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Obamacare: The Republican Party's Long Con

by Michael I. Niman, ArtVoice 11/14/13, Truthout 11/18/14

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Never underestimate the resilience of the Republican Party. After the fall of Tricky Dick Nixon, pundits wrote its eulogy, warning that the US was in danger of becoming a one-party state. Four years later, Republicans were back at the helm, taking the White House for another 12 years, only to surrender it to Bill Clinton, who succeeded in moving the Republican agenda forward better than any traditionally branded Republican.

Now once again, after the Republicans gave us two of the lamest House sessions in history, humiliating us internationally with crazed apocalyptic rhetoric while giving us the government shutdown and little else, the pundits are back at it, foretelling the 2014 collapse of the Republican brand.

What they don’t understand and haven’t factored in is the combined power of a short national attention span and a long con.


The long con is the Affordable Care Act, what both parties now term Obamacare, with the Democrats wagering on its eventual popularity and the Republicans on its failure. The global move toward universal healthcare came after World War Two, with almost every industrialized nation, and many developing nations, guaranteeing a base level of healthcare to all of their citizens by the end of the 20th century. As momentum for a European- and Canadian-style single-payer healthcare system grew in the US, Republicans turned toward their think tanks to come up with a plan to thwart healthcare reform.

Being nothing more than a mob of wholly owned flunkies for corporate greed and oligarchic wealth, Republican lawmakers prioritized their agenda. Since capturing the White House in 1980, they’ve been working to give the largest public sectors of the economy—education, prisons, and the military—over to corporate pillage, what they term “privatization,” opening new terrain to a corporate profit skim where no such skim previously existed.

The healthcare sector, however, which competes with the military for the largest slices of the budget pie, was already safely in corporate hands. With healthcare profits trickling into their campaign coffers, as well as those of compliant Democrats, maintaining this private, for-profit healthcare system has always been a top priority for the party. Any ersatz healthcare reform had to maintain this corporate domination.

Toward that end, the ultra-corporatist Heritage Foundation came up with the blueprint for a Republican plan for universal healthcare. They strategically tossed it at one of the bluest and most likely states to pioneer healthcare reform, but one that also had a Republican head of state: Massachusetts. Thus was born Romneycare, the blueprint for what later became Obamacare. The Heritage plan allowed the universal healthcare juggernaut to move forward like a speeding locomotive, cleverly switching it to a siding that enshrined the entire corporate healthcare structure in perpetuity moving forward.

When Barack Obama was elected president with a promise to bring the US into the fold of civilized nations with the establishment of universal healthcare, Republicans geared up for a fight. Their “compromise” involved Obama adopting their plan—the Massachusetts model. As quickly as the president moved toward the Republican plan, the Republicans backed away from it, leaving Obama “owning” a structurally doomed system that has to both hold costs down while enshrining gigantic corporate profits and executive salaries. And it’s not just corporate profits that are driving up the cost of American healthcare.

The high costs of a sick population

Healthcare costs are also being driven up by the combined factors of an ever sicker population and healthcare advances that keep this sicker population alive and receiving treatment for longer periods of time.

While keeping people alive is good, making them sick isn’t. Yet the biggest disease vector is our consumer culture, which aggressively markets a toxic diet of industrial junk food, much of it subsidized by our endemically corrupt government, to an ever sickening population. The results of a diet burdened by high fructose corn syrup, greasy sodium-laced fats, and feedlot-fattened meats is our historically unprecedented obesity epidemic, which in turn fuels a plethora of health problems ranging from cancer and heart disease to nervous system disorders. Add to that a mélange of chemical additives and pesticides in our food, and persistent environmental toxins, all of which contribute to cancer and a host of other ailments, and we get a glimpse of the big picture behind spiraling healthcare needs and costs.

A comprehensive national healthcare system would work more holistically and efficiently, funding not just the treatment of sickness but the prevention of sickness and the promotion of health. Hence, a first step, for example, would be to stop subsidizing corn production and the infusion of high fructose corn syrup into our diet. This is off the table, however, because corporate agriculture, like the healthcare sector, is a major Republican sponsor.

The current system is working just fine, according to most Republicans, with corporations skimming profits both by poisoning people and by treating them. This is also good for the GDP, representing growing levels of economic activity as the population sickens.

A comprehensive healthcare system would also fund itself by capturing some of the societal costs that the sickening industries foist onto the public. Under the current system, producing unhealthy food is profitable since producers don’t have to include the costs of treating their victims on their balance sheets. The same holds true for corporations that poison our air and water. A national healthcare system, backed by a Congress that isn’t corrupt, would develop mechanisms to move the costs of treating sick people back onto the balance sheets of the corporations that sicken them.

This is not radical socialism. It’s a conservative principle of making people and businesses individually responsible for their actions, instead of socializing the costs of treating the problems they create. The fix here would be in the form of a tax on unhealthy foods, and maybe a subsidy for healthy foods, which is already a popular idea around the world. With junk food becoming more expensive, and healthy food becoming cheaper, the latter effect finally putting an end to the nutritional war against the poor, we’d see a healthier nation and hence lower overall healthcare expenditures.

Again, however, this holistic approach to national healthcare is off the table as it threatens the junk food industry’s ability to profit at the expense of the nation’s health. The junk food industry is just one more dirty business that has invested in mob protection in the form of a bought-and-paid-for Congress.

With Obamacare, it’s business as usual. In fact, this was one of the president’s promises, that we wouldn’t see any essential changes in the way our healthcare system operates. Locked into this status quo health plan is a continuing spiral of high costs, as we move forward giving corporations a near monopoly to treat an ever-sickening population. The sicker we get, the more money is spent treating us, the more dollars pass through the health insurance and treatment industries, the larger their skim.

The long con

The key to Obamacare’s survival, and the health insurance industry’s continuing support of the plan, is the universal mandate, where everyone has to carry insurance, subsidized by the government if you are poor, or by individuals if the government determines you can afford it. This will be a boon for the health insurance industry, as universal auto insurance mandates have been for auto insurers. This is also where the Republican long con comes into play.

The fly in the ointment is that young people never were big on buying health insurance. Odds are, they won’t get sick. And if they do, they’re often judgment proof, often near destitute as they start out in life, or financially upside-down, mired in student loan and credit card debt. So why pay for health insurance when you’re essentially already bankrupt? Factor in the bravado of youth: Young people feel invulnerable, and often they pretty much are, so why think about disease or accidents?

The Heritage, Romneycare, Obamacare calculus mandates that insurance premiums paid by healthy young people, who won’t need much care, will offset the expenses of caring for older sicker segments of the population. If this doesn’t happen, the system won’t pay for itself.

Insurance has always been about spreading risk over large populations. This concept is not new. But it is new to the health insurance industry, where insurance companies refused to sell policies to sick people and high-risk populations, leaving them to go without care, or to get rudimentary care and go bankrupt. Applying a more democratic risk-sharing protocol to health insurance isn’t so much about spreading a somewhat random risk, as in auto or home insurance, but in accepting a clear probability. And for young people, the probability is that they will shoulder the cost of caring for the sick and elderly. This is the concept behind most social programs, but nowhere is it made so clear as with a government mandate that you must buy a private insurance policy.

This is also where Republicans will apply their mischief as the next election cycle heats up. The old men who run the Republican Party will incite generational warfare against their own generation in an attempt to pry young voters away from the Democratic Party. And it just might work.

Saddled with college debt caused by Republican-sponsored cuts to higher education, or locked out of good blue collar manufacturing jobs as a result of Republican-backed free trade policies, young voters are feeling too much of a financial pinch to accept shouldering the costs of caring for a generation that, unlike them, enjoyed government-funded education and a better job market. Right now many young people, some encouraged by Republican-sponsored advertising campaigns promoting an Obamacare boycott among the young, aren’t signing up for health insurance. Just about election time next year, the government will be coming after them, enforcing the mandate to fork their meager savings over to the for-profit health insurance industry. This will also be the same time the old Republican men who engineered this crisis will position themselves as saviors of youth, protecting them from the overreach of what everyone has branded, Obamacare.

With the information dominance their propaganda system enjoys, this will be the meme at election time, with 2013’s Republican antics lost and forgotten down the memory hole.

Dr. Michael I. Niman is a professor of journalism and media studies at SUNY Buffalo State. His previous columns are at, archived at, and available globally through syndication.


ęCopyright 2013

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