How to Defend the Affordable Care Act

I’ve been getting into a lot of debates about the Affordable Care Act  on Friday nights. 

Here’s what happens: When I’m out-and-about, inevitably, somebody will ask me what I do for a living. I say, “I’m a freelance writer. Specifically, I write a lot about the hospital and healthcare industry.”

I’m usually met with one of these responses:

A.    A blank stare.

B.    “Oh, so how you do you feel about ObamaCare?”

For a while, when people would ask me — I would just politely avoid the conversation. “Oh, it’s complicated,” or “What do you think?” or just, “Excuse me, I need another whiskey sour.”

But if there’s anything I’ve learned from politics — it’s that we all need to start talking and listening to each other more. And if there’s a bunch of mildly intoxicated people who want to listen to me talk about healthcare reform — fine, I’ll take whatever audience I can get.

For starters, I understand why people are upset about the Affordable Care Act. Individual healthcare costs and deductibles have risen. Doctors are overloaded with more paperwork. Some insurance companies have left the market. It's not perfect. 

But despite that, the law provides healthcare insurance to 20 million Americans. Some of my fellow bar patrons might say that healthcare insurance should only come from a person's employer — and it’s not the government’s responsibility to get involved.

But we have to acknowledge there are a lot of people out there who work in low-paying, part-time jobs for companies that don’t provide healthcare insurance. We also have to acknowledge there are a lot of people in America living in poverty. And once we acknowledge that, I feel like we have a responsibility to do something about it.  

But that’s too long of a feel-good soliloquy for my new bar friends to swallow. It’s 2 a.m. It’s loud and dark. And just like a political operative on “Meet the Press,” I know I have less than 90 seconds to get my talking points across as quickly and as pithy as possible.

Here goes:

• We take for granted that before healthcare reform, nobody who had a pre-existing condition could get healthcare insurance. A few years ago, if you were a 45-year-old guy who had high blood pressure — and you just lost your job, no insurance company would cover you.

• Do you have a younger brother or sister? Thanks to the ACA, they can stay on your parent’s insurance until age 26.

• Costa Rica, Kyrgyzstan and Cuba provide healthcare insurance to their people. Before the ACA, we were one of the few democracies that didn’t. (This is the point in the conversation where I slap them on the back and say, “Let’s go, ‘Merica!”) 

• The law is more popular than you think. Only 26 percent of people want to repeal and replace the whole thing.

• Here’s something a lot of people don’t know: Before the ACA, hospitals would make money by providing services, regardless of whether the services kept people healthy in the long-term (examples: countless MRIs, over-treatment for care or too much medication). Now, hospitals have to consider the long-term health of a patient and won’t be incentivized to charge the patient repeatedly for different services. This new model not only lowers the cost for care, but encourages best practices in care delivery.

• The ACA focuses on preventative medicine. That means that you can see your primary care doctor for a check-up, take a smoking cessation class or do cancer screenings for free.

• What’s the alternative?