Sometimes we get so caught up in the nuts and bolts of the real-world impact of laws that we forget that they can have a powerful psychological and sociological impact as well.
Republicans and conservative thought leaders understand this far better than liberals do and it explains a lot of their actions. For example, while it's true that Republicans went to war against Obamacare because they hated Obama with the power of a thousand exploding suns, it doesn't fully explain what we saw happen over the last 8 years. To fully understand why they went scorched earth against what was literally their own healthcare policy, you have to read Charles Krauthammer's column in The Washington Post about the Trumpcare disaster.
After describing how Republicans can resurrect Trumpcare, defeat Obamacare, and pin it all on the Democrats, he gets to the main reason why Obamacare must be destroyed and it's one that Republicans have known all along even if they got bogged down in the details:
But there is an ideological consideration that could ultimately determine the fate of any Obamacare replacement. Obamacare may turn out to be unworkable, indeed doomed, but it is having a profound effect on the zeitgeist: It is universalizing the idea of universal coverage.
That, right there, is what Republicans and conservative think tanks feared more than life itself. Why? Because universal coverage inevitably leads to some form of single payer. It has to. And Krauthammer knows it:
A broad national consensus is developing that health care is indeed a right. This is historically new. And it carries immense implications for the future. It suggests that we may be heading inexorably to a government-run, single-payer system. It’s what Barack Obama once admitted he would have preferred but didn’t think the country was ready for. It may be ready now.
And that's the psychological and sociological victory of Obamacare that the left does not truly understand or appreciate. 10 years ago, the overwhelming majority of the country scoffed at the idea of "Medicare for all" because we simply didn't talk about healthcare. But with the insane circus Republicans made out of the passage of Obamacare, most of the country was suddenly forced to take a look at what they were already paying for and what was now obviously wrong with it (the irony of this is as thick as it is delicious).
But that was always the point of the law. Yes, the ostensible goal was to get as many people as insured as possible but true intent was to make people understand, after decades of being told otherwise, that healthcare is a fundamental human right. And it worked. That's why Republicans couldn't just repeal the law and call it a day; we as a people now rail against the idea of having our healthcare stripped from us whereas before we meekly accepted it as "the way things were." "Pre-existing conditions" is an unacceptable reason to be denied insurance. Rescission is a moral and legal abomination. Keeping children on their parent's insurance until they're 26 and afford their own is just common sense.
None of that was true in 2008.
This is not the first time a law has shifted the way we think as a country. Social Security and Medicare shifted our perspective from "Wow, it's hard to be old" to "Senior citizens should have security and safety in their twilight years." Republicans fought against both. Civil rights legislation shifted our thinking from "America is for whites only" to "America is for everyone." Southern conservatives from both parties fought against it. Laws protecting the LGBT community from discrimination are already shifting the public's perception of them. In a generation, the idea that two women can marry will be no more shocking than a black woman marrying a white man is today. Republicans are desperately looking for ways to overturn marriage equality without much luck so far.
Obamacare was always the kind of change that would pave the way for something better down the road and now that Republicans have made sabotaging it their main focus, it may happen even sooner than we'd hoped:
As Obamacare continues to unravel, it won’t take much for Democrats to abandon that Rube Goldberg wreckage and go for the simplicity and the universality of Medicare-for-all. Republicans will have one last chance to try to persuade the country to remain with a market-based system, preferably one encompassing all the provisions that, for procedural reasons, had been left out of their latest proposal.
Don’t be surprised, however, if, in the end, single-payer wins out. Indeed, I wouldn’t be terribly surprised if Donald Trump, reading the zeitgeist, pulls the greatest 180 since Disraeli “dished the Whigs” in 1867 (by radically expanding the franchise) and joins the single-payer side.
Krauthammer considers this to be a disaster in the making (he calls it "an American Krakatoa") and it will be: For the greedy insurance companies that have been bleeding us dry for decades. Please take a moment for a single tear to be shed. After that, we can get back to spending billions of our money on ourselves instead of lining the pockets of worthless CEOs.
But aside from enjoying Krauthammer's misery, it's incredibly frustrating that far too many on the left don't understand what conservatives already do: Obamacare doesn't have to be perfect in order to move the national conscience in the direction we want. And this wasn't even a tiny incremental step of the kind that is often demonized; we went from most people not even knowing what "single payer" meant to tens of millions of people demanding it in less than a decade. That was not because of the Bernie revolution, it was because the ACA built that foundation for them to stand on.
That's not just a win for progressive values, that's a crushing defeat for the regressive status quo. No wonder Republicans are so angry. Now if we could just get our side to understand their own power in this victory, we might actually be able to accomplish our goal of true universal healthcare.
There are 582 days left to the 2018 elections.
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