Tag: Affordable Care Act

Culture, Politics

God says ‘no’ to birth control in proxy war over Obamacare

by Paul ValeLeave a Comment on God says ‘no’ to birth control in proxy war over Obamacare

To what extent should an employer’s religious beliefs affect the rights of its employees? You’re quite correct – they shouldn’t. Once you pass from the private sphere into the public sphere – the marketplace, for example – employees are protected from the whims of employers by the law.

This is fairly straightforward stuff, yet amazingly this simple premise is set to be challenged in the US, with the Supreme Court hearing two cases in which employers will argue that their private religious affiliations prevent them from offering female employees birth control provisions.

Let me run that by you again – the seemingly most prosperous, scientifically forward and politically advanced (the American revolution is after all still going) nation in the world is set to debate whether employers can legally refuse to provide female birth control as part of their healthcare package.

Unsurprisingly, as with everything in contemporary US politics, this is yet another proxy war over the Affordable Care Act, with Obama’s landmark legislation being tested, pushed, pulled, bitten, scratched and kicked at every turn by a Republican Party that has placed its entire stack of chips (plus its watch, its car, the house and its wife) on Obamacare’s repeal.

Myriad companies have attempted to sue the government over a rule in the Act that states for-profit companies (excluding Churches and non-profits) should provide birth control in their health insurance plans. We’re not talking about abortion here – we’re talking about IUDs and the morning after pill.

Yet that has been enough for two companies, aided by a febrile atmosphere in which the political right are determined to scupper the ACA backed by a religious right determined to see birth control reduced to prayers and a pair of crossed fingers, to have their grievance heard by the highest court in the land.

The companies in question are a Christian-owned craft supply chain called Hobby Lobby and a furniture company owned by a family of Mennonites. Both argue that they morally object to being made to pay for birth control provisions because they believe it is akin to abortion.

Yet even if you think religion is an important matter – it is soaked into American political culture like a 200-year-old bloodstain – the problems of letting employers decide on which laws they will follow and which they won’t because of moral objections are obvious. What if an employer believes cancer treatment is morally wrong? What if they believe HIV is a curse sent by God and those infected deserve his wrath? Should the employees be forced to pay for these prohibitively expensive treatments on their own?

What if a restaurant owner objects to serving black people on moral grounds? Should they be allowed to circumvent the law based on whimsy? The Supreme Court is due to hear the cases early next year, with a decision likely next summer. Fortunately, the Obama administration has proved itself resolute on matters of the Affordable Care Act, despite the main exchange website offering all the technical wherewithal of a ZX81.

“The President believes that no one, including the government or for-profit corporations, should be able to dictate those decisions to women,” read a White House statement on Tuesday. We wait to see if the Supreme Court agrees.

This article first appeared in The Huffington Post. The original article can be found here.

Culture, Politics

Fear mongering about socialism is ‘nothing new’ for Republicans in US healthcare debate

by Paul ValeLeave a Comment on Fear mongering about socialism is ‘nothing new’ for Republicans in US healthcare debate

In January 1948, British Prime Minister Clement Attlee gave a radio address to explain the introduction of the National Health Service (NHS), part of the “most comprehensive system of social security ever introduced to any country“. Notably, the Labour leader said during the creation of these new social services, “all parties in the state have borne their part and I am therefore not speaking to you in any controversial spirit.”

Three years earlier, President Harry Truman had come to power in Washington, lending his full support to similar provisions of publically funded healthcare. However, unlike Attlee, Truman had met with staunch opposition, most notably from the American Medical Association (AMA), who were quick to entangle the debate with the Cold War politics of the day.

As such, Truman’s vision of compulsory health insurance was quickly mired in anti-socialist fear mongering, so much so that during a 1946 Senate hearing on the National Health Insurance Bill, Republican Senator Robert Taft shouted out: “I consider it socialism. It is to my mind the most socialistic measure this Congress has ever had before it,” before leading his party members out of the room.

An AMA pamphlet printed two years later suggested the tone had not changed: “Would socialised medicine lead to socialization of other phases of life?” it read, adding: “Lenin thought so. He declared socialised medicine is the keystone to the arch of the socialist state.” Despite Truman’s victory in the 1948 election, his healthcare plan remained sidelined, unable to counter the influence of interest groups or to corral a public seemingly happy with its health system.

Resistance to healthcare reform in the ’40s mirrored that faced by FDR and his social security expansion of the 1930s; the debate over Medicare in the ‘60s proved equally fractious, likewise the Clintons’ push to pass the Health Security Act in the ’90s. More recently, the Affordable Care Act (ACA), famously referred to as “the crown jewel of socialism” by Michele Bachmann, has drawn out similarly toned opposition, with Louie Gohmert, a Republican congressman from Texas, finding the bill so repulsive he felt compelled to ask: “How much more socialist can you get than the government telling everybody what they can do, what they can’t do, how they can live?”

According to Iwan Morgan, the Commonwealth Fund Professor of American History at University College London, GOP right-wingers’ use of Socialism to instil fear about healthcare reform “is nothing new”.

“Their patron saint [Ronald Reagan] did it a half-century ago when the Cold War was at its height,” he told HuffPost, highlighting a record cut in 1961 entitled, ‘Ronald Reagan Speaks Out Against Socialized Medicine,’ which was sponsored by the AMA as part of its campaign against the pre-Medicare Herr-Mills bill.

“In this, Regan asserted that ‘one of the traditional methods of imposing statism or socialism on a people has been by way of medicine’,” said Morgan, adding: “If you read the speeches of modern day conservative Republicans, they continually condemn healthcare reform in particular and, more generally, any expansion of the federal government’s socio-economic responsibility (but not socio-moral responsibility) as socialistic in intention.”

For Dr Jonathan Bell, a specialist on US social change at the University of Reading, there was a critical moment in the ’40s when healthcare reform in the US looked likely, however because of the Cold War and the “way the American political system was so receptive to extreme ideas”, particularly a fear of totalitarianism and communism, it “allowed opponents of the New Deal state to take control of the political agenda.”

Yet scaremongering is not the only reason why the US has proved so resistant to progressive healthcare policy, while Britain, France Canada, Japan, Australia and many others have long-since moved to wards a more egalitarian system.

According to Bell, one of the main hurdles to a single-payer system is the way the US medical profession has developed into a powerful and strong private sector lobbying presence in government “that’s very much been concerned to ensure private healthcare has predominated.” As such, lobbying groups have not allowed government to get a foothold in the provision of medical care. “It has been very strongly felt by the AMA and medical lobbyists that their control over their own ability to decide medical procedures and finances would be damaged by government,” said Bell.

That was also true in Britain – the British Medical Association (BMA) was initially hostile to the NHS – but that opposition was quickly abandoned. “The medical lobby has to be put into the context of the American political system,” said Bell.

It is also worth noting that in the ’40s and ’50s, healthcare in the US was not the sprawling mass of conglomerated hospitals and medical maintenance organisations underpinned by private insurance it is today. It was often smaller practises, usually family run, while the expansion of the insurance industry in the decades after the war meant that most people were covered via their employer.

“There was the sense that people didn’t need a public option,” said Bell. “It was only when that health insurance system started unravelling and coming under strain in the ’70s and ’80s that the issue raised its head again.”

Following Obama’s victory in 2008, the Democrats used their sizable majority in Congress to pass the ACA, patching up the US system by adding government regulation to remove inequities and by increasing coverage. However, as a consequence of finally pushing through healthcare reform, Republican opposition was able to wipe out the Democratic majority in the House of Representatives in 2010, from where they’ve been conducting a massive and quite personalised, bitter war with the President ever since.

This article first appeared in The Huffington Post. The original article can be found here.

Politics

US government shutdown over Obamacare has serious implications for global economic recovery

by Paul ValeLeave a Comment on US government shutdown over Obamacare has serious implications for global economic recovery

Once again Europeans may be forgiven for looking on baffled at the bizarre maneuverings of Washington’s political class this week as the US government careers towards a shutdown. The Affordable Care Act (ACA), better known as Obamacare, remains the President’s signature legislative achievement, having made its torturous journey through Congress in 2010, emerging with the promise of finally providing coverage for an additional 30 million people that had been cast adrift by the country’s failing health care system.

Yet despite being signed into law more than three years ago, the legislation, a major part of which is due to be finally implemented this week, threatens to derail not only the US government but provides an ominous portent for the US debt ceiling debate, with severe implications for Britain, the eurozone and beyond.

Unlike the single-payer systems of Europe and Canada, the ACA offers a mechanism for those without insurance to pool together for lower health insurance premiums through state-run exchanges, scheduled to open on Tuesday. This follows several provision that have already been implemented, most notably a ban on insurance companies hiking up premiums based on pre-existing medical conditions.

Even before it became law, Obamacare had been the target of vehement hostility, representing for some an unwelcome federal intrusion into medicine, for others a step towards a European socialised system, and to a vocal few confirmation that the President was indeed the anti-Christ. Still, the law was passed and was subsequently upheld during a Supreme Court challenge, followed by the 2012 election in which the GOP candidate, Mitt Romney, ran on a platform of repeal, effectively turning the vote into a referendum on Obamacare. It was a campaign that Romney and the Republicans lost, despite myriad shortcomings of the Obama administration over the previous four years.

Even after being signed, upheld and then ratified by the electorate, the law remains almost pathologically unpopular with members of the GOP, so much so that the Republican-led House Of Representatives has fielded more than 40 (mostly symbolic) challenges to the ACA since 2012. As Alex Waddan, a US specialist in Leicester University’s department of politics, points out, all major social welfare policy change is controversial, “but comprehensive health care reform is especially so,” he tells the HuffPost UK. That’s not to dismiss Obamacare as just another difficult piece of legislation, amounting to “the biggest health care shift since at least the mid-1960s and the introduction of Medicare and Medicaid.”

Both the Clinton and Bush (43) administrations failed to pass welfare reforms, while the last comprehensive social policy that was successfully introduced was the 1996 Personal Responsibility and Work Opportunity Act, a Republican-backed welfare reform bill signed by Clinton despite opposition from the left.

Yet what is distinct about the current fight is its longevity. As Waddan makes clear: “What is unusual about Obamacare is three years after it became law and a year after the Supreme Court upheld most of its provisions, the battle to repeal it still rages.”

Such is the dogmatism within a minority of Republican members that the ACA has become a proxy war between a Tea Party faction bent on repeal and the establishment GOP. And with the implementation of Obamacare drawing near, the so-called “extreme wing” has spent the past week attempting one last assault, dragging a seemingly rudderless party with it, by threatening to close down the government unless the Democrats agree to delay the individual mandate for a year(thus giving the GOP an opportunity to take both houses of Congress in the 2014 mid-term elections, effectively killing the law for the reminder of Obama’s second term).

On Tuesday, Tea Party-backed Senator Ted Cruz, aided by a pair of “comfortable tennis shoes”, spent the best part of 21 hours speaking in favour of defunding the law. It proved a bizarre oratory with little practical purpose beyond raising the Texas senator’s profile and solidifying his position as head of the extreme faction which make up about 18% of the elected GOP.

With the Democrats holding a majority in the Senate and Obama wielding the power of veto, Republican ambitions of passing a measure that tied government funding to a one-year delay of Obamacare had no chance of success, leading to this week’s likely shutdown and the temporary closure of some federal agencies and welfare provisions. A similar shutdown in 1995 led to a decrease in Q4 growth in the US, which, if it happens again, could have a knock-on effect for growth in the UK. More worrying, however, the fight over Obamacare could be a prelude to a more critical battle ahead – the increase of the US debt ceiling.

Last week, US Treasury Secretary Jack Lew implored Congress for a speedy resolution on an agreement to raise the $16.7 trillion statutory limit on government borrowing, which is likely to expire on the 17 October. The Republicans have already agreed to raise the limit, but only if it’s tied to a raft of conservative causes, concessions the President has flatly refused to countenance. Should the parties reach a similar impasse as they have over tying Obamacare to the budget, the effects would have far graver repercussions for the US and beyond, leaving British officials looking on with nervousness.

The Bank of England is already holding off printing more money as Ben Bernanke is expected to start winding down the Federal Reserve quantitative easing programme. However, the US being unable to service its debts could force the Federal Reserve to inject another dose to for stabilisation, which would likely force the Bank of England’s hand as they rush to keep the shaky economic recovery on track in Britain.

Their efforts to steady the British economy could see interest rates increase, investors take fright and the FTSE 1000 tumble. Businesses would inevitably suffer should US debt ceiling paralysis take hold due to its trading relationship with the UK, receiving 16% of British exports. “The US is the UK’s individually biggest export market so it matters hugely what happens there,” Martin Beck, UK economist at Capital Economics, tells the HuffPost UK. Beck anticipates that the economic shock would not be as severe as the full brunt of the Eurozone crisis in 2012, partly because the share of UK exports going to the EU is 45%, many times more than go to America.

Yet the European economy would be in line for a similar shock should the US default. Jonathan Loynes, chief European economist at Capital Economics, tells HuffPost: “If the US recovery comes to a grinding halt and there’s serious market volatility then that’ll have quite serious knock on effects on Europe.” However, Loynes adds a caveat. Congress could just be engaged in another bout of political brinksmanship. Even if it is an act, Loynes warns that the political instability could show how weak America’s finances are.

“It is worrying that these sorts of episodes seem to be occurring at such a regular basis and it’s indicative that the US fiscal position is not in such a good shape and at some point they’ll have to implement more fiscal tightening,” he said.

Yet for Waddan, the current wrangling over Obamacare could in fact help negotiations over raising the debt ceiling. “If the House Republicans need a chance to let off steam and that happens over the continuing resolution bill to keep government open then perhaps the debt ceiling negotiations might be easier.” he said.

“The administration has insisted that it will not negotiate over the debt ceiling, but the House republicans might simply see that as giving them more leverage. On the other hand, the potential consequences of default – and no-one really knows what the consequences would be – should make everyone think twice before going down that route.”

This article first appeared in The Huffington Post and was written with Asa Bennett. The original article can be found here.