Texas Tech University Health Sciences Center
Is Yesterday’s “Radical” Idea the New Normal?

Is Yesterday’s “Radical” Idea the New Normal?

A few years ago my wife and I attended a Christmas party where a fellow guest was running for Congress. Although this person was not elected, he was in the throes of his campaign and therefore shaking hands and talking with everyone. Amidst his campaigning at the party, he stopped talking long enough to say, “You work in healthcare, what do you think about Obamacare?” I was pleased that he wanted my opinion and started answering his question. My response ran along the lines that it had quite a bit good about it, yet a number of aspects of it clearly needed to be fine-tuned.  (After all, it was 2,300 pages long.) He looked at me like I was speaking in Greek and said, “It has got to be repealed. “ I pressed my points further as he looked at me with a bit of a blank stare. Before, departing to shake the next hand, he repeated, “Obamacare has got to be repealed.” He had that part of his campaign platform down pat.

It is interesting that now, with talk of Medicare for All and single-payer health care system being bantered about, a good number of doctors, hospital leaders, pharmaceutical companies executives, and CEOs of insurance companies are banning together to kill these proposals, according to recent news reports. These groups are organizing a massive campaign, they call the Partnership for America's Health Care Future, to provide "counter-messaging" against Medicare for All and to thwart any effort that moves away from the status quo of private insurance and toward a big new public program. 

They can probably put their checkbooks away. It seems that as people think more about it and consider the cost of what it would take to replace today’s Medicare, Medicaid, and most private insurance with a massive federal program, their interest drops faster than the temperature during a West Texas blue norther. For example, a recent Kaiser Family Foundation poll says that although people like the concept of Medicare for All, net favorability drops by about 50 points when presented with difficult facts such as higher taxes, less provider choice, and longer wait times for appointments. Other polls show that most people like their employer providing them with health insurance, thank you very much.

By the way, the cost of a consolidated federal effort is estimated to more than $30 trillion over 10 years. I cannot even fathom that Carl Sagan sounding number. The most surprising thing though is that these business type groups are now fans of the Affordable Care Act and that is my point in this article. Of course, with the specter of “Medicare for all” a fading thought, their ardor for the ACA will likely fade with it. Many, but not all of these business folks, even want to see states such as Texas, Florida, and the rest expand Medicaid under the Affordable Care Act. Probably to nobody’s surprise they want to keep (and even expand) federal subsidies and they like the reinsurance programs and the protection they offer.

Maybe we are seeing a very visible manifestation of the Overton Window in that ideas that would have been considered radical (Medicare for All, for example) are coming into sight and yesterday’s “radical” idea is now the new normal and embraced, or at least, accepted, by the so-called establishment. The fact that House Democrats’ bill to extend Medicare to all Americans and eliminate private insurance has than 100 co-sponsors is worth noting.

All of this makes me think of my conversation with the would-be member of Congress a few years back and his “repeal Obamacare” chant (a chant he repeated with the zeal of the most ardent adherent of meditation) and wonder what he is saying today. But, come to think of it, he probably has not thought much about Obamacare since his failed congressional bid.