Healthy Ideas with Defects

When America’s web-based health insurance exchanges launched Tuesday, the rush was so great that the computer systems could not cope. This is how Americans without a health insurance plan, up until now, will be able to acquire one. On the same day, a related but entirely different chaos broke out: Major parts of government services were shut down as a result of a Republican blackmail tactic to stop the reform.

The majority of Americans are insured through their employer. On the other hand, a fifth, almost 50 million, have been without insurance. President Obama’s reform would help these people into the system. This simple thought was transformed into the complicated and hardly perfect “Obamacare,” the cause of both frenzied protests and the populist tea party movement that has hijacked the Republican Party.

There are two key elements: Everybody must have insurance or pay a fine, and the insurance companies are not allowed to turn away people who are already ill. Making it mandatory is logical because otherwise the second part could not be financed. The people covered by company insurance are hardly affected. Employers of more than 50 full-time staff will be obliged to insure their employees. The remaining citizens will have to go to the health insurance exchanges, and the people who cannot afford insurance are entitled to a state allowance. The health care program, Medicaid, is also supposed to cover more people.

“Obamacare” has been depicted as a devious plan to nationalize all health care, but this is far from the truth. Private companies would provide the insurances, and over half of today’s health care is already publicly funded, even if Americans believe otherwise.

However, the reform also has genuine problems. One is political. Republican-controlled states, with the support of the Supreme Court, have refused to expand Medicaid. Millions of Americans fall through the cracks in the system; they are neither poor enough, nor rich enough.

Even from the start, this reform did not have the chance of reaching its theoretical purpose of creating universal health care — and there are more causes for concern.

How this will effect employment is so far speculation. Different parts of “Obamacare” will have an effect in different areas. It will be easier to move from one job to another without the risk of losing your health insurance, while warped incentives could make people work less or make companies reduce the number of full-time employees.

As important parts of this reform are in their early stages, there are also questions regarding the economy. Health care in the U.S. is already the most expensive in the world, and the costs are drawing near to 20 percent of gross domestic product. However, whether Obama’s over-optimistic figures or his opponents’ predictions of gloom and doom have any relevance remains to be seen.

To think that the U.S. would switch to a European model is a naïve expectation. “Obamacare” is a serious attempt to repair a hole in American social security, even if the system will need readjusting. The risk remains that too many young and healthy people will choose to pay the fines and delay getting insurance until they get ill. This would mean that the system would collapse.

A completely different matter is that Republicans, blinded by their hatred of this reform, are threatening to destroy America’s credit rating. This shows a complete lack of responsibility.

The U.S. certainly needs healthy finances. The way to achieve this is not through unhealthy politics.