A Communitarian’s View

Updated: added Additional Resources at end of post

I’ve been engaged in a running conversation on Facebook with friends who don’t support the Affordable Care Act, aka Obamacare. We also wandered into the cost of other government-provided benefits like SNAP (food stamps) and mobile phones. It’s hard to cover all my points and supporting documentation in a Facebook conversation, so I’m expanding it to this space. 

First, in defining myself as a communitarian, I’m trying to establish a foothold outside the usual liberal/conservative terminology. While my political views are decidedly liberal, I’m comfortable with certain conservative viewpoints as well. Ultimately, what I believe in is a system where we, as humans, share a responsibility for each other. I also believe that both government and individuals have important roles to play in meeting that responsibility. 

So let’s get started. 

My ingoing position on Obamacare is this: I strongly supported a “Medicare for all” solution. As a pragmatist, though, I knew this would never fly. What we’ve ended up with is something that dissatisfies everyone, for different reasons. But a few important points: 

• Only in the U.S. would people label a program that relies on private-sector companies to insure its citizens as a “government takeover.” Let’s make sure we don’t miss this point: those who avail themselves of a policy on their state’s exchange will not be paying premiums to the government but to a private insurance company. They may, however, qualify for subsidies provided by the government, depending on their incomes – akin to the earned income tax credit (something enacted and expanded under Republican administrations, and historically considered an acceptable way to conservatives of providing aid).
   
• There’s a reason the ACA was set up the way it was: its key provisions were developed and vetted by Republicans and conservative think tanks like the Heritage Foundation. Don’t believe me? Check out this side-by-side comparison of Obamacare and RomneyCare. 

• What about the affordability of the ACA? My conservative friends believe it will bankrupt us, and cite statistics about the number of employers who are moving full-time employees to part-time in an effort to avoid paying for their benefits. Except…that doesn’t appear to be true, at least not yet. 
  
  Nor will the plans necessarily be as unaffordable as some would have us believe. For the cheapest plan on the Nevada exchange for a healthy 20-year old male, the cost is about $160 – before any subsidies based on their income.  (See Additional Resources at the end of this post for more information on affordability.)
   
• Moving on to tort reform, according to Howard Dean (whom I saw speak the other night), it’s largely driven by the state you live in. According to Dean, in his home state of Vermont, any savings from tort reform would be negligible; Vermont juries don’t tend to give large awards. In other states, it might be more. In any case, tort reform is not a good place to look for national savings because it’s state-driven. And states don’t need to look to the federal government to enact their own tort reform.

 To summarize my feelings on Obamacare: I don’t believe the program is perfect and in fact, think there will be a number of issues as it goes into effect. That doesn’t mean I think we should scrap it. Instead, I’d like to see members of both parties weed out what doesn’t work and continue to look for ways to strengthen and improve it so that it’s both cost-efficient and effective.

 And yes – I’m willing to invest my tax dollars in a program that will cover the majority of our citizens so they don’t have to face the prospect of choosing to treat a health condition over eating: it’s as simple as that.

Moving on to anti-poverty programs.

I plan for this to be the last time I discuss “Obamaphones” – a misnomer if there ever was one. So I will simply point you to the history behind this program (called Lifeline). While it’s true that a 2012 survey found evidence of fraud, the FCC took steps to correct that. As a result: 

“The FCC also slashed 75 percent of available subsidies for the program, which eliminated a “perverse” incentive for some phone companies to enroll ineligible persons. The FCC projects its modifications will save up to $2 billion over three years.” 

But it’s incorrect to say our taxes fund these phones; they’re funded by telecom customers who pay a universal service fee as part of their phone bills (my monthly share is $1.81). Or some telecom customers pay this fee; it’s not government mandated but at the phone company’s discretion. The FCC describes this charge as follows:

Because telephones provide a vital link to emergency services, to government services and to surrounding communities, it has been our nation’s policy to promote telephone service to all households since this service began in the 1930s. The USF helps to make phone service affordable and available to all Americans, including consumers with low incomes, those living in areas where the costs of providing telephone service is high, schools and libraries and rural health care providers. Congress has mandated that all telephone companies providing interstate service must contribute to the USF. Although not required to do so by the government, many carriers choose to pass their contribution costs on to their customers in the form of a line item, often called the “Federal Universal Service Fee” or “Universal Connectivity Fee.”

Last, anti-poverty programs. I will admit that here, I struggle sometimes to understand the insensitivity and anger I see directed towards the less fortunate among us.

Who are we talking about when we talk about food stamp recipients? Well, according to the USDA, it’s about 15 percent of the population, or one in seven Americans. Of those, 47% are children under 18, and 8% are seniors. You can read more here.

Who are these hungry families and how do they get by? They’re not all those for whom “food stamps have become a way of life.” Many are proud and self-reliant people who for one reason or another (including the continuing fall-out from a devastating recession) have fallen on hard times.

And why is all the outrage I see coming from the conservative media machine directed at this population? Where’s the outrage at the agribusiness subsidies, whose funding the House voted to continue? How about the fact that the USDA overpaid farmers over $20 billion last year?

Why does Representative Stephen Fincher, who represents the people living in Dyersburg, Tennessee, believe that, with regard to food stamps, “The role of citizens, of Christianity, of humanity, is to take care of each other, not for Washington to steal from those in the country and give to others in the country,” -- but not that the farm subsidies of $3.5 million he received from the government from 1999 to 2012 are wrong as well?

And even if you believe that many adults on this assistance don’t deserve it, what about their children? Have we really become a country that would deny basic food security to our young?

The last and most poignant link I’ll end with is a devastating documentary from the BBC on child poverty in America. I encourage everyone to carve out an hour to watch the entire show.

Additional Resources

• Left Behind: Stories from Obamacare's 31 million uninsured
   
• Why the Health Care Law Scares the GOP
• Yes, we know premium prices under Obamacare. No, we don't know if people will think they're affordable
  
  
• Household Food Security in the United States in 2012

• Feeding America

• An Early Look at Premiums and Insurer Participation in Health Insurance Marketplaces, 2014 (Kaiser Family Foundation)