means no one left out. Obamacare creates narrow networks of physicians and hospitals, leaving many off the insurance plan panels. Many of the best hospitals are out-of-network for Obamacare plans, as are many top physicians. As a result, patients suffer. If they like their doctor, they can not necessarily keep their doctor, despite promises to the contrary. Again, the “pro-choice” argument but more importantly the personal and professional stigma for healthcare providers being excluded, told to sit in the back of the Obamacare bus. Non-inclusive. Unacceptable.

Lastly the problem of “sustainability.” Not of Antarctic ice, but of the entire healthcare system. Obamacare is in a death spiral according to many, including Aetna’s CEO. Ever increasing premiums and deductibles making insurance unaffordable. Leaving fewer paying into insurance pools, with only the sicker and more expensive patients sharing in a dwindling pot of insurance premiums. Unsustainable for the many insurance companies pulling out of Obamacare. If it’s unsustainable, what are we leaving to our children and grandchildren?

Common sense, already in short supply in Washington, DC, is unfortunately not part of the repeal and replace discussion. Therefore, why not use the language of the left? The very words progressives use daily to shame conservatives and advance their liberal agenda. Think of it as social justice grammar. If anything, it will be amusing watching liberals and the media trying to defend Obamacare when their pet words are turned against them.

Brian C Joondeph, MD, MPS, a Denver based physician and writer. Follow him on Facebook,  LinkedIn and Twitter.