Though many questions remain[1], the Affordable Care Act, or "Obamacare," looks to be a step in the right direction, albeit an underwhelming one.
Perhaps the plan's most noteworthy deficiency is its lack of a public option.[2] With this feature, the government would basically create its own insurance company and compete with the private sector. Though miles away from a proper national healthcare system, this would be a much bigger move toward the United States joining the developed, modern world. As it stands, according to a Bloomberg ranking of countries with the most efficient healthcare systems, the United States ranks 46, with Iran and Serbia for next door neighbors.[3]
Despite wide support among the American people, the public option was removed (by Democrats) from the bill. And despite even broader support for universal healthcare - normally around 70 percent - the mere notion is completely off the agenda. (See my May 31 blog post on Canada.)
So for now, we have Obamacare. The model for it was designed in the late 1980s by the Heritage Foundation, a conservative think tank that works in the service of the Republican Party.[4] Fast forward twenty or so years, Obama and the Democrats took up the plan and made it their own. By default, the GOP has denounced it. This rejection has now reached the level of revilement, presumably out of fear that Obamacare might end up working and find popularity among Americans; the evidence in Massachusetts, where the plan was passed by former governor and Republican presidential candidate Mitt Romney and successfully implemented, indicates this is a likelihood.
To sum up: The country didn't get universal healthcare or even a public option. What it got was a Republican program that benefits the healthcare industry. The plan was then simply painted blue and appropriated by the Democrats. However, regardless of its original color, what should be called "Heritage Foundation care" is still an improvement on a (still) wholly corporatized and therefore grossly inefficient system. It's a start.
Ultimately, Obamacare can serve as a platform on which the American people can demand a more civilized system, the one they've wanted in enormous numbers for quite some time now.
NOTES
[1] Thorough interview with an ACA "navigator":
http://www.democracynow.org/2013/9/27/decoding_obamacare_a_guide_to_new
[2] Ezra Klein on the public option:
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/22/whatever-happened-to-the-public-option
[3] Bloomberg rankings according to healthcare efficiency:
http://www.bloomberg.com/visual-data/best-and-worst/most-efficient-health-care-countries
[4] James Taranto from the Wall Street Journal takes to task Stuart Butler. Butler was one of the Heritage Foundation's principal architects of the healthcare mandate, and has tried to distance himself from the ACA:
http://online.wsj.com/article/SB10001424052970204369404577211161144786448.html
