It’s no secret that Bentley dislikes the legislation, formally known as the Patient Protection and Affordable Care Act. He voiced his opposition while running for governor in 2010. He applauded Alabama joining a lawsuit intended to derail the law in the courts. He has regularly decried it as “the single worst piece of legislation to come out of Congress.”
Yet, Bentley’s declaration Friday at the annual meeting of the Public Affairs Research Council of Alabama was stunning in its brazen disregard for all that has transpired in the past three years. Obamacare, in the governor’s estimation, will “destroy” the practice of medicine. Because he is a physician, Dr. Bentley said, his opposition is “personal.”
Bentley is not alone. Plenty of Americans view Obamacare as a sort of creeping socialism, complete with death panels and gross inefficiencies that will lead the nation to ruin. Much the same was said of Medicare 50 years ago, but we’ll get to that in a minute. The vast majority of Obamacare’s sworn enemies are not the governor of a state where an estimated 14.6 percent of its residents lack health insurance.
Also amid this opposition is a camp we might label “resigned to reform.” They — doctors, hospital administrators, politicians, patients — might not like Obamacare, but they have decided to make the best of something that’s not going away.
Two developments over the past eight months have secured Obamacare’s future. The first — on June 28, 2012 — came when the Supreme Court ruled the Patient Protection and Affordable Care Act constitutional by a 5-4 vote. The second arrived in early November when Obama was elected to a second term. Those two events secured the future of Obamacare, a nickname intended as a slur by opponents of the program. Now, though, the chances are very good that “Obamacare” will become a badge of honor for original supporters and a landmark achievement of the nation’s 44th president.
Decry if you like. Slander it if it makes you feel better. But realize that a system positioning the United States closer to the rest of the developed world and those nations’ universal health care is here to stay. Obamacare will surely need minor adjustments along the way, just like any other big legislation that comes out of Washington. However, seeking outright repeal is a dead end.
Well, not according to everybody. Gov. Bentley has refused to set up an insurance exchange, and in the process turned down tens of millions of dollars the federal government would provide to set it up. Last Friday, he repeated his call for solidarity, for Republican governors to resist cooperating with the feds on Obamacare. Of course, that sort of unity in the Supreme Court case yielded nothing but money wasted on legal fees.
History provides a handy lesson. Dr. Atul Gwande, in an April 2010 edition of the New Yorker, wrote, “On July 30, 1965, President Lyndon Johnson signed Medicare into law. In public memory, what ensued was the smooth establishment of a popular program, but in fact Medicare faced a year of nearly crippling rearguard attacks.”
Many doctors were displeased by the law and promised to boycott Medicare. Southern hospitals vowed to disobey the anti-segregation provisions of the 1965 law. To the shame of our state, “Alabama’s Governor George Wallace was among those who encouraged resistance,” Gawande writes.
Such resistance looks both silly and futile at this point, not to mention mean-spirited and intolerant. Almost 1-in-5 Alabamians depend on Medicare, according to the Kaiser Family Foundation. No politician, not even George Wallace, would dare attempt to repeal Medicare today.
Gov. Bentley stands at a critical point. He can continue in his role as Robert the Nullifier, fighting to the bitter end against Obamacare. Or, he can find ways to work with Obamacare to provide health insurance for the estimated 700,000 Alabama residents without it.