When Obamacare was enacted, I saw a large decrease in my insurance premium and out-of-pocket expenses for doctor's visits and medications. My income was low enough for me to receive large subsidies, which, combined with mandates for certain services to be covered, meant very low copays and no charge for prescriptions. As someone who requires regular doctor visits and medication, I found Obamacare to be a major relief. Without the law, I would be unable afford the $275 per month that this generic medication costs.
Like many others, I saw my premium increase dramatically in the second year of my enrollment, but, now in my third year of exchange coverage, my premium is still only about the same as it was before Obamacare, when I also had to pay a large fee to see my doctor and was charged $600 for one month's supply of medication.
Nonetheless, I am mindful that many have found Obamacare to be a major burden. Contrary to President Obama's promises, they had to change their doctor and insurance plan, and their premiums increased tremendously. They resented having to pay for services, such as birth control, that they did not personally need. Many people found their incomes too high for them to qualify for substantial, or any, subsidies.
People in the latter situation have good reason to be angry. They are completely justified in demanding change. It does sadden and anger me, however, that this is what it took for people to become intensely dissatisfied with the American health care system. As long as they were paying affordable premiums and receiving health care that satisfied their needs, most were content to maintain a health care system that made insurance and adequate care unavailable to millions of people.
Indeed, the pre-Obamacare system was worse in many ways than the current system is even for those who are rightly upset. The old system allowed people to be denied insurance because of pre-existing conditions. People who could neither afford insurance nor qualify for assistance went without insurance and without the health care they needed. Many young adults aged out of their parents' insurance plans and could not afford their own.
Many people, including those critical of Obamacare, did appreciate the law's fixes for those problems. Still, when, prior to the law, they personally did not suffer from the system's deficiencies, they had no motivation to push for changes. But, now that they are affected by adverse changes in the system, they expect legislators to act. Indeed, some are willing to see the law abolished even with no immediate replacement.
The reasonable dissatisfaction of uncovered people prior to Obamacare, and covered-but-gouged people now, points to the need for a system that covers everyone on equitable terms. Indeed, people's self-interested motivations for their views on health care might ultimately prove beneficial. The law's adverse consequences might persuade them to support either a radically different system or, at least, a reformed one that treats everyone fairly rather than providing health care to some by placing undue burdens on others.
When, newly enrolled in Obamacare, I saw a charge of $0.00 for my next prescription, I felt guilty at first, knowing that other people were paying substantially more to make this relief possible for people like me. Then I remembered all the money I had paid toward Social Security and Medicare over the years. I remembered the federal and state income taxes withheld from my meager paychecks. I still felt happy to have helped pay for the care of elderly, poor, and disabled people even during the years when I had to forgo health care myself, earning too much to qualify for federal assistance but too little to pay for all the care I needed. But I also decided not to feel guilty for finally being included in the system into which I was paying, even if I was paying less than people who made (but had to pay) more. I did not feel bad for accepting help to get the care I needed in order to be a productive member of society.
I still would like to see one health care system that covers everyone equally: a single-payer system that funds all medically necessary care through federal taxes. I'm not certain that such a system is politically viable or economically feasible, but if it could somehow overcome these hurdles, it would seem to be the most equitable system and, even if it required higher taxes, would relieve middle-income people of the burden of escalating premiums. Unlike in the truly socialized British system, people would retain their ability to choose their doctor; unlike in the private but restrictive Canadian system, people would retain their ability to elect to pay for care privately, the same way people can elect to send their children to private schools but can also choose to send their children to public schools tuition-free. Presumably, these differences would partially alleviate the problem of appallingly long waiting times that plague those other systems.
Against my nature, I am choosing to be optimistic that middle-class anger about health care will lead to universally positive changes in the system; that a now-Republican-led government will support health care for all with the same commitment they have had for repealing the first serious attempt at providing it. Republicans have long said that they have a better way to achieve those parts of Obamacare that people like but eliminate the parts that people do not like. So far they have shown no more competence in achieving the desired results than the Democrats did. America's first experiment with (near-)universal health care has had mixed results. Going forward on this issue, let's be sure to preserve the welcome ones.