Leader Blues

Tuesday, March 23, 2010

EDITORIAL >>Health care a good deal

By Arkansas standards, our area is relatively prosperous and secure, but in the next three to six months, some 13,000 people who have lost their health insurance because of chronic sickness or a pre-existing condition will get to buy affordable insurance for the first time, another 75,000 to 100,000 elderly residents with high drug bills will get some help, and insurance companies will stop dropping people when they get sick, stop denying coverage to children with pre-existing conditions and stop capping lifetime medical payments for people with catastrophic illnesses.

Those are some of the first consequences of the Patient Protection and Affordable Care Act, which President Obama signed into law yesterday morning. Scores of other changes in the nation’s patchwork insurance system, the more sweeping ones, will occur over the next nine years. It will take three years or so for state governments and the insurance industry to set up exchanges where more than 150,000 uninsured people and 16,500 small businesses in our eight counties can for the first time shop for affordable coverage for their doctor and hospital bills.

That is the big change that is roiling the country. The Republican Party calls it socialism and tyranny and promises to repeal the law if the party controls Congress next year. Almost to the last person, Republican candidates for the U. S. Senate and House of Representatives in Arkansas joined that crusade this week.

We mentioned the first effects of the law only to emphasize how far-fetched is the idea that the Republican Party or any party will repeal the massive law no matter how many gains the party makes in the approaching election. Modifications, yes — it will need fine-tuning for many years, just like every other economic-security law in history — but it will not be repealed.

Here are the arguments that the repealers will have to make should they get a bill to the floor even late this year: “We must stop today insuring children with birth disabilities or crippling childhood illnesses; we must stop drug discounts and make the elderly and disabled pay more for their medicine; we have to stop allowing people with long-term illnesses or pre-existing conditions to get affordable insurance; we must kick sons and daughters off their parents’ insurance policies if they are over 21.” And so on.

The insurance lobbyists will cheer them on — that will be quite a racket — but not many others.

As people learn about the more far-reaching provisions of the bewilderingly complex law and discover that all the scary claims were lies, they will not want to go back on those either. When they find that the law affects insurance and not their medical care and that the government is not taking over medical care, few will want to go back to the good old days when only the well-to-do or the well-employed could get insurance, and even they were at the whims of the underwriters.

If there was anything at all to the fearmongering charges that the bill would destroy the doctor-patient relationship and put medical care under the control of government bureaucrats, the act would not have had the strong support of American hospitals, nurses and the American Medical Association, which spent 60 years fighting every national health-insurance proposal on those very grounds, until this one.

It was reassuring that our congressman, Vic Snyder, voted for the bill, the only one in the delegation to do so, although the representatives from our east and south, Marion Berry and Mike Ross, had voted for more liberal versions of it at some point last year.

Snyder knew the huge benefits to his district and the greater benefits to the rest of the state even if his colleagues were afraid to acknowledge them. We wished Snyder would be more assertive rather than merely consistent and knowledgeable, but that is Snyder’s manner. We will miss it.

Gov. Mike Beebe weighed in after the vote that he would have voted against the final bill, although he thought much of it would be good for the state. He worried that the burden on the state government from the expansion of Medicaid coverage to children and childless adults in 2014 would be too great. Beebe must not have understood the bill.

As Snyder ever so politely pointed out, the federal government will cover 100 percent of the Medicaid costs through 2016, and over the next four years after that the state will start bearing a small share of the cost each year until it reaches close to 10 percent. Hundreds of billions of dollars will flow into the state, shouldered by wealthy taxpayers in other states and the insurance, pharmaceutical and medical-equipment industries, and Arkansas will match only a small portion of those funds.

The extra state revenues generated from such an infusion of capital will surely oblige the governor’s fiscal concerns.

Even Sen. Blanche Lincoln, who was for the Patient Protection and Affordable Care Act before she joined the Republican coalition to try to trap and kill it on a procedural technicality, was moved yesterday to praise the law’s great benefits to Arkansas. She may be timid, but she ain’t dumb.

That adjective has to describe the Arkansas politicians who joined the cry this week to use the ancient slaveholders’ doctrine of nullification to try to stop the patient protections from becoming law in Arkansas. They want the state attorney general to issue an opinion saying that the United States Constitution doesn’t mean what it says in the Supremacy Clause and that the United States Supreme Court misspoke in Marbury v. Madison in 1803, which settled for all time the issue of whether every state can interpret the U. S. Constitution as it wishes.