Ky. Voices: Phony crisis over health care reform rooted in partisanship, fear of law's success

September 30, 2013 

Our current congressional representative, Andy Barr, prefaces his case for defunding the Affordable Care Act by professing that his top priorities "have always been getting Kentuckians back to work and averting a national debt crisis."

Regarding his first priority, it is worth noting that he says nothing about what concrete steps he has taken in Congress to create job opportunities for those he represents. Could it be that his silence is testimony to his utterly blank record of any job promotion or creation since he arrived in Washington with the second wave of Tea Partiers in 2013?

As for his second, it is a phony crisis that the Republican House has acknowledged by its own legislative proposals, most notably the Ryan budget that would inflate the deficit at an unprecedented rate.

By some weird logic, Barr argues that President Barack Obama is prepared to shut down the government by refusing to support the Tea Party's quixotic defunding of the ACA. Never mind that the Congress itself enacted the ACA into law, the president signed it and the Supreme Court affirmed its constitutionality. Never mind that Congress has the obligation to fund that legislation which it has already passed.

None of this matters when the elimination of the ACA has become an irrational obsession, as the 40-some ritual repeals of the law by the Tea-Party controlled House of Representatives amply underscore.

And what does Barr offer as justification for defunding the law? It is, he reminds us, a very unpopular law that will prove a "train wreck" for the American economy by increasing unemployment, sharply driving up health costs and sending the deficit soaring. In a word, it is unworkable.

Let's look at these charges.

Regarding the ACA's popularity, Barr twists statistical studies to lump together those who flatly oppose the ACA with those who are unhappy that the law did not go far enough in reforming health care. More relevant is that a solid majority oppose repealing the law, which says more about the growing support for the law.

As to the job-cutting effect of the act, the frightening trend he projects of businesses, unable to afford the costs of covering their workers that the law imposes, having no choice but to lay off workers, is basic fear-mongering. The vast majority of small companies (45 to 50 employees) that he considers most vulnerable already provide health care.

Barr, of course, does not mention the large number of jobs that will be created within the health-care industry by the ACA's addition of nearly two score millions of Americans to coverage.

Are health costs already soaring under the ACA?

It is true that they are increasing. That is no surprise. Skyrocketing health costs have long been a dominant feature of the free-market health care system that the law replaced. A more significant development is the decreasing rate of increase in health-care costs, which gives promise of even greater decrease in the near future. At the individual level, the most important effect for the overwhelming majority of those who currently have health care will be, not a threat to their coverage but, at worst, no change whatever, and, for a great many, more and better choices.

And the deleterious impact on the deficit?

Actually, impartial assessors predict that the ACA will reduce the deficit by well over $100 billion over the next decade. An unworkable law? Only to those who know that their only chance, small as it is, of getting rid of the ACA is to prevent it from going into full effect and having the American people quickly realize all the benefits it will provide.

Hence, the attempts in many Republican-controlled states to sabotage the implementation of the law.

Barr concludes by looking forward "to the day that we can replace Obamacare with patient-centered reforms that lower costs without growing government."

Ah, the sweet sirens of the marketplace and the unfettered individual who assure that once capitalism is fully free from government's heavy hand, comprehensive health care will follow at nominal cost to society.

What a fantasy that flies in the face of all that our history teaches us about the correlation between the expansion of government and the ongoing providing for the needs of the American people, not least of which is health care.

Health care, after all, is not a business but a service, as virtually all advanced nations recognize, a service the government has a responsibility to provide for its citizens.

The Affordable Care Act is an imperfect, but major, step toward making that service a universal reality in America.


At issue: Sept. 20 commentary by U.S. Rep. Andy Barr, "Obama willing to shut down government over bad health law"

Robert Emmett Curran of Richmond is professor emeritus of history at Georgetown University in Washington, D.C.

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