Affordable Care Act Deserves Patience, Not Defeatism
by Robert B. Reich
Whatever happened to American can-do optimism? Even before the Affordable Care Act covers its first beneficiary, the nattering nabobs of negativism are out in full force.
"Tens of millions more Americans will lose their coverage and find that new Obamacare plans have higher premiums, larger deductibles and fewer doctors," predicts Republican operative Karl Rove. "Enrollment numbers will be smaller than projected and budget outlays will be higher."
Rove is joined by a chorus of conservative Cassandras, from
Robert Laszewski, president of
Professor John Cochrane of the
The round-the-clock naysaying is having an effect. Support for the law has plummeted to 35 percent of those questioned in a recent
Even liberal-leaning commentators are openly worrying. On
Some congressional Democrats are getting cold feet. West Virginia Sen. Joe Manchin recently fretted that, "If it's so much more expensive than what we anticipated and if the coverage is not as good as what we had, you've got a complete meltdown."
Get a grip.
If the past is any guide, some fixes will probably be necessary -- but so what? Our current health-care system is the real disaster -- the most expensive and least effective among all developed countries, according to
But we won't get it perfect immediately. What needs fixing can be fixed. And over time we can learn how to do it better.
If enrollments are lower than anticipated, the proper response is to keep at it until larger numbers are enrolled. CHIP, the Children's Health Insurance Program, got off to a slow start in 1998. The Congressional Research Service reported "general disappointment ... with low enrollment rates early in the program." CHIP didn't reach its target level of enrollment for five years. Now it enrolls nearly 90 percent of all eligible children.
Richard Nixon's Supplemental Security Income program of 1974 -- designed to standardize welfare benefits to the poor -- was widely scorned at the time, and many states were reluctant to sign up. Even two years after its launch, only about half of eligible recipients had enrolled. Today, more than 8 million Americans are covered.
If mistakes are made implementing the Affordable Care Act, the appropriate response is to fix them. When George W. Bush's
If young people don't sign up for the Affordable Care Act in sufficient numbers and costs rise too fast, other ways can be found to encourage their enrollment and control costs. If there aren't enough doctors initially, medical staffs can be utilized more efficiently. If employers begin to drop their own insurance, incentives can be altered so they don't.
Why be defeatist before we begin? Even
As Alexis de Tocqueville recognized as early as the 1830s, what distinguishes America is our pragmatism, resilience and optimism. We invent, experiment and fix what has to be fixed.
Of course there will be problems implementing the Affordable Care Act. But if we're determined to create a system that's cheaper and more effective at keeping Americans healthy than the one we have now -- and, in truth, we have no choice -- we have every chance of succeeding.
Article: Copyright ©, Tribune Content Agency.
"Affordable Care Act Deserves Patience, Not Defeatism"