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Defending Obamacare: 5 Basics

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The June 28 th Supreme Court decision that let "Obamacare" stand gives the President, and all Democrats, an opportunity to re make the case that the Patient Protection and Affordable Care Act is a good thing.  That's a blessing because many American voters do not understand Obamacare.

The most recent USA Today/Gallup Poll finds Americans evenly split on Obamacare with 46 percent agreeing with the Supreme court decision, 46 percent disagreeing, and eight percent unsure.  While Democrats and Republicans divided along Party lines, a slight plurality (45 percent) of Independents approved the ruling.

Nonetheless, many of those who say they do not like Obamacare do not understand it.  An April < Kaiser Family Foundation Tracking Poll found that only 51 percent of respondents believed they had enough information about how the law would affect them personally.  However, when asked their opinion about specific provisions of the law -- "the law will prohibit insurance companies from charging women higher premiums than men" -- typically a strong majority approved.  When voters understand Obamacare they like it. (Even Republicans.)

President Obama, and all Democrats, needs to do a better job of conveying the benefits of the Affordable Care Act.  Here are 5 points to remember:

1.  Obamacare reflects values not policy.  At the root of the healthcare controversy are two different conceptions of America.  Most Democrats believe that we belong to a "benevolent community" and work together for the common good; as President Obama has repeatedly said, "It is that fundamental belief: I am my brother's keeper, I am my sister's keeper, that makes this country work. It's what allows us to pursue our individual dreams and yet still come together as one American family." Linguists George Lakoff and Elisabeth Wehling refer to this notion as "The Public," "everything that our citizenry as a whole provides to all."

On the other hand, Republicans believe the US is a collection of rugged individuals, each competing in the free market.  Lakoff and Wehling term this worldview, "The Private," noting "a free market economy depends upon a strong Public."

 From the benevolent-community perspective government, The Public, is how we organize to get certain things done: build roads, construct schools, and make sure that every American has a minimal standard of living including access to affordable healthcare.  From the rugged-individual concept, government is an encumbrance; the Private already provides healthcare for some Americans.

2. Healthcare is a right not a product. Those of us who believe in the benevolent-community vision of America view healthcare as a right that should be enjoyed by all Americans.  Those of us who believe in the free-market vision of America see healthcare as a product; Republican Rudy Giuliani once likened healthcare to a flat-screen TV, "If you want a flat screen TV, buy one; and if you don't have the money, go earn it. If you can't, too bad, you don't deserve it." 

3. The Patient Protection and Affordable Care Act (Obamacare) regulates insurance companies; it does not regulate healthcare. Obamacare guarantees access to healthcare for all American -- except illegal immigrants -- by regulating insurance companies.  President Obama defended this by observing,

"Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy.  These are not primarily people on welfare.  These are middle-class Americans.  Some can't get insurance on the job.  Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.  Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or too expensive to cover.  We are the only democracy -- the only advanced democracy on Earth -- the only wealthy nation -- that allows such hardship for millions of its people.  There are now more than 30 million American citizens who cannot get coverage.  In just a two-year period, one in every three Americans goes without health care coverage at some point.  And every day, 14,000 Americans lose their coverage.  In other words, it can happen to anyone."

4. Obamacare will lower insurance costs.  The Affordable Care Act will lower insurance premiums for most Americans.  First, it requires everyone to have insurance and eliminates free loaders.  Second, it requires insurance companies to spend money on services and not overhead. 

5. Obamacare will decrease the deficit.  Mitt Romney, and Republicans in general, have spread misinformation about this.  However, "in February 2011, the CBO estimated that Obama's health-reform law would reduce the deficit by $210 billion over 10 years."

To summarize the healthcare debate comes down to five points.  Two are value drive and three are factual.  Obamacare stresses the primacy of the Public over the Private and asserts that healthcare is a right for every citizen.  Furthermore, Obamacare regulates insurance companies thereby lowering consumer costs and the deficit.  The Affordable Care Act is worth defending.


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Bob Burnett is a Berkeley writer. In a previous life he was one of the executive founders of Cisco Systems.
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