Greenbeard
Gold Member
Why are liberals in support of Obamacare
I can't tell you why "liberals" are but I can give you some reasons I support it.
- The law tackles deficiencies in the existing health insurance markets, particularly for the minority of folks who have to buy it in the poorly regulated individual market because they don't get it as part of a group through their jobs. It creates new, competitive marketplaces in which those people can shop for insurance, a marketplace that's transparent, has consumer protections, and levels the playing field to make comparison shopping easier and meaningful. These marketplaces are designed and generally under the jurisdiction of state governments to meet the needs of their populations and their market conditions. The law also creates marketplaces for small businesses that can offer a bit more predictability in their future health costs.
- It reforms Medicaid, offering support for states to replace the often antiquated IT systems they use to manage the program. The law expands it, largely at federal expense (though after Thursday's ruling, that expansion is now a state option, as opposed to a condition of continued participation in the Medicaid program). It simplifies the enrollment process to make Medicaid more accessible to those eligible for it, and it gives states a number of new options and opportunities to experiment with ways to contain costs and improve the way care is delivered.
- It starts the process of reforming Medicare, most importantly by starting to change the way Medicare pays for services to shift it towards paying for quality instead of just some quantity of procedures. This is where it really starts getting at health care reform (you can already see reorganizations among providers of the way they deliver services to offer more value for what they're paid). It also fixes some expensive deficiencies in the way we pay for the privatized portion of Medicare.
- It makes needed investments in prevention and public health. The provisions in that section of the law are too numerous to list here but includes bits like support for school-based health centers, grants to communities to build up their infrastructure for preventing chronic disease, resources to support epidemiology and public health labs at the state and local level, and a hodgepodge of other provisions aimed at either prevention or public health.
- It starts the ball rolling on building up the health care workforce to meet the current and coming demands on it. It has loan repay opportunities, training programs, additional funding for health centers, provisions for re-allocating residency slots and grants to establish new primary care residency programs, and things like that.
If you want a shorter answer: our health care institutions--from private insurance markets to provider organizations to our public programs and our public health infrastructure--are not set up to meet the demands of the 21st century. We literally can't afford for them to approach the problems of the next 50 years the way they tackled the problems of the last 50 years. They need to be more nimble, more data-driven and evidence-based, more accountable, more outcomes-oriented, and ultimately much better at delivering bang for buck (i.e. value). The ACA takes this approach and it does so on a number of different fronts simultaneously, including by building up other major pieces of health legislation passed by the 111th Congress.
The oversimplified panaceas folks fling back and forth at each other ("tort reform!" "insurance across state lines!" "single-payer!") are missing the forest for the trees big time.