Rant on Obamacare

So I have no answers about the current stupid shutdown, but these are my thoughts on Obamacare.

The bill that the Congress didn’t know the details of what was in it was signed and made law by the President whose Health and Human Services and Internal Revenue Service as a consequence of such confusion didn’t know how to implement it—leading to all sorts of exemptions on ad hoc bases—is now the law governing over the people who are clueless as to the details of it, except for those aspects that they happen to like, but who are simultaneously against those aspects they don’t like. But if Jimmy Kimmel’s anecdotal street interview is to believed then anything is to be believed by the public. No one knows what this law called Obamacare/the Affordable Care Act is for. However, by evidence of the interviews, it turns out that those who don’t like Obamacare have reasonable objections even if they don’t know that the name of Obamacare is actually the Affordable Care Act.

Yet the partisans remain there to praise and excoriate the law. Short of praise and excoriation are those wonks who actually know the details, and it turns out neither side is satisfied with the law, but some say it is good enough and others say it is too bad. Without knowing the details of the law, it is surely a problem when no one in the general public knows the details. This makes it impossible for both Democrats and Republicans (and in Congress!) in a meaningful way to defend and criticize it. This is why neither side has much to say on the content of the law. Rather each side offers mirror images of hope and change, which seem to be equally empty of content, but effective at mobilization. Mobilization for what?

On the one hand, health care costs have inflated (like college costs) at a rate far exceeding other commodity costs. On the other hand, many Americans—40 million if rhetoric is to believed—have no access to health care. These two things are connected perhaps, but that requires an analysis of Medicaid and Medicare, and the employer based health insurance system. Uninsured wait unit they have a heart attack and then they go to the emergency room and regular insurance payers end up paying for that surgery which all the while leads to rising premiums for everyone.

But that is only a part of the reason for health care costs. No one knows why one regular acetaminophen pill cost $15 dollars in the hospital, and why they receive notices in the mail which say THIS IS NOT A BILL even though it says they owe the said amount. What is up with this? We can only expect more confusion after Obamacare. No one knows what they’re paying for.

If the confusion pertains to Medicare, then this is apparently politically untouchable as a third rail topic. But somehow the confusing add on of Obamacare as another layer of government program is going to both cut costs and bring the 40 million into the insured pool? Count me skeptical. My doctor friends think they will only work more with more patients and paperwork and less quality of care. It’s simple supply and demand.

But it seems it is better to deal with confusion by more confusion. One party seeks to deal with the unsustainability of long-term governmental commitments, and the other seeks to make more such commitments. One party says it can’t last, the other says you want starving children and a Paul Ryan lookalike to push grandma over the cliff.

You can tell which side I’m on, but I’m actually for saving grandma as well as providing junior grandson for providing for his own healthcare too. He needs to see that, while financial considerations are important, it is viable for him to have a career and also make a family and make a home for a family.

So you may say that I am arguing against feminism. Far from it! Women are equal to men in my mind, but the idea that women need to be equal to men in ambition for public or business careers has its limits. I am not against family leave pay and all that, but until men can have babies, we need to distinguish between men and women on the most fundamental level. This is not easy in terms of equality. I’m just saying that it is important to support families as well as support equal education and opportunity. In our democratic times, men need to own up to family obligation, but women must have responsibilities too. That’s why raising kids and caring for the elderly and other such deep and personal necessities need to have more appreciation these days. I have no answers here other than the old fashioned ones.

But perhaps we could submit to a fate of scientific method, make it up as you go along that is indicative of Obamacare. Give everyone, male and female, equal opportunities in an opportunity neutral way. Families need not be families anymore, men need not be men, women need not be men, etc. A world where no one knows what is what. Perhaps such indecidability gives a frisson of living on a knife edge of what is most modern (or postmodern), but when it comes to your own family, it also seems ridiculous, or at least impractical.

So Obamacare is law, but what is that law?