It's difficult to discuss any aspect of the Affordable Care Act without sliding into a political discussion. I try to avoid that as much as possible, because I really don't care what political party, if any, you support or whether your political attitudes mesh with mine. To each his or her own. It's called freedom.
That said, it's hard to ignore the ACA right now, as it is as certain to be on the evening news as bad weather, forest fires, or the latest on the crack-smoking mayor of Toronto. So I've chosen to go ahead and express my opinions on the subject, opinions that fall on both the plus and the minus side. First, some things that bother me.
I find it incredible that, given the immense complexity involved, a better contractor could not have been found to design and implement the system. True, the government usually goes, at least in theory, with the lowest bidder, but "lowest" doesn't have to mean "least competent." Our government has fought major wars successfully -- well, not always, but at least one really big one -- and has put men on the moon, along with countless other successes that we have absorbed so completely that we rarely remember they were initially begun by the government. So I don't buy the idea that government can't do things as efficiently as the private sector.
I find it equally hard to understand why the administration has not sold its program more effectively. There is a lot of confusion, because it's a complicated program, but the confusion could, in my opinion, have been reduced by a barrage of TV, newspaper, and Internet publicity, explaining over and over the details of the ACA and how it is to work. There are supposed to be trained guides to help citizens cope with the system. I would think their names and locations would have been so publicized by now that finding one would be like locating the nearest McDonald's. But not so.
On the other hand, I believe that the program can be tweaked and adjusted, and that it will eventually be, if not perfect, certainly better than what we have. The tweaking and adjusting would be a lot more effective, and faster, with a cooperative effort, but that's not going to happen. A friend who lives in Massachusetts, where the Romney program that is essentially the same as the ACA is in place and is now well received, says that program was full of faults and upsets initially, and that it took about a year or more for it to be adjusted, corrected, and finally functioning as it should.
Not everyone will be pleased, of course, ever. Some people will complain that they have to pay for something they don't now need so others can be covered. My Massachusetts friend explains this more clearly than can I. This negative view of healthcare, she says, "depends on people having no idea how private insurance works. They don't want to have to pay for other people's health care? Guess how private insurance works! They don't like to have to pool their money with everyone else's for the common use? Guess what an insurance company is and does! Public insurance does exactly the same thing as private." In fact, what we're really talking about here is private insurance companies, onto whose rolls masses of citizens are being herded. Public or private, they work the same.
Then of course, there's that old bogeyman, SOCIALISM. Many are convinced, or profess to be, that the Affordable Care Act is a socialistic program. Actually it doesn't fit that pattern nearly so closely as does Medicare. And if we ban every activity that bears the faintest socialist coloration, we'll be moving out of modern society and back toward a simpler, and far more difficult, time. We'll have to give up public education, police services, and many other blessings we take for granted every day.
Last week, my wife became very ill one evening. She'd not long ago undergone surgery and a two-month stay in the hospital. Her symptoms became severe, and our primary care physician, called at home, told me to get her to the nearest emergency room as quickly as possible. I called 911, and soon an ambulance appeared, and an EMT worked with her on the way to the hospital. I could have avoided using the service, which is decidedly socialistic. Fortunately for my wife, I valued her life more than any questionable allegiance to a vague political tag.
Robert B. Simpson, a 28-year Infantry veteran who retired as a colonel at Fort Benning, is the author of "Through the Dark Waters: Searching for Hope and Courage."