A little perspective on the private option

Posted on February 21, 2014. Filed under: Arkansas Democrat-Gazette Columns | Tags: , , , |

It’s always an impossible task, but I’m going to make an effort to restore a little civility to politics, in this instance as it regards the private-option debate.

By my press time, the Arkansas House had already voted twice against renewing the state program, which was enacted with bipartisan support under the auspices of the Medicaid expansion in Obamacare and fully funded for the first three years by the federal government.

When it was proposed over a year ago, I thought it was a good idea, as did many people of both political parties and myriad philosophical persuasions.

“But it’s Obamacare!” some conservative friends hissed, until I explained to them that no, it isn’t, not really.

State options to expand Medicaid are indeed part of the Patient Protection and Affordable Care Act, but it’s easy to support the private option without wholeheartedly endorsing Obamacare.

As the arguments have heightened leading up to this year’s legislative session, so has the hype and misinformation by both political parties.

On an issue like this, pundits and politicians alike—on both sides—seem hell-bent to not only epitomize ignorance, but also wave it like a banner.

Private-option opponents are painted as heartless hard-liners who couldn’t care less about the plight of the poor. Supporters are cast as hapless lackeys totally unconcerned about the decline of America’s fortunes and national character.

Fortunately, neither stereotype holds true.

What’s been lost in translation during this shouting match is perspective.

The private option is not a referendum on Obamacare.

Nobody in America believes that Arkansas is a pro-Barack Obama state. The president lost 36 counties here in the Democratic primary (who even remembers the winner?), and didn’t get our electoral votes.

Whether or not our Arkansas legislators continue the private option, with barely 1 percent of the national population and an even tinier fraction of its wealth, Arkansas is not likely to strike any symbolic blow for or against Obamacare.

What the private option is, and has been, is a benefit for low-income working Arkansans.

A lot of people think the national debt is too high, and it is. But as Gov. Mike Beebe pointed out in 2012, Arkansas refusing our share of any federal funding doesn’t shrink the deficit—some other state just gets our share.

A lot of people think the healthcare system in general needs fixing, and it does. But ending the private option remedies nothing.

A federal dollar is a federal dollar, and yet if it’s an Obamacare dollar it’s suddenly more holy or more revolting, depending on how you voted.

That’s not the case with federal funds to train workers, for example, or to feed hungry children. As one of the poorest states, we normally welcome a little help.

The main perspective that’s gone missing with the private option is that it has genuinely helped a lot of hardworking people.

When political passions run high, memories sometimes run dry. It’s easy to forget that Arkansas is a Bottom-10 state in many healthy measures, and a Top-10 state in many unhealthy ones.

Many diseases are equal-opportunity attackers, and it’s easy to forget that for every Lou Gehrig—who braved illness as a national hero—there are thousands of men and women here in Arkansas who display the same courage to their families, their neighbors and their communities.

Who are the nearly 100,000 Arkansans who signed up for the private option? Most of the loudest mouthpieces on either side don’t know them and don’t care, because they’re only arguing about Obamacare, not Jane Doe’s particular situation.

Applicants for the private option have jobs, families, kids, and often health problems.

It’s easy to forget that, without the private option, the uninsured still receive medical treatment—usually at a hospital emergency room. Where the cost is higher, and we all pay it through higher insurance premiums.

If the shrill accusers on both sides would actually talk to some people involved with enrolling private-option applicants, it would help restore the discussion to reasonable levels.

Blindly raging opponents need to see the young working couple with kids bring in their tax returns to find out if they qualify, and hear the husband talk selflessly about the main coverage he wants as being for his wife’s diabetes and his kids.

Blindly raging supporters need to see an extended family trying to manipulate the system, and hear the discussion meander around to whether another baby to the unwed mother would result in “another check.”

Both sides, in essence, need to see first-hand proof to dispel their haughty stereotyping.

All politics is local, the old adage goes, and so is all health care. Arguing over generalizations about Obamacare as national policy is fine, even welcome.

But let’s not confuse the issues to the point that we start to believe the ugly things we’re saying about each other. Or that we forget in our argumentative ardor that generalizations don’t apply at the individual level.

Let’s not wage a false battle over Obamacare on the backs of, or at the sacrifice of, the many hardworking but struggling people the private option has helped-and will help.

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