The Affordable Care Act

Warning: this rare post of mine has nothing to do with games. Worse yet, it’s political in nature! I know, I know… how self-indulgent of me. If you’re easily offended by political commentary, skip this article.

Lately I’ve been depressed by the number of arguments I’ve witnessed about the US Affordable Care Act that revolved around anecdotes as opposed to facts. “My buddy Joe’s premiums doubled because of this stupid law!” “Oh yeah? My cousin Susan was dying of cancer and couldn’t get insurance, until this law saved her life!” I expect this kind of thing from politicians (“Let me tell you about Mary Sue of South Dakota…”) but not from my friends and family. How about we break down a few simple stats instead:

A large, recent Gallup poll that asked respondents: “are you satisfied with the availability of quality healthcare in your city or area” and “do you have confidence in your national healthcare system” pegged the United States below countries like the UK, France, Austria, Netherlands, Denmark, Switzerland, and Iceland *on both questions.* Interestingly, even when the US tied or slightly edged out countries on the “availability” question, we fall way behind other countries on the “confidence” question… folks in Turkey and Mexico have more confidence in their medical system than we Americans do.

We’re also below most of our peer nations when it comes to life expectancy. Of course there are many factors that influence life expectancy, but it seems fair to say that if socialized medicine were a disaster, you’d expect to see some sort of impact on this metric. (Or perhaps French lifestyle and dietary habits are so utterly superior to ours that their life expectancy is greater in spite of their terrible healthcare system… that they nevertheless appreciate more than we Americans appreciate ours?) The USA isn’t used to seeing itself rated below Qatar, Costa Rica, Greece, Slovenia, or Chile on too many metrics, and on this one in particular, we really should be outraged.

Then of course, there’s the simple fact that we pay radically more for various medical services than anybody else. Not 10% more. Not 50% more. Not 200% more. How about 10x more for, as just one example, bypass surgery?

This doesn’t mean the ACA will solve all our problems. Not by a long-shot. But if your argument against it is “socialized medicine just can’t (or shouldn’t) work” you are metaphorically sticking your fingers in your ears and shouting “NAH NAH NAH NAH” like a small child.

The ACA website rollout is totally fubarred. That sucks. (Doesn’t help that the deployment team was contending with massive obstructionism at the state and federal level by opponents of the law, but hey, let’s ignore that for the moment.) Pretty much every big project the government has tackled in recent memory has started out all screwed up. If we terminated every major infrastructure project at the first sign of serious problems, there would quite literally be no new major highways and all our old bridges would crumble to dust (spoken as a former resident of Boston during the Big Dig and current resident of Seattle during the 520 rebuilding project.)

Most Americans agree that government doesn’t tend to be the most competent of institutions. But we also really like having police to guard our homes, armies to defend our borders, inspectors to safeguard our food and CDC scientists to safeguard us from the outbreak of virulent diseases. I’m not sure what separates those things from “doctors to keep us healthy,” other than our own stubborn insistence that healthcare is somehow a privilege, not a right.

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