Hillary, the ACA and the Art of the Possible

Cursor_and_hillary_clinton_-_Google_SearchThough I’m a solid Hillary Clinton supporter, I don’t particularly relish defending her at water coolers, dinner tables and social media venues.  When defending Hillary Clinton to those who hoped for more, I often feel like I do when defending the Affordable Care Act (ACA) to those who hoped for more.

To be clear, neither Hillary nor the ACA were my first choice. Elizabeth Warren and single payer were my first choices.

Neither Hillary nor the ACA are as bold as I’d prefer. They both promise modest incremental change, rather than the more revolutionary change that is needed.

Neither Hillary nor the ACA are, shall we say, untouched by special interests. The ACA is the product of accommodations made to private health insurers, physicians and the pharmaceutical industry, while Clinton is the product of accommodations made to corporations, unions and military leaders.

Also, neither Hillary nor the ACA are easy to understand. Hillary is a wonk’s wonk whose eye-glazing 20-point policy plans don’t exactly sing to lightly engaged voters.   Likewise, the ACA has given birth to 20,000 pages of the densest regulations you’ll ever find. (By the way, a primary reason the ACA is so complex is that conservatives and moderates insisted that it accommodate dozens of for-profit insurance companies instead of  using the more linear single payer model that has been proven effective and efficient by other industrialized nations. In this way, the need for much of the ACA complexity was created by conservatives, not liberals.)

At the same time, neither Hillary nor the ACA are anywhere near as bad as the caricatures created by their demagogic critics. Hillary is not a serial liar and murderer any more than the ACA led to “Death Panels” and force-fed birth control.

The bottom line is that both Hillary and the ACA, for all their respective flaws, are far superior to the alternatives. The steady, smart, savvy, and decent Clinton is much better than the erratic, ignorant, inept and vile Trump. The current ACA era, with a 9.2% uninsured rate (4.3% in Minnesota, where the ACA is more faithfully implemented than it is in many states) and all preexisting conditions covered is much better than the pre-ACA status quo, with an uninsured rate of 15.7% (9% in Minnesota) and millions denied health coverage because of pre-existing medical conditions.

Hillary and the ACA both bring progress, but they are hardly the final word.  The fact that I am supporting the ACA in 2016 doesn’t mean I’m going to stop advocating for ACA improvements, a Medicare-for-All option and ultimately a single payer system. The fact that I am supporting Hillary in 2016 doesn’t mean I’m not going to push for more progressive, bold, compelling and independent leaders in the future.

But politics is the art of the possible.  Hillary and the ACA are what is possible at this point in the history of our imperfect democracy.   As such, I can champion both comfortably, if not entirely enthusiastically.

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