Medicare Single-Payer vs. Affordable Care Act (Obamacare)

The overwrought and repugnant response to the Affordable Care Act (Obamacare) by Looney Tunes Tea Party “activists” and by many so-called mainstream Republicans, is patently absurd in a country that already has a nearly 50-year-old single-payer, government-run, health care insurance program called Medicare. And I purposely include “insurance” in the description of Medicare, because that’s exactly what it is. It is NOT socialized medicine. You still see your private doctor with Medicare. You can still go to a private hospital with Medicare.

But here they go, the right-wingers are going to call me out. They say Medicare is not a single-payer health care insurance program. Why do they point this out? Beats me. They say because Medicare pays 80% of your medical bills, that means it cannot be a single-payer system. But when we talk about health care insurance programs or systems, we are talking about insurance. If you have to spend 20% out of pocket, you are certainly free to call yourself a “payer” but you aren’t a system. And even if you chose to buy supplemental insurance to cover that 20%, that is private insurance that is separate from the system. When we talk about the basic level of coverage you get with Medicare, there is not another player or payer, Medicare is the only game in town. Therefore Medicare is a single-payer system, even if it’s not a comprehensive single-payer system that covers 100% of medical costs.

But now I’ve distracted myself from the original point. If there’s one thing right-wingers are good at, it is changing the subject or modifying the premise to suit their ideology. The original point I’m trying to make is that on a Left/Right scale (for lack of a creative alternative), Medicare sits far to the left of the Affordable Care Act (Obamacare). And because that is true, the over-the-top anti-Obamacare rhetoric from the Right is nonsensical.

Remember all the crazy shouting and demagoguery during the 2009/10 health care “debate”? Or how about all the insane Republican obsession with repeal of the Affordable Care Act? All of the foaming at the mouth nonsense directed at a private market-based solution (Obamacare), has happened in a country that already has a government-run solution called Medicare.

Medicare is a single-payer health care insurance program run by the government, and it has a large insurance pool, which gives it tremendous negotiating ability to keep procedure costs down compared to private insurance. Imagine if Medicare wasn’t age-limited, how much bargaining power would it wield then?

By contrast, Obamacare is a market-driven solution. The Affordable Care Act relies on private for-profit insurance, or in other words, it didn’t change the system we already had, it simply tweaked it. The ACA is simply a set of rules to further regulate a health care marketplace that already existed. And while I have plenty to say in opposition to market-based solutions for health care, this isn’t the article for that.

Nope, the point of this article is not to sell Medicare-for-all, although I do think single-payer is the best solution to our rising health care costs. And the point of this article is not to point out the flaws of a capitalist marked-based health care solution. Instead, the point of this article is make a reasoned distinction between Obamacare and Medicare and then ask a simple question — Can you honestly and with a straight face defend the rabid fanaticism and incendiary oratory (“it will end freedom,” “it will destroy America,” etc.) directed at the Affordable Care Act by many Republicans and conservatives?

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