The drumbeat about "Obamacare" has nothing to do with the Affordable Care Act (ACA) or even with fiscal conservative values. If your friend or neighbor has been watching too much Fox News, here are ten reasonable retorts to the paradoxes of the Radical Right that they use to hook the Obamacare-obsessed.
1. The Private Sector Paradox - The ACA is based entirely on the blueprint created by the ultra-conservative Heritage Foundation for a private national health insurance system. The same Heritage Foundation who now opposes it. The Heritage Foundation's current leader, Jim DeMint, when he was a U.S. Senator, backed both what became known as "Romneycare," after the Massachusetts implementation of the law, and Romney in his first presidential bid. Advocates at the time touted using the private sector to solve the healthcare crisis. There are no government insurance companies involved. This isn't Medicare. The exchanges refer people to private insurance companies. The only major change to the ACA is that a black president embraced a conservative concept, and conservatives have been washing their hands of it ever since.
2. The Food Stamps Paradox - Republicans rail at SNAP, the Supplemental Nutritional Assistance Program because supposed "welfare cheats" and "loafers" aren't paying their own way, yet they have no problem with healthcare cheats and loafers not paying their own way for their own health care. They resent paying for other people's food out of their tax money, but they seem to have no problem with those not paying their way with their medical bills clogging up ERs, driving up prices of health care, etc.
3. The Selfishness Paradox - Obamacare-obsessives don't want to pay for anyone else's health care with the partial government subsidies. Paying for them through higher insurance premiums and the whopping increases in hospital costs that cover the cost of saving the lives of the uninsured seemed to work just fine for them.
4. The Transparency Paradox - Fox News pundits will scream transparency all day long to wipe out demon Obamacare, but how transparent is the system that they want to maintain? Funding for the poor and those with some ability to pay refusing to take health insurance by way of those elevated hospital bills is hardly transparent. Covering the poor under Medicaid, and making everyone pay their fair share of their healthcare costs is far more accountability, which Republicans have historically supported. The ACA requires greater transparency from both insurers and the medical industry about costs, access to particular benefits, and what elements of providing quality care affect the cost of operation of health systems.
5. The Affordability Paradox- Republicans tell anyone who will listen that "Obamacare" is going to send costs skyrocketing, but any insurance actuary could tell you that increasing the pool of insured people, more people paying into the system, reduces overall costs and improves risk spreads for private insurers.
6. The Corporate Socialism Paradox If you believe the daily spew of Republican congressmen and their radio and television propaganda wings, government socialism is evil. Yet corporate socialism is generally acceptable. A key tenant of GOP-think is that the private sector can always outdo the government in the solution of a problem. We'll recall that this was blown out of the water by what would have been a domino-effect collapse of the private insurance industry which had been speculating with billions prior to the 2008 Great Recession, but let's work with their fantasy. Modern reporters, clever little people that they aren't, seem to fail to ask the obvious question: If the private sector solves all, then why isn't the ACA, which gives a massive windfall to corporate insurance companies, a big win for the GOP and its dogma?
7. The Bureaucracy Paradox - Republicans rail against the wasteful government bureaucracy but the bureaucracy of private health insurance is staggering, and adds enormous costs to health care as doctors and hospitals wrangle with literally thousands of plans. U.S. News in 2012 found more than 1200 plans per state. Those plans add huge bureaucracy and cost on every end of the healthcare system, from the bloated bureaucracy of the insurance companies which administer the plans to the large staffs of hospitals and doctors who must wade through the nuance of the rules of myriad different plans. As for accountability, the government has procedures and rules, and you can always complain to your local elected official. If an insurance company screws you, suing them, and the years thousands of dollars in legal fees that a civil action takes, may be your only recourse.
8. The Death Panels Paradox - Sarah Palin and her lot bogeyman the ACA with "death panels" scare tactics, but insurance companies have had their own "death panels" for decades. Pre-existing condition limiters, and denial of care by insurance companies for people with insurance, and lifetime caps on payouts to people with chronic illnesses and birth defects have been death sentences. More than 105 million people are benefitted by the ACA's end of pre-existing condition limiters and lifetime caps.
9. The Jobs Paradox Mr. Boehner's much ballyhooed cry of "Jobs! Jobs! Jobs! in the private sector hasn't materialized into real employment, but implementation of the ACA means thousands of new jobs added at the private insurance companies as they hire on more people to take care of all of those being added to the private insurers' rolls.
10. The Pills and Pillows Paradox- Improving access to healthcare increases its use. That means more goods and services being used by healthcare providers, more money flowing to pharmacies and pharmaceutical companies, manufacturers of healthcare equipment, linens, surgical suppliers, and many many more. For conservatives who believe in "trickle down" economics, increases in delivery of goods and services at lower costs should be a win-win.
The truth is that a small handful of very wealthy people who are old-school John Birch Society Libertarians oppose the ACA. It is their hundreds of millions pitted against the millions of Americans. Up until they infected the system with their selfish billionaire bile, the majority of fiscal conservatives could have reached consensus on the ACA, and drowned out the dittohead drumbeat and the paranoids pablum dished up by the flame-fanners of Fox News.
My shiny two.